Clinical ethics, personal values, legal uncertainties, and possible conflicts in cases of brain death in Türkiye: an applied study

Temel M. K.

Turkiye Klinikleri Journal of Medical Ethics, Law and History , vol.31, no.1, pp.70-76, 2023 (Peer-Reviewed Journal)


ABSTRACT: Both clinically and legally, brain death has long been recognized as death. However, many people including patient relatives still equate death with cardiopulmonary death (irreversible cessation of heartbeat and breathing), and thus may oppose withdrawal of life-support technologies and refuse to consider organ donation in brain death. Such reactions may lead to problematic or dilemmatic situations in relation to the norms and practices of justice, beneficence, paternalism, futile care, defensive medicine, due care, consideration of personal beliefs and values and financial and emotional burdens, etc. Although the determination of brain death and procedures of organ donation have been legally regulated in Türkiye since the late twentieth century, there have also been legal uncertainties about the decision to terminate care, particularly the extent to which the decision depends on the agreement of patient relatives. With consideration of historical developments, legal documents, ethical issues, and personal attitudes, the present study aimed to analyze the nature of such conflicts between patient relatives (agents that act with subjective priorities) and health-care providers (agents that should act within certain standards) as the two parties in a typical case of brain death. For particular emphasis on the pivotal role of information and communication in the resolution of potential conflicts in real cases of brain death, the discussion was made with application in a hypothetical case.