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Yıl:2011; Cilt: 1; Sayı: 1>> Özet
Psikiyatride Güncel; 2011;1(1):13-19
Ceza Yasasının 280. Maddesi: Etik Çelişkiler, Diğer Ülkelerde Durum ve Ülkemizdeki Uygulamalar
H Soysal, RU Soysal
Hekim ve diğer sağlık çalışanlarının, mesleklerini yaparken bir suç belirtisine rastladıklarında yetkili makamlara bildirmemeleri halinde ceza
almalarına ilişkin maddenin, aradan geçen beş yıl içinde çok yaygın davaların açılmasına neden olmadığı, ancak tıp etiği ve demokratik ülkelerdeki
ilke ve kurallarla çelişkili bir düzenleme olduğu anlaşılmaktadır. Suçların aydınlatılmasındaki kamu yararı tartışılmaz. Ancak suçun
aydınlatılmasına ilişkin kamu yararı, kovuşturulma korkusu ile hekime başvurmayan kişilerin yaşama hakkından daha ağırlıklı değildir.
TCK'nın 280. maddesi, ayrıca ihbar yükümlülüğünün ?hangi anda? yerine getirileceği konusunda bir açıklık içermemektedir. Evrensel etik
ilkeler; cinayet, ensest, tecavüz ve çocuk istismarının bildirilmesi yönündedir. Etik olarak bildirilmesi benimsenmeyen suç belirtilerinde kayıtların
sonradan hekimin suçlanmayacağı şekilde genel ifadeler içerecek şekilde tutulması önerilmektedir. Ancak etik ilkeler gereği hekimin
bildirimde bulunmadığı durumlarda, etik kodlara uygun davranmış olması adli süreçlerde hekimi korumaya yetmeyebilir. Yasal düzenlemenin
ardından geçen beş yılda yapılan değerlendirme ve tartışmalarda, maddenin kapsamının çok geniş, sınırlarının belirsiz olduğu ortak görüşü
oluşmuştur. Buna karşın kaygı duyulduğu kadar fazla dava açılmaması, savcıların öncelikle doğal nedenlerle olmadığı şüphesi uyanan
ölümlerde polis veya savcılığa bildirilmeden defin ruhsatı düzenlenmesi ile küçüklerin hamileliği durumundaki doğum ve diğer tıbbi müdahalelere
önem verdiklerini göstermektedir. Etik ilkelerle çelişen, gizlilik ilkesini yok sayan unsurları giderecek yasal bir düzenleme yapılmasına
gereksinim olduğu, bu yapılıncaya kadar hekim ve diğer sağlık çalışanlarının daha sonra adli kurumlara yansıma olasılığı yüksek olan durumlarda
polise veya savcılığa bildirim konusunda özenli davranmaları önerilir.
280th Clause of Turkish Penal Code: Ethical Conflicts, Practices in Turkey and in Other Countries
Although the The Penal Code that compels physicians and other healthcare professionals to report any findings suggestive of crime that they
detect while executing their profession, and punishing those that do not report have not resulted in a very large number of law suits, it still seems
like a regulation incompatible with medical ethics, and the principles and regulations of democratic countries. The public benefit that is gained
by bringing a crime to light is beyond argument. On the other hand, the public benefit gained by bringing a crime to light is not more important
than the right to live of a person that cannot see the doctor for a fear of prosecution. Then 280. clause of Turkish Penal Code (TCK) is not clear
about the ?time point? at which there the responsibility of reporting is mandatory. The universal ethical principles are in favor for reporting
homicide, incest and rape and also child abuse. Findings suggestive of crimes which are ethically not considered mandatory to report
should advisedly be recorded in as generalized sentences as possible, which do not permit prosecution of the physician. But, in cases where
the physician does not report his findings to the authorities with ethical concerns, the ethical codes may not prevent the physician in
legal proceedings. In the assessments and discussions that were done in the 5 [year]s after this legal regulation came into effect, a consensus
was reached that the extent of the act is too large and its limits too obscure. On the other hand, the absence of the anticipated large number
of law suits suggests that in fact prosecuting attorneys pay special attention to death certificates given outside the information of the police
or prosecuting attorneys, to deaths in which there is a suspicion of not being due to natural causes, and to births given by minors and other
suspicious medical interventions. It is believed that a legal adjustment in regulations is needed to get rid of elements conflicting with ethical
principles, and ignore the principle of confidentiality, and advised that physicians and other healthcare professionals to act with caution in
reporting to the police and prosecution in situations where there is a high probability of transference to judicial institutions in the future.

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