The approach taken by the physicians working at educational hospitals in Izmir towards patient rights.

OBJECTIVE: Considered as a reflection of human rights in our modern day, patient rights have been gaining increasing importance. This particular subject has been discussed from various perspectives in different countries and legal sanctions imposed. "Patient Rights Directives" in Turkey came into effect in 1988. The present study was carried out in order to determine how well the physicians working in Izmir, the third largest city of Turkey, are aware and informed of these directives. METHODS: Our study is an observational-cross sectional descriptive one. The research was conducted among the physicians working in nine training hospitals in Izmir province using a random sampling method. 1,500 questionnaires with 19 multiple-choice questions were distributed in the study. 567 of the forms were returned. Statistical assessment of the data obtained was carried out using the x(2) test on SPSS 10.0 Windows Program. RESULTS: Of the physicians participating in the study, 43% were female and 57% male. The average age was 32 +/- 7.76 years. 40% of the participating physicians were not aware of the legal arrangements (directive). 63% of the participants stated that they had not read any kind of legislation related to patients' rights. Only 34% of the participants knew that the legal sanctions were put into effect in the form of "directive." CONCLUSION: Legal arrangements related to patient rights in the world are being put into effect within the framework of human rights. Turkey is one of the first countries to have completed the legal procedures in this field. PRACTICE IMPLICATIONS: We believe it is necessary that this particular issue be included both in the training programs of the medical faculties and supported by all parts of the society including physicians if these legal procedures are to work effectively.

Malpractice and system of expertise in anaesthetic procedures in Turkey.

Deaths which occur during the administration of anaesthetics require medicolegal investigations. The objective of this study is to form a database for future comparisons related to anaesthetic-associated malpractice claims and also to investigate the system of expertise, pertaining to such procedures. The decisions of the Supreme Health Council, whose expert opinion is requested by legal authorities (judges, prosecutors) for health workers brought to trial in a criminal court, were examined retrospectively over the period 1995-1999. In 21 (2.3%) of the 888 decision reports prepared by the council the team members (the anaesthesiologist , the anaesthetic assistant, the anaesthetic technician, the nurse) were directly interrogated. Data concerning these 21 council decisions were evaluated within the scope of this study. It was found that 57% of the 21 decisions were related to medical procedures carried out in state hospitals. Of the 21 cases, 62% were males, 38% females. General anaesthesia was applied to 19 of the cases while one received regional (local) anaesthesia and one axillary blockade. Twenty died of complications associated with anaesthesia. Autopsy was performed on 11 (55%) of the dead. Health workers were found to have different degrees of liability in the 16 (76%) of the 21 decision reports. In their medical practices, anaesthesiologists , like other specialists, are subject to legal procedures in the country where they perform their duties, to national and international principles of ethics, and to diagnostic and curative standards/procedures relevant to the scientific level of the country concerned. In anaesthetic malpractice claims, certain standards need to be followed in inquiries and approaches so as to determine the real reasons behind the disabilities and/or deaths which occur. In order that sound evaluations could be made in such cases, the experts as well as the system of expertise should be efficient and authorized.