Good laboratory practice for PGT-M: Turkish Society of Reproductive Medicine guidelines.

This guideline was prepared by the Turkish Society of Reproductive Medicine to define the conditions and requirements for an outsourced preimplantation genetic testing (PGT) programme in line with the experience and needs of practitioners. This guideline is intended to be a reference document for assisted reproductive technology centres, genetic diagnosis centres, non-governmental organizations working on reproductive health, legal experts, consultants working on laboratory accreditation, academicians specializing in ethical issues, and policy makers. The Consortium aims to provide recommendations addressing the challenges of genetic testing, especially PGT for monogenic diseases (PGT-M) due to the high rate of consanguineous marriage in Turkey. For this purpose, this summary document specifically includes challenges and recommendations regarding PGT-M practice, and aims to identify and aid in prevention of errors leading to misdiagnosis. The recommendations can be modified to fit other locations.

The Ethics of Teaching Physicians Electronic Fetal Monitoring: And Now for the Rest of the Story.

Electronic fetal monitoring (EFM) does not predict or prevent cerebral palsy (CP), but this myth remains entrenched in medical training and practice. The continued use of this ineffectual diagnostic modality increases the cesarean section rate with concomitant harms to mothers and babies alike. EFM, as it is used in defensive medical practice, is a violation of patient autonomy and raises serious ethical concerns. This review addresses the need for improved graduate medical education so that physicians and medical residents are taught both sides of the EFM-CP story.

Enhancing John Rawls’s theory of justice to cover health and social determinants of health / Mejora de la teoría de justicia de John Rawls para abordar temas de salud y los determinantes sociales de la salud / Enfatizando a teoria da justiça de John Rawls para envolver a saúde e as determinantes sociais da saúde

The vast improvements in medical technology reviled the crucial role of social determinants of health for the etiology, prevalence and prognosis of diseases. This changed the content of the right to health concept from a demand of health services, to a claim of having access to all social determinants of health. Thus, the just allocation of scarce resources of health and social determinants of health became an issue of ethical theories. John Rawls developed a theory of justice. His theory suggests that the principles of justice should be determined by individuals in a hypothetic initial position. In the initial position, individuals agree on principles of justice. Rawls puts forth that the institutions of the society should be structured in compliance with these principles to reach a fair social system. Although Rawls did not justify right to health in his theory, the efforts to enlarge the theory to cover right to health flourished quite fast. In this paper first the basic components of Rawls theory is explained. Then the most outstanding approaches to enlarge his theory to cover right to health is introduced and discussed within the discourse of Rawls theory of justice.

Los grandes avances en tecnología médica desafían el papel crucial de los determinantes sociales de la salud en la etiología, prevalencia y prognosis de las enfermedades. Esto cambio el contenido del concepto de derecho a atención de salud desde la demanda de servicios de salud a la demanda por tener acceso a todos los determinantes sociales de la salud. Por lo tanto, la distribución de escasos recursos en salud y los determinantes sociales de la salud llegaron a ser tema de teorías éticas. John Rawls desarrolló una teoría de la justicia. Su teoría sugiere que los principios de justicia deberían ser determinados por los individuos desde una posición inicial hipotética. En la posición inicial, los individuos se ponen de acuerdo en principios de justicia. Rawls establece que las instituciones de la sociedad deberían estructurarse para cumplir con estos principios para poder alcanzar un sistema social justo. Aunque Rawls no justificó el derecho a la atención de salud en su teoría, se introduce y discute dentro del discurso de la teoría de justicia de Rawls, los esfuerzos para ampliar su teoría para cubrir el derecho a la atención de salud.

Os amplos aperfeiçoamentos da tecnologia médica deturparam o papel crucial das determinantes sociais para a etiologia, prevalência e prognóstico das doenças. Isto tem mudado o conteúdo do conceito do direito à saúde originado da demanda de serviços de saúde para a reclamação de acesso a todas determinantes sociais da saúde. Assim, a adequada alocação de escassos recursos para a saúde e as determinantes sociais de saúde tornam-se um tema de teorias éticas. John Rawls desenvolveu uma teoria de justiça. Sua teoria sugere que os princípios de justiça deveriam ser determinados pelos indivíduos numa situação hipoteticamente inicial. Na situação inicial, os individuos concordam sobre os princípios da justiça. Rawls coloca objetivamente que instituições sociais deveriam ser estruturadas em conformidade com estes princípios para alcançar o sistema de justiça social. Embora Rawls não tenha justificado o direito à saúde em sua teoria, os esforços para ampliar a teoria para envolver o direito à saúde floresceu rapidamente. Neste artigo primeiramente os componentes básicos da teoria de Rawls são explanados. Então, as mais importantes abordagens para ampliar esta teoria para alcançar o direito à saúde são introduzidas e discutidas dentro do discurso da teoria de Rawls sobre a justiça.

Perpetuating Myths, Fables, and Fairy Tales: A Half Century of Electronic Fetal Monitoring.

Electronic fetal monitoring (EFM) entered clinical medical practice at the same time bioethics became reality. Bioethics changed the medical ethics landscape by replacing the traditional Hippocratic benign paternalism with patient autonomy, informed consent, beneficence, and nonmaleficence. But EFM use represents the polar opposite of bioethics' revered principles-it has been documented for half a century to be completely ineffectual, used without informed consent, and harmful to mothers and newborns alike. Despite EFM's ethical misuse, there has been no outcry from the bioethical world. Why? This article answers that question, discussing EFM's history and the reasons it was issued an ethics pass. And it explores the reason that even today mothers are still treated with blatant medical paternalism, deprived of autonomy and informed consent, and subjected to real medical risks under the guise that EFM is an essential safety device when in fact it is used almost solely to protect physicians and hospitals from cerebral palsy lawsuits.

The Royal Book by Haly Abbas from the 10th century: one of the earliest illustrations of the surgical approach to skull fractures.

Haly Abbas was one of the pioneering physicians and surgeons of the Eastern world in the 10th century who influenced the Western world by his monumental work, The Royal Book. The book was first partly translated into Latin by Constantinus Africanus in the 11th century without citing the author's name. Haly Abbas was recognized in Europe after full translation of The Royal Book by Stephen of Antioch in 1127. The Royal Book has been accepted as an early source of jerrah-names (surgical books) in the Eastern world. The chapters regarding cranial fractures in Haly Abbas' work include unique management strategies for his period with essential quotations from Paul of Aegina's work Epitome. Both authors preferred free bone flap craniotomy in cranial fractures. Although Paul of Aegina, a Byzantine physician and surgeon, was a connection between ancient traditions and Islamic interpretation, Haly Abbas seemed to play a bridging role between the Roman-Byzantine and the School of Salerno in Europe.

An evaluation regarding the current situation of stem cell studies in Turkey.

Turkey is in a parallel state to that of other countries for developments in stem cell research and practices. Nevertheless, Turkish law has no regulations for stem cell practices. To define a legal framework for stem cell research, rules of general content should be used as the starting point. In 2005 and 2006, a general regulation and guidelines on stem cell research were published by Turkish Ministry of Health. Thus, the ministry, based on this first general regulation, stopped "Embryonic Stem Cell Research", while allowing "Adult Stem Cell Research" by a second general regulation. The method of such research was regulated with the addendum of 'Guidelines for Clinical Research on Non-embryonic stem Cell'. With the latest regulation, clinical stem cell research in Turkey has been based on 'Regulations for Clinical Research', which was legislated in 2009. However, the aforementioned regulations by the ministry are still legally binding. In addition, other regulations such as Medical Deontology Regulations of 1960 and Patients' Rights Regulations of 1998 are to be consulted for stem cell research in Turkey. While it is especially important that research that is still at experimental level not provide an opportunity for trade of hope in patients and their relatives, ethics discussions are enlightening in developing regulations and critical evaluation of current practices.