33 Union of Turkish Bar Associations Review 2022 Süleyman ÖZAR the ethical obligations incumbent on the health-care staff and domestic legislation, not the legislation but the ethical principles be abided by.102 In this sense, as also indicated in the principles declared by the Turkish Medical Association, “if the hunger striker loses his consciousness or falls into a coma, the physician shall take an action in consideration of the final decision of the hunger striker.” At this stage, making a distinction on the basis of whether the striker is a prisoner would fall foul of the Physician’s Pledge, Declaration of Geneva adopted by the World Medical Association, which would amount to discrimination.103 According to the ethical principles of the Turkish Medical Association, the physician should check the striker’s state on a daily basis and inform him/her of the probable consequences of his/her refusal to eat. The physician should also keep a medical follow-up form where it should be certainly indicated whether the person concerned will consent to medical treatment in the event of loss of consciousness.104 The opinion of the Ethical Board of the Medical Association, which is dated 24 September 2018, also points out that the medical profession does not entail the duty of keeping the person alive at all costs but primarily requires respect for his personal autonomy and dignity. According to the Ethical Board, in the event of hunger strikes, ethical values such as respect for personal autonomy, informed consent, privacy and right to refuse medical treatment within the framework of physicianpatient relationship that is based on trust should be taken into consideration.105 The physician may administer medical treatment only when he considers that the previous expressions whereby the person concerned has refused medical treatment were uttered under duress. In that case, 102 https://tihv.org.tr/wp-content/uploads/2020/04/istanbul-protokolu.pdf (p. 15). 103 Onur Naci Karahancı & Nüket Örnek Büken, “Evrensel Etik İlkeler Işığında Açlık Grevleri ve Hekimlik (Hunger Strikes and Medical Profession in the light of Universal Ethical Principles)”, Sürekli Tıp Eğitimi Dergisi, Vol. 26 Issue 4, 2017, p. 170. 104 Turkish Medical Association, “Açlık Grevi Sırasında Tıbbi Etik İlkeler ve Bunun Yansımaları (Ethical Principles in Medicine during a Hunger Strike and Repercussions)”: https://www.ttb.org.tr/aclik_grev/tibbi.html (10.02.2021). 105 Turkish Medical Association, “Özgürlüğünden Yoksun Bırakılanların Sağlık Hakkı ile İlgili Etik Kurul Görüşü (Ethical Board’s Opinion on the Right to Health of Those Deprieved of Liberty)”: https://www.ttb.org.tr/makale_goster.php?Guid=cca66a7e-bff9-11e8-bd5600aa55ab5dcd (10.02.2021)
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