Ethical Decisions at the End of Life in an Intercultural Context. German and Turkish Perspectives

Decisions about changing the goal of medical treatment or limiting such treatment at the end of life are associated with a large number of ethical questions. Culturally shaped values are of key significance when choosing between a therapy aimed at preserving life and one directed towards alleviating suffering.

Against this background, ethical conflicts of interest and decision-making may arise in intercultural treatment situations at the end of life, posing special challenges not only for patients and their relatives, but also for physicians and nursing staff. Such situations in which decisions need to be made and action be taken without clear ethical grounding can cause considerable uncertainty in clinical practice for all those involved.

The broad spectrum of difficult situations includes the handling of information about critical diagnoses and unfavourable prognoses, cultural aspects when determining a medical treatment’s futility, and different views about the significance of patient and family autonomy. Due to diverging values based on cultural factors, but also because of the different economic and legal frameworks, the handling of these issues at the end of life is different in Germany and in Turkey.

Given the large proportion of patients of Turkish origin in Germany and the growing number of patients of German origin being treated in Turkey, the German Ethics Council together with Turkish scientists addresses the described issues in an interdisciplinary public symposium. For the first time in the history of the two countries, such an international interdisciplinary exchange takes place in order to improve mutual understanding as well as communication towards finding solutions to problems. The meeting contributes to the international social discourse and aims at raising awareness of these issues in health policy.

The event focuses on the following questions:

• How do ethical perceptions and legal frameworks regarding the end of life differ in Germany and Turkey?
• What ethical and legal questions and challenges arise in intercultural treatment situations in the two countries?
• What approaches do exist for dealing with these questions in an ethically and legally appropriate way?

Chair:
Rainer Brömer · Istanbul University

Welcome
Christiane Woopen · Chair of the German Ethics Council
Jutta Wolke · Consul General of the Federal Republic of Germany in Istanbul
Sedat Murat · Vice Rector of Istanbul University

Medical Aspects
Elisabeth Steinhagen-Thiessen · German Ethics Council
Presentation

Oktay Demirkiran · Istanbul University

Discussion

Legal Aspects
Jochen Taupitz · German Ethics Council
Presentation

Yener Ünver · Özyegin University Istanbul
Presentation

Discussion

Ethical Aspects
Michael Wunder · German Ethics Council
Presentation

Ilhan Ilkilic · German Ethics Council; Istanbul University
Presentation

Discussion

Round Table Discussion
Christiane Woopen · Chair of the German Ethics Council
Elisabeth Steinhagen-Thiessen · German Ethics Council
Fatis Altindas · Istanbul University
Hakan Ertin · Istanbul University
Chair: Ilhan Ilkilic · German Ethics Council; Istanbul University