June 10th, 2017

Dear Prof. Stella Reiter-Theil,
dear members of the Jury of Hans-Joachim Schwager Award,
dear colleagues

It is a great honour and a privilege for me to be deemed to deserve the ‘Hans-Joachim Schwager Award’. I would like to thank you and the members of the Jury sincerely.

I would like to congratulate all of my colleagues.

I believe I have been awarded for encouraging a seed to grow. It is a seed indeed, since Clinical Ethics Consultation (CEC) is a newborn in Turkey, and I believe we have lots of work to do in order to contribute to the improvement of healthcare. And this Award will have a significant impact on our efforts.

Patients may be disadvantegous in their relationship with medicine and physicians, not only due to the disease and pain they already have, but also because of the closed structure of medicine as a societal institution, hegemony of the paternalist approach, language and education differences between them and healthcare workers, and also the access problems due to many reasons including the ability to pay. Clinicians, on the other hand, might not be aware of the ethical dimension of the case they face, they might not have enough training for handling ethical dilemmas appropriately, and/or they might have concerns and hesitations triggered by the hierarchical power relationships and the vagueness of legal regulations. Yet they might think that “I can solve ethical problems on my own”, “Clinical ethics consultation would be an intervention to my professional integrity”, and “I don’t think that it would improve the situations significantly.”

In the circumstances mentioned above, which I believe not uncommon in other countries as well, CEC has a significant potential for helping both patients and clinicians. The ‘Ethicist’ faces a special challenge to find a balance in the process: She tries not to feed / provoke the prejudices of clinicians, while advocating relevant rights and emphasizing responsibilities. She tries not to be a part of the instrumentalization of CEC for covering up the flaws of hospital and physicians, while trying to gain trust of both providers and patients. This is what I struggle most of the time, indeed.

 

This Award is invaluable to me for protecting hope.

Especially in these harsh times …

Prof. Dr. M. Murat Civaner

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