{"id":11074,"date":"2022-03-12T15:34:52","date_gmt":"2022-03-12T12:34:52","guid":{"rendered":"http:\/\/blog.ulubat.org\/?p=11074"},"modified":"2022-06-08T23:31:20","modified_gmt":"2022-06-08T20:31:20","slug":"11074","status":"publish","type":"post","link":"https:\/\/blog.ulubat.org\/index.php\/genel\/11074\/","title":{"rendered":"HEK\u0130ML\u0130K B\u0130R YEM\u0130NE SI\u011eAB\u0130L\u0130R M\u0130?"},"content":{"rendered":"\n

HEK\u0130ML\u0130K B\u0130R YEM\u0130NE SI\u011eAB\u0130L\u0130R M\u0130?<\/h1>\n\n\n\n
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Ortada Hipokrat oturmakta solunda Empedokles, Platon, Aristoteles; sa\u011f\u0131nda ise hasta ba\u015f\u0131nda Herofil bulunmaktad\u0131r.<\/p>\n<\/div><\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n\n\n\n

Bilindi\u011fi \u00fczere hasta hekim ili\u015fkileri, t\u0131bbi etik tart\u0131\u015fmalar\u0131n\u0131n temelinde yatan ana konulardan biridir. \u00d6yle ki t\u0131bbi eti\u011fi bir \u00e7\u0131nara benzetecek olursak k\u00f6klerinin hasta hekim ili\u015fkileri oldu\u011funu s\u00f6ylemek ve eti\u011fin de bu k\u00f6klerden beslenerek geli\u015fip d\u00f6n\u00fc\u015ft\u00fc\u011f\u00fcn\u00fc belirtmek san\u0131r\u0131m yanl\u0131\u015f olmayacakt\u0131r.  O nedenle bu yaz\u0131mda hasta hekim ili\u015fkilerinin hekimlere bakan y\u00f6n\u00fcne bir giri\u015f olarak Hipokrat yemininden bahsetmek istiyorum. Hekimlik g\u00f6revinin yemin edip diplomay\u0131 ald\u0131ktan sonra ba\u015flad\u0131\u011f\u0131n\u0131 d\u00fc\u015f\u00fcn\u00fcrsek etik sorumluluklar\u0131m\u0131z\u0131n da bu yeminle resmiyet kazand\u0131\u011f\u0131n\u0131 s\u00f6yleyebiliriz. G\u00fcn\u00fcm\u00fczde bir\u00e7ok t\u0131p fak\u00fcltesinin mezuniyet t\u00f6renlerinde hekim adaylar\u0131n\u0131n sesiyle salonlarda yank\u0131lanan bu yemin, ba\u015fta hekim-hasta ili\u015fkileri olmak \u00fczere hekimler aras\u0131 ili\u015fkiyi de kapsayan hekimlik de\u011ferlerinin bir mihenk ta\u015f\u0131 olarak g\u00f6r\u00fclmektedir.<\/p>\n\n\n\n

H\u0130POKRAT YEM\u0130N\u0130 NED\u0130R?<\/strong><\/h2>\n\n\n\n
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Atina’da Hipokrat\u0131 i\u00e7eren bir fresk sanat\u0131<\/p>\n<\/div><\/div>\n\n\n\n

Hipokrat yemini 4. yy \u2018da ortaya \u00e7\u0131kt\u0131\u011f\u0131 d\u00fc\u015f\u00fcn\u00fclen ve Hipokrat\u2019\u0131n ad\u0131n\u0131 ta\u015f\u0131sa da onun yazd\u0131\u011f\u0131na dair kan\u0131tlar\u0131n olmad\u0131\u011f\u0131 hatta \u00f6l\u00fcm\u00fcnden 100 y\u0131l sonra yaz\u0131ld\u0131\u011f\u0131 iddia edilen kutsall\u0131k dahi atfedilen bir belgedir. (1) 2500 y\u0131l i\u00e7inde orijinal formundan g\u00fcn\u00fcm\u00fcze dek bir\u00e7ok kez yenilenmi\u015f, son olarak 2017\u2019de g\u00fcncellenerek D\u00fcnya Tabipler Birli\u011fi Cenevre Bildirgesi ve Hekimlik And\u0131 ad\u0131yla an\u0131lmaya ba\u015flam\u0131\u015ft\u0131r.<\/p>\n\n\n\n

Bu belge hekimlik mesle\u011finin etik davran\u0131\u015f standartlar\u0131n\u0131 belirleyen ilk yaz\u0131l\u0131 belge, etik kod olarak g\u00f6r\u00fclmektedir. G\u00fcn\u00fcm\u00fczde yasal h\u00fckm\u00fc olmayan ancak yayg\u0131n olarak kabul g\u00f6ren onurlu davran\u0131\u015f\u0131n esaslar\u0131n\u0131 tan\u0131mlamakta ve bu konuda hekimlere bir \u00e7er\u00e7eve \u00e7izmektedir.<\/p>\n\n\n\n

H\u0130POKRAT YEM\u0130N\u0130N\u0130N EN ESK\u0130 FORMU<\/h2>\n\n\n\n
\"\"<\/figure>
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Hipokrat yemini<\/p>\n<\/div><\/div>\n\n\n\n

Hipokrat yemininin en eski formundaki baz\u0131 k\u0131s\u0131mlar\u0131n ger\u00e7ek anlam\u0131 tam olarak anla\u015f\u0131l\u0131p kavranamad\u0131\u011f\u0131 i\u00e7in hakk\u0131nda farkl\u0131 kaynaklarda farkl\u0131 \u00e7eviriler mevcuttur. Sizler i\u00e7in birka\u00e7 kaynaktan yararlanarak derledi\u011fim bir \u00f6rne\u011fi \u015fu \u015fekildedir:<\/p>\n\n\n\n

\u2018Hekim Apollon, Aesculapius, Hygia, Panacea ve b\u00fct\u00fcn tanr\u0131 ve tanr\u0131\u00e7alar ad\u0131na yemin ederim ki g\u00fcc\u00fcm yetti\u011fince ve yarg\u0131m \u00f6l\u00e7\u00fcs\u00fcnde bu yemini ve \u015fart\u0131 yerine getirece\u011fim: Bana bu sanat\u0131 \u00f6\u011freteni annem ve babam kadar de\u011ferli g\u00f6rece\u011fim, onunla bu hayatta yolda\u015f olaca\u011f\u0131m, mal\u0131m\u0131 onunla payla\u015faca\u011f\u0131m, gerekti\u011finde ihtiya\u00e7lar\u0131n\u0131 kar\u015f\u0131layaca\u011f\u0131m; neslini karde\u015flerim olarak g\u00f6rece\u011fim ve \u00f6\u011frenmek isterlerse onlara bu sanat\u0131 \u00fccret veya ko\u015ful olmaks\u0131z\u0131n \u00f6\u011fretece\u011fim; belirlenmi\u015f kurallar, dersler ve her t\u00fcrl\u00fc \u00f6\u011fretim \u015fekliyle bu sanat bilgisini sadece o\u011fullar\u0131ma, \u00f6\u011fretmenlerimin o\u011fullar\u0131na, bu s\u00f6zle\u015fmeye ba\u011fl\u0131 kalan ve t\u0131p yasas\u0131na g\u00f6re bu yemini eden \u00f6\u011frencilere aktaraca\u011f\u0131m ancak ba\u015fkalar\u0131na aktarmayaca\u011f\u0131m. Yetene\u011fim ve yarg\u0131m \u00f6l\u00e7\u00fcs\u00fcnde hastalar\u0131m\u0131n yarar\u0131na oldu\u011funu d\u00fc\u015f\u00fcnd\u00fc\u011f\u00fcm tedaviyi uygulayaca\u011f\u0131m ve zararl\u0131 ve zarar verici her ne varsa ondan ka\u00e7\u0131naca\u011f\u0131m. \u0130steyen hi\u00e7 kimseye \u00f6l\u00fcmc\u00fcl bir ila\u00e7 vermeyece\u011fim ve b\u00f6yle bir tavsiyede bulunmayaca\u011f\u0131m. Benzer \u015fekilde bir kad\u0131na \u00e7ocuk d\u00fc\u015f\u00fcrmesi i\u00e7in ara\u00e7 vermeyece\u011fim. Safl\u0131k ve kutsall\u0131kla hayat\u0131m\u0131 s\u00fcrd\u00fcrecek ve sanat\u0131m\u0131 uygulayaca\u011f\u0131m. *Ta\u015f nedeniyle ac\u0131 \u00e7eken hastalar\u0131 kesmeyece\u011fim ancak bu i\u015fi uygulay\u0131c\u0131lar\u0131na (cerrahlara) b\u0131rakaca\u011f\u0131m. Hangi eve girersem gireyim oraya hasta yarar\u0131na girece\u011fim ve ister h\u00fcr ister k\u00f6le olsun erkek ve kad\u0131nlar\u0131n v\u00fccudunu k\u00f6t\u00fcye kullanmak dahil her t\u00fcrl\u00fc kas\u0131tl\u0131 zarar ve suiistimallerden ka\u00e7\u0131naca\u011f\u0131m. Hastalar\u0131m\u0131n hayatlar\u0131nda, mesle\u011fi prati\u011fim ile ili\u015fkili olsun ya da olmas\u0131n, d\u0131\u015far\u0131da konu\u015fulmamas\u0131 gereken ne g\u00f6r\u00fcr ve duyarsam t\u00fcm bunlar\u0131 \u00f6zel kabul edip gizli tutaca\u011f\u0131m. Bu yemini \u00e7i\u011fnemeden tuttu\u011fum s\u00fcrece hayat\u0131m\u0131 ve sanat uygulamalar\u0131m\u0131 mutlulukla insanlar\u0131n t\u00fcm\u00fcnden ve her zaman sayg\u0131 g\u00f6rerek s\u00fcrd\u00fcrmek bana bah\u015fedilsin! Ama ona ihanet eder veya onu \u00e7i\u011fnersem tam tersini ya\u015famak nasibim olsun!\u2019 (2, 3, 4)<\/p><\/blockquote>\n\n\n\n

*\u00c7evirilerde en \u00e7ok tart\u0131\u015f\u0131lan k\u0131s\u0131m buras\u0131. Farkl\u0131 \u00e7eviri yazarlar\u0131 bu b\u00f6l\u00fcm\u00fc \u2018Ta\u015f i\u00e7in cerrahi yapmayaca\u011f\u0131m. Bunu yapanlara b\u0131rakaca\u011f\u0131m.\u2019 veya \u2018B\u0131\u00e7a\u011f\u0131 ta\u015f nedeniyle ac\u0131 \u00e7ekenlerde dahi kullanmayaca\u011f\u0131m, ancak bu i\u015fle u\u011fra\u015fanlar lehine geri \u00e7ekilece\u011fim.\u2019 \u015feklinde farkl\u0131 \u015fekillerde \u00e7evirmekte. Burada tart\u0131\u015f\u0131lan birinci konu ta\u015f ile kastedilenin safra kesesi mi mesane mi yoksa b\u00f6brek ta\u015f\u0131 m\u0131 oldu\u011fudur. \u0130kinci k\u0131s\u0131m ise hekimlerin her t\u00fcrl\u00fc cerrahi i\u015flemden mi yoksa sadece litotomi ve kastrasyondan m\u0131 ka\u00e7\u0131nd\u0131\u011f\u0131d\u0131r. (7) Bunun d\u0131\u015f\u0131nda cerrahiden ka\u00e7\u0131n\u0131lma sebebi olarak o d\u00f6nemde cerrahinin hekimler taraf\u0131ndan hor g\u00f6r\u00fclmesi ile cerrahinin olduk\u00e7a mortal seyretmesi \u015feklinde farkl\u0131 g\u00f6r\u00fc\u015fleri \u00f6ne s\u00fcrenler de bulunmaktad\u0131r.  Bunula ili\u015fkili olarak hastaya yarardan \u00e7ok zarar verilebilece\u011fi ve bu nedenle bu i\u015fin cerrahlara b\u0131rak\u0131lmas\u0131 gerekti\u011fini savunan taraflar da mevcuttur.<\/p>\n\n\n\n

MODERN H\u0130POKRAT YEM\u0130N\u0130<\/h2>\n\n\n\n
\"\"<\/figure>
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Hipokrat\u0131 simgeleyen bir heykel<\/p>\n<\/div><\/div>\n\n\n\n

Hipokrat yemininin ilk formu y\u00fczy\u0131llar boyunca hekimlere \u0131\u015f\u0131k tutmu\u015f, zaman i\u00e7inde her d\u00f6nemin de\u011fi\u015fen ko\u015fullar\u0131 gere\u011fince adeta bir heykelt\u0131ra\u015f\u0131n elindeki bir heykel gibi yontularak, d\u00f6n\u00fc\u015ft\u00fcr\u00fclerek g\u00fcn\u00fcm\u00fczdeki son \u015fekline kavu\u015fmu\u015ftur. Bu yemini temel alarak bir\u00e7ok \u00fcniversite ve dernek Hipokrat yemininin analoglar\u0131n\u0131 olu\u015fturmu\u015flard\u0131r. Bunlardan en \u00e7ok bilinenlerinden biri de D\u00fcnya Tabipler Birli\u011fi b\u00fcnyesinde Eyl\u00fcl 1948\u2019de Cenevre\u2019de kabul edilen Cenevre Bildirgesidir. (6) 1968, 1983, 1994\u2019te s\u0131ras\u0131yla Sydney, Venedik ve Stockholm\u2019de de\u011fi\u015ftirilen; May\u0131s 2005 ve 2006\u2019da Fransa\u2019da g\u00f6zden ge\u00e7irilen ve son olarak Ekim 2017\u2019de de\u011fi\u015ftirilen bildirgenin g\u00fcn\u00fcm\u00fczdeki \u015fekli a\u015fa\u011f\u0131daki gibidir:<\/em><\/p>\n\n\n\n

Hekimlik mesle\u011finin bir \u00fcyesi olarak;
Ya\u015fam\u0131m\u0131 insanl\u0131\u011f\u0131n hizmetine adayaca\u011f\u0131ma,<\/em><\/p>\n\n\n\n

Hastam\u0131n sa\u011fl\u0131\u011f\u0131na ve esenli\u011fine her zaman \u00f6ncelik verece\u011fime, <\/em><\/p>\n\n\n\n

Hastam\u0131n \u00f6zerkli\u011fine ve onuruna sayg\u0131 g\u00f6sterece\u011fime,<\/em>
\u0130nsan ya\u015fam\u0131na en \u00fcst d\u00fczeyde sayg\u0131 g\u00f6sterece\u011fime,<\/em><\/p>\n\n\n\n

G\u00f6revimle hastam aras\u0131na; ya\u015f, hastal\u0131k ya da engellilik, inan\u00e7, etnik k\u00f6ken, cinsiyet, milliyet, politik d\u00fc\u015f\u00fcnce, \u0131rk, cinsel y\u00f6nelim, toplumsal konum ya da ba\u015fka herhangi bir \u00f6zelli\u011fin girmesine izin vermeyece\u011fime,<\/em><\/em><\/p>\n\n\n\n

Hastam\u0131n bana a\u00e7t\u0131\u011f\u0131 s\u0131rlar\u0131, ya\u015fam\u0131n\u0131 yitirdikten sonra bile gizli tutaca\u011f\u0131ma,<\/em><\/em><\/p>\n\n\n\n

Mesle\u011fimi vicdan\u0131mla, onurumla ve iyi hekimlik ilkelerini g\u00f6zeterek uygulayaca\u011f\u0131ma,<\/em><\/em><\/p>\n\n\n\n

Hekimlik mesle\u011finin onurunu ve sayg\u0131n geleneklerini b\u00fct\u00fcn g\u00fcc\u00fcmle koruyup geli\u015ftirece\u011fime,<\/em><\/em><\/p>\n\n\n\n

Mesle\u011fimi bana \u00f6\u011fretenlere, meslekta\u015flar\u0131ma ve \u00f6\u011frencilerime hak ettikleri sayg\u0131y\u0131 ve minnettarl\u0131\u011f\u0131 g\u00f6sterece\u011fime,<\/em><\/em><\/p>\n\n\n\n

T\u0131bbi bilgimi hastalar\u0131n yarar\u0131 ve sa\u011fl\u0131k hizmetlerinin geli\u015ftirilmesi i\u00e7in payla\u015faca\u011f\u0131ma,<\/em><\/em><\/p>\n\n\n\n

Hizmeti en y\u00fcksek d\u00fczeyde sunabilmek i\u00e7in kendi sa\u011fl\u0131\u011f\u0131m\u0131, esenli\u011fimi ve mesleki yetkinli\u011fimi korumaya dikkat edece\u011fime,<\/em><\/em><\/p>\n\n\n\n

Tehdit ediliyor olsam bile, t\u0131bbi bilgimi, insan haklar\u0131n\u0131 ve bireysel \u00f6zg\u00fcrl\u00fckleri \u00e7i\u011fnemek i\u00e7in kullanmayaca\u011f\u0131ma,<\/em><\/em><\/p>\n\n\n\n

Kararl\u0131l\u0131kla, \u00f6zg\u00fcrce ve onurum \u00fczerine, ant i\u00e7erim. (5)<\/em><\/em><\/p>\n\n\n\n

G\u00dcN\u00dcM\u00dcZDE H\u0130POKRAT YEM\u0130N\u0130NE YAKLA\u015eIM<\/h2>\n\n\n\n
\"\"<\/figure>
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Amsterdam’da Hipokrat Heykeli<\/p>\n<\/div><\/div>\n\n\n\n

G\u00fcn\u00fcm\u00fcz modern formlar\u0131 inceledi\u011fimizde de\u011fi\u015fen ve d\u00f6n\u00fc\u015fen d\u00fcnya ko\u015fullar\u0131 sebebiyle tanr\u0131 ve tanr\u0131\u00e7alar ad\u0131na yeminin, son k\u0131s\u0131mdaki dileklerin, g\u00fcn\u00fcm\u00fczde \u00e7ok\u00e7a tart\u0131\u015f\u0131lan \u00f6tenazi ve abortus k\u0131s\u0131mlar\u0131n\u0131n \u00e7\u0131kart\u0131ld\u0131\u011f\u0131n\u0131 g\u00f6rmekteyiz. Bunun da asl\u0131nda t\u0131bb\u0131n her alan\u0131nda oldu\u011fu gibi g\u00fcncelli\u011fi koruma gayretinden do\u011fdu\u011funu s\u00f6yleyebiliriz. Bu gayret g\u00fcn\u00fcm\u00fczde etik tart\u0131\u015fmalarla hala s\u00fcrmekte, D\u00fcnya Tabipler Birli\u011fi gibi uluslararas\u0131 derneklerin genel kurullar\u0131nda al\u0131nan karalarla da tescillenmektedir. \u00d6te yandan g\u00fcn\u00fcm\u00fczde Hipokrat yemininin gereklili\u011fi hakk\u0131nda da tart\u0131\u015fmalar s\u00fcregelmekte ve yeminin g\u00fcn\u00fcm\u00fcz t\u0131p prati\u011fi ile ilgisiz oldu\u011funu ve ihtiya\u00e7lar\u0131 tam olarak kar\u015f\u0131lamad\u0131\u011f\u0131 y\u00f6n\u00fcnde konuyla ilgili bir\u00e7ok kar\u015f\u0131t g\u00f6r\u00fc\u015f de bildirilmektedir.<\/p>\n\n\n\n

Elbette Hipokrat yemininin her \u015feyi kapsad\u0131\u011f\u0131n\u0131 savunmak hekimli\u011fin bir yemine s\u0131\u011fd\u0131r\u0131labilece\u011fini iddia etmek kimimize g\u00f6re \u00fctopik olacakt\u0131r belki ancak \u00f6n\u00fcm\u00fczde bize yol g\u00f6sterici bir rehber olarak durmas\u0131, \u00f6nemli ve \u00fczerinde durulmas\u0131 gereken noktalar\u0131 vurgulamas\u0131 a\u00e7\u0131s\u0131ndan Hipokrat yemini bence olduk\u00e7a k\u0131ymetli ve e\u015fsiz bir eserdir. Zaman zaman budansa da yeniden dallar veren bir \u00e7\u0131nar misali y\u00fczy\u0131llard\u0131r ayakta duran ve k\u00f6kleri tarihe uzanan bu yemin yine bir \u00e7\u0131nar misali bir g\u00fcn k\u00f6k\u00fcnden kesilip devrilir mi yoksa etraf\u0131 ku\u015fat\u0131rcas\u0131na sar\u0131p sarmalar m\u0131 bilemem. Ancak her iki t\u00fcrl\u00fc de belki de hekimli\u011fi bir yemine s\u0131\u011fd\u0131rabilmek m\u00fcmk\u00fcnd\u00fcr. \u00c7\u00fcnk\u00fc \u00f6nemli olan hekimlikten ne anlad\u0131\u011f\u0131m\u0131z, hekimli\u011fi nas\u0131l g\u00f6rd\u00fc\u011f\u00fcm\u00fczd\u00fcr. O y\u00fczden bu sorunun cevab\u0131n\u0131 herkes kendince cevaplamal\u0131d\u0131r bence: \u2018Hekimlik bir yemine s\u0131\u011fabilir mi sizce?\u2019<\/p>\n\n\n\n

KAYNAK\u00c7A:<\/h2>\n\n\n\n
  1. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5755201\/<\/a><\/li>
  2. https:\/\/www.nlm.nih.gov\/hmd\/greek\/greek_oath.html<\/a><\/li>
  3. https:\/\/www.britannica.com\/topic\/Hippocratic-oath<\/a><\/li>
  4. https:\/\/www.pbs.org\/wgbh\/nova\/doctors\/oath_classical.html<\/a><\/li>
  5. https:\/\/www.ttb.org.tr\/haber_goster.php?Guid=295283a8-f03e-11eb-9018-02370ea20223<\/a><\/li>
  6. https:\/\/www.ttb.org.tr\/haber_goster.php?Guid=b6b3bd8a-c9e0-11e7-8a71-159198489f44<\/a><\/li>
  7. https:\/\/www.researchgate.net\/publication\/309275597_Lithotomy’s_prohibition_and_referral_to_experts_in_medical_oaths_of_hippocratic_stemma<\/a><\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"

    HEK\u0130ML\u0130K B\u0130R YEM\u0130NE SI\u011eAB\u0130L\u0130R M\u0130? Ortada Hipokrat oturmakta solunda Empedokles, Platon, Aristoteles; sa\u011f\u0131nda ise hasta ba\u015f\u0131nda Herofil bulunmaktad\u0131r. Bilindi\u011fi \u00fczere<\/p>\n","protected":false},"author":532,"featured_media":11076,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[24,1,23,6,165],"tags":[2160,2163,426,2164,255,267,990,266,37,2162,265,1988,34,2159],"acf":[],"views":4022,"_links":{"self":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/11074"}],"collection":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/users\/532"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/comments?post=11074"}],"version-history":[{"count":4,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/11074\/revisions"}],"predecessor-version":[{"id":11087,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/11074\/revisions\/11087"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media\/11076"}],"wp:attachment":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media?parent=11074"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/categories?post=11074"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/tags?post=11074"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}