THIRD WEEK

SCENARIO
TERMINOLOGY
 Bioethical base rule
rules which must be obeyed by doctors in
relationship with living organisms
Beneficence principle
doing the good thing
Autonomy principle
self-supporting right
 Informed consent
agreement from patient and family after
explanation

Ethical clearance
rules given by research commission to a
research that relates with living organisms
 MKEK
Majelis Kehormatan Etik Kedokteran
(Medical Honor Council of Ethics)

MKDKI
Majelis Kehormatan Disiplin Kedokteran
Indonesia (Indonesian Medical Honor
Council of Discipline)
DETERMINE
PROBLEM
1. What are the contents of geneva oath?
2. What are the rules from ministry of health
about human right in health?
3. What are the contents of human rights in
health sector?
4. What are the laws who set about ethic,
discipline, and law of medical?
5. What are rights and obligations of doctors
to patients?
6. What are the characteristics of
beneficences basis?
7. What are the characteristics of
autonomys basis?
8. What are basic principles of bioethics?
9. What are principle, purpose, and role of
informed concent?
10.Can you explain about aspect ethic,
discipline, and law of medical?
11.What are stewardship of discipline
systems and law systems?
12.Can you explain about ethical clearance?
THE ANSWER OF THE
PROBLEMS
1. What are the contents of
geneva oath?
Life Devoted to the Interests of Humanity
Will maintain the dignity and noble
traditions of medical office
Will serve with dignity and have good
morals
Perform tasks in the public interest
 Keep secret everything that is known
Would not use the knowledge for
something that is against humanity
Respect every human life from the
moment of conception
Prioritize patient health
 Will endeavor not to be influenced in the
discharge of duty to the patient
will give thanks and honor to the teachers
treat colleagues as wish to be treated
observe and practice of Indonesias
medical ethics
2 & 11 What are the rules from ministry
of health about human right in health?

Government's Ministry of Health established IDI ,

IDI established MKDKI and MKEK is responsible for:
Keep an eye doctor in profession

Make a law or regulation as a foundation doctor in

undergoing the process

Receive complaints from the public on matters in

violation of ethics , discipline , and law to be medicine
physician may be sued in civil and criminal
3 & 5 What are the contents of
human rights in health sector?
Patients' rights :
Accept any medical treatment according to
the standard
Giving consent (informed concent )
Getting the medical record
Getting the info from the doctor honestly
Right fatherly receive opinions from other
doctors
 Rights physician :
- Receive legal protection for practice
- Obtain complete information from patients
- Accepting payment for services

Patient liability :
- Provide a full description of the condition
- Comply with the instructions of doter
- Comply with the rules on health care advice
- Provide fee
Doctors liability :
- Providing health care services in
accordance with the procedures
- Refer patients
- Keeping on the state of the patient
- Perform first aid
- Adding science
4. What are the laws who set about
ethic, discipline, and law of medical?

Law. 29 of 2004 on the practice of medicine:

Medical ethics : Article 1, Article 8, Article 68

Medical discipline : Chapter VIII, Article 55-70,
Article 44, 45, 46, 48
Medical Law : Chapter X, Chapter VI, Chapter VII
6. What are the characteristics
of beneficences basis?
- No strings attached
- Looking at something or someone not
only benefit doctors
- Greater patient benefits from loss doctor
- Respect the rights of patients
- Much out justice in action
- Much out of the interests of patients
7. What are the characteristics
of autonomys basis?
- Respect for the right of self-
determination by patients
- Frankly
- Respect the privacy of patient
- Keeping a secret
- Free and rationa
8. What are basic principles of
bioethics?
a. The principle of beneficence
b . Autonomy
c . Nonmalaficence (emergency) : do not
do bad things (losses)
d . Justice (legal) : Fair
9. What are principle, purpose,
and role of informed concent?
8. The principle of informed consent
purposes :
Patients determine what should be done
to him
Purpose : so that there is no case against
the doctor at the end of the medical
process later
10. Can you explain about aspect
ethic, discipline, and law of medical?
Medical ethics : Doctors behave
individually as physicians in the
implementation of the practice of
medicine
Discipline of medicine : the physician
behaves during practice medicin
Law of medicine : physician behavior as
individuals in relationships in the
community
12. Can you explain about
ethical clearance?
Feasibility ethical clearance information
provided by the research ethics committee
for research involving living beings ,
namely :
Plant
Animals , provided that :
There should be killed at birth
Classification between adult animals and is still in
progress
Kill quickly
Humans :
Given informed consent ,
The doctor did not force
Have the right to participate in the
research autonomy
" humanize human beings "
ANALYSIS
 Doctor Rights and
Code of
s
Ethics Informe Duties of
Oath d Doctors and
Consent Patients
Genera
l
Specifi
c Science and
Rules
Aspect of
Ethic
Medical Aspect of
Practice Norm Discipline
Clinic

Ethical
Bioethi Aspect of Law Rule
Clearanc
cs Rule
e

- Beneficence
- Non Maleficence Human Rights Sanctio
- Justice Protection n
- Autonomy Institutions
 LEARNING
OBJECTIVES
1. Students are able to explain rights and
responsibilities of physicians and patients
2. Students are able to explain essence of
doctorss oath
3. Students are able to explain code of
conduct in performing the medical
profession
4. Students are able to explain aspects of
discipline
5. Students are able to explain basic principles
of bioethics
6. Students are able to explain ethical clearance
7. Students are able to explain principles, roles
and purposes of informed consent
8. Students are able to explain rules and
institutions that regulate the medical practice
act
9. Students are able to explain violations and
penalties in the medical practice act
 THE ANSWER OF
LEARNING OBJECTIVES
1. Essence of Geneva Oath
An official statement uttered by a new
doctor.

Started by the oath of Hippocrates

Reappear by Ibnu Sina
After World War II , WMA meeting in
Geneva in 1948
Doctors outh Indonesia based on the
Declaration of Geneva
 Doctors Oath Indonesian was first used in
1959
Oath improved in 1983, 1993, 2012.

The contents of the oath

 Life Devoted to the Interests of Humanity
Will maintain the dignity and noble
traditions of medical office
Will serve with dignity and have good
morals
Perform tasks in the public interest
Keep secret everything that is known
Would not use the knowledge for
something that is against humanity
Respect every human life from the
moment of conception
 Prioritize patient health
Will endeavor not to be influenced in
the discharge of duty to the patient
will give thanks and honor to the
teachers
treat colleagues as wish to be treated
observe and practice of medical
ethics Indonesia
2. Students are Able to Explain the Rights
and Obligation of Patient and Doctor

Rights of Doctor Based on UU No. 29 at 2004 article

50 :

1. Getting law protection as long as doing their

task based on profession standard and standard
of operational procedure
2. Giving medical services based on profession
standard and standard of operational procedure
3. Getting complete and true information from the
patient or their relative
4. Gaining fee from their action
Outside of Acts :

Doing practice after getting SID,STR,SIP

Refuse to do medical treatment against
law ethic, religion ethic, and their inner
heart
Rights of doctor's privacy
Rights to release doctor's statement letter
Obligation of Doctor:

1. Giving medical service based on standard

of profession and standard of operational
procedure and patient medical necessity.
2. Referring patient to other doctor who has
better capability if he can not do
examination and medical treatment.
3. Keeping patient secret even though they
already passed away
4. Giving emergency aid based on humanity
unless he sure there is someone who could
do that
5. Increase their knowledge and follow the
development of medical knowledge
Rights of Patient :

Getting complete explanation of medical

treatment
Asking for other doctors opinion
Getting service appropriate to their need
Refusing medical treatment
Getting medical record
 You may expect to be treated with dignity
and respect
You may expect be accorded privacy and
confidentiality
You may expect receive care in a safe and
secure environment
You may expect to know the names of the
people caring for you
 You may expect to be given information on
your care and treatment
You may expect participate in decision
about your care
You may expect to understand your
hospital bills
You may expect to have your compliments,
concerns and complaints addressed
Obligation of Patient :

1. Giving complete and true information

about their health problem
2. Obey the advice and direction from the
doctor
3. Obey the regulation in health care facility
4. Giving fee from the service they got
3.students should be able to explain about
ethical codes in working as a doctor

Profession ethical codes: a kind of orientations to

organize moral and ethical principles in having
profession.

The orientations are composed into KODEKI

Some things that should be applied in having

profession according to ethical codes:
Profesionality
Honesty
Law
Longlife learning
 Medical ethics contains:
Sacrifices
Dedications
Submissions
Connections between doctor-patients
Connections between doctor-doctors
4.students should be able to explain about dicipline
aspects in working as a doctor

Medical diciplines: the rules for doctors to

apply knowledges in attendances

The aim of applying Medical diciplines:

To give protections to society
To defend and increase health service qualities
To keep the respects of professions
 Violations of Medical diciplines:
Medical negligence : in medical aspect
Serious profesional misconduct : in actions to
patients

Sanctions for Violations of Medical

diciplines:
Warning
Recommendations of taking STR/SIP of
Reeducation
5. Students are able to explain basic
rules of bioethics

The basic principle of bioethics

1. Beneficence
-> action that is given to patients should be
beneficial and avoid of disability

. Characteristics:
. Prioritize Alturisme
. Maximize a whole of patient's rights
. Guarantee a good life
. Try to take a good and benefit much more
than badness
2. Non-malficence
-> a principle that a doctor doesnt perform an
acts that make the patients getting worse

Characteristics:
Helping emergency patients
Treating patients whose wounds
Do not kill the patient
Dont view the patient as an object
Protect patients from attacks
3. Justice
-> the principle in which a doctor treats
equally and fairly to all of the patient.
Characteristics:
Treat everything universally
Appreciate the healthy rights of patients
Appreciate the legal rights of patients
4. Autonomy
-> Every human has the rights to determine
the actions to himself

Characteristics:
Respect the right of self-determination
Keeping the patients confidential
Implementing Informed Consent
6. Students are able to explain ethical
clearance

Ethical Clearance
-> written statement that given by research
ethics committee for research that involve
living creatures which states that a
research proposal is feasible
Requirements to ethical clearance be
issued :
Researchers submit a request to the head
EC team
Fill out papers application for approval of
EC
Completing administrative
Roles and responsibilities of the EC
commission:
1. Protect the rights, safety, and welfare of
research subjects
2. Avoid a conflict between the interests of
research and interests of subjects
3. Reviewed the protocol of the danger risk
4. Should be independent, efficient,
competent, and punctual
5. Evaluation when research in progress
7. Detail of Informed Consent

Medical Service
Objective: patient acquire enough
information
Function:
Doctor secure feeling when doing
medical services, as long as he/she
doesnt careless
Patient valuation of his/her right
Law fulfillment of consensus principle
 Research, principles:
Obtaining agreement from test subject
Using understandable language: patient dont
understand, research cannot be conducted
Giving time

Researcher doesnt have to do informed consent if

he/she refers only to medical records
8. Regulations and Institution
that Manage Medical Practice
REGULATIONS
Regulation from Indonesian Health Minister
about permission and execution in medical
practice
Indonesian medical ethical codes
UU no.29 tahun 2004
UU no.36 tahun 2009
UU no.44 tahun 2009
Standard Competence of Indonesian Doctor
Institution
MKEK
MKDKI
KKI
IDI
9. Students can explain about the
violations and sanctions of medical
practice

Pure ethics violations:

a. Take the high price from the families of
the other doctors
b. Take over the patients without any
information
c. Praise yourself in front of the patients
 Etikolegal violations:
a. The service is bad for the patients
b. Publish the fake explanation latters
c. Open the secrets of patients
Sanctions
Warning or guidance from oral and written
Delay of increase salary or grade
Decrease of salary or grade
Miss the permit of medical practice for a
while or forever
For etikolegal cases, they will get the
punishment appropriate what they do
THANK YOU