KEPANITRAAN KLINIK SMF ILMU KEDOKTERAN FORENSIK DAN

MEDIKOLEGAL

FAKULTAS KEDOKTERAN UNIVERSITAS WIJAYA KUSUMA

SURABAYA TAHUN 2022

GEDE DAMA YASA WIGUNA

22710116

INFORMED
CONSENT IN
PEDIATRICS
Dosen Pembimbing :
dr. Meivy Isnoviana, S.H, M.H
Informed Consent ?
(INFORMED CONSENT) IS A CONSENT GIVEN BY
THE PATIENT OR NEXT OF KIN AFTER
RECEIVING AN EXPLANATION IN DETAIL ABOUT
HEALTH SERVICES THAT WILL BE CARRIED OUT
ON THE PATIENT CONCERNED WITH THE
PROCESS OF INSPECTION, MAINTENANCE AND
TREATMENT.
 Four essential elements of

consent

1 2 3 4
CAPACITY DECISION KNOWLED
VOLUNTA
-MAKING GE
Capacity is the RINESS
ability to Decision-making Knowledge means
Voluntariness is
understand means the that sufficient
indicated by the
the nature of ability to information has
willingness to
treatment and take decisions. been given to the
undergo
the For a consent to patients to
treatment.
consequences of be understand the
them legally valid, all nature
the above- and consequences
mentioned of the treatment.
elements should
be present
 Informed consent
in Pediatrics
Informed consent can only be given by adults who have the ability to receive
and digest explanations from doctors. In the majority of pediatric patients
this has not been implemented. Patient autonomy as an important principle
in the ethics of the doctor-patient relationship contains correct and complete
explanations, understanding, and informed consent. This last thing is not
owned by the child, so he is shown by his parents or caregivers.
The abilities that most consistently
appear to be relevant to patients’
capacity to make logical decisions
regarding treatment fall into the
following categories:

Ability to understand relevant information

• Ability to retain, make and communicate choices
• Ability to appreciate the situation and its likely
consequences.
• Ability to manipulate information rationally
 case

A 12-year-old teenager came with his mother to the hospital, after anamnesis and
examination, the patient was diagnosed with certainty that he had acute rheumatic
fever. Consequently he must receive protection against infection with Streptococcus beta-
hemolyticus, namely benzathine penicillin every month, for at least 5 years. If the patient
refuses to be injected and chooses to be given oral drugs (penicillin V, erythromycin,
sulfa) while the parents choose to be given injections, what will the doctor's attitude be?
The doctor must explain the advantages of giving injections, namely that the
administration can be controlled and does not cause streptococcal resistance to
penicillin. On the other hand, a teenager who has had to take medication for years when
he is not at all sick can cause him to be reluctant or bored or not do it regularly. As a
result, giving becomes uncontrolled. On the other hand, many bacteria are also reported
to be resistant when given oral drugs. In this case, the mother may ignore the opinion of
her child with the consequences of having an impact on the relationship between mother
and child, especially if the child considers it a heavy burden, but after negotiating with
her child the child wants to obey her mother's words.
Ethical Dilema

Non Maleficience Autonomy

 Case Analysis

Non Maleficience Autonomy

the doctor gives informed consent about
giving the drug to the patient that the drug
is given by injection to prevent the
occurrence of drug resistance to
Streptococcus beta-hemolyticus bacteria
After giving informed consent, then agreeing,
the doctor takes action according to the
procedure and the patient's rights
Four box method of
clinical ethics
Reference