Presentation

“Moral Basic Principle”

By:
Group D
RST Dr. Soepraoen Malang

Medical Faculty
Wijaya Kusuma Surabaya University
 Presentation
“Moral Basic Principle”

By:
Rossa Setyowati
17710099
RST Dr. Soepraoen Malang Group D

Medical Faculty
Wijaya Kusuma Surabaya University
 CASE 1
A 28 years old pregnant women with gestational aga 36-37 week
G1P0000Ab000 patient come to the emergency unit RST Dr. Soepraoen with
tension headache, nausea and vomiting symptoms. When examining vital signs
the blood pressure is 160/90 mmHg. The regular control patients in midwives
and don’t have hypertensive history during pregnancy. The doctor reported to
doctor SpOG and doctor SpOG asked that patient be treated at the hospital to
control his blood pressure, because when the blood pressure gets higer, it will
cause seizures and life-threatening conditions , then the doctor explains to the
patient’s husband like what doctor SpOG is saying. The patient’s husband
agreed to be treated at the hospital. When she arrived at the room, the patient
complaining that the head was getting worse and suddenly the patient was
seizure, then the doctor kept giving therapy to overcome the seizure and
reported to doctor SpOG, and doctor SpOG asked that the patient be prepared
for cito section caesares after the seizure was overcome. the doctor explained
to the patient's husband that he must immediately do cito section caesares to
help the mother and the baby. the husband and family agreed and asked the
doctor to do their best.
 Beneficence
Criteria Yes No
1. Prioritizing altruism (helping selflessly, willing to sacrifice) √

2. Guaranteeing the basic values of human dignity √

3. Looking at the patient / family and something not to the √

advantage of the doctor
4. Trying to make the benefits more than the evil. √

5. Responsible √

6. Ensure a good minimum human life √

7. Restriction Goal-Based √
 Beneficience

Criteria Yes No
8. Maximizing the satisfaction of happiness / patient √
preferences
9. Minimize adverse consequences. √

10. Obligation to help emergency patient √

11. Respect the patient's rights as a whole √

12. Do not withdraw honoraria beyond appropriateness √

13. Maximizing the highest satisfaction overall √

14. Develop the profession continuously √

15. Providing nutritious yet inexpensive medicine √

16. Applying the Golden Rule Principle √

 Non Maleficence

Criteria YES NO
1. Helping emergency patient √
2. The conditions for describing these criteria are: √
• The patient is in a dangerous condition.
• Doctors are able to prevent harm or loss.
• The medical action proved effective
• Benefits for patient > doctor's loss (only experiencing
minimal risk).
3. Treat injured patient √
4. Do not kill patient (do not do euthanasia) √
5. Not insulting √
6. Do not view patient as objects √
7. Treating disproportionately √
 Non Maleficence

Criteria Yes No

8. Do not prevent patient dangerously √

9. Avoid misrepresentation of patient √

10. Do not endanger the patient's life due to negligence √

11. Does not give life spirit √

12. Does not protect patient from attacks √

13. Do not do white collar in the health field √

 Autonomy

Criteria yes No

1. Respecting the right to self-determination, respecting the √

dignity of patient.
2. Do not intervene in patient in making decisions (under √
elective conditions)
3. Put on the line √

4. Appreciate privacy. √

5. Keep personal secrets √

6. Appreciate patient rationality. √

7. Carry out informed consent √

 Autonomy

8 Allowing adult patients and competent to make their own √

decisions.

9 Do not intervene or obstruct patient autonomy. √

10 Prevent other parties from intervening in patients and making √

decisions, including, including the patient's own family.

11 Patiently waiting for the decision to be taken by the patient in a √

non-emergency case.

12 Don't lie to the patient even for the benefit of the patient. √

13 Maintain relationship (contract) √

 Justice

No Criteria Yes No
1 Enact everything universally √

2 Take the last portion of the dividing process he has done. √

3 Giving equal opportunities to individuals in the same position. √

4 Respecting patients' health rights (affordability, equality, √

accessibility, availability, quality)
5 Appreciate the legal rights of patients. √
6 Respect the rights of others. √
7 Maintain vulnerable groups (the most disadvantaged) √

8 Do not abuse. √
 Justice

9 Wise in macro allocations. √

10 Provide a contribution that is relatively the same as the patient's √

needs

11 Request patient participation according to ability. √

12 The obligation to distribute profits and losses (costs, expenses, √

sanctions) fairly

13 Return rights to the owner at the right time and competent. √

14 Does not give heavy burden unevenly without valid reasons √

15 Respect the rights of the population who are equally susceptible to √

diseases / health problems.

16 Does not distinguish patient services on the basis of SARA, social √

status etc.
 NON-
AUTONOMY
MALEFICIENCE

NON-
PRIMA FACIE
MALEFICIENCE
Ethical priciples
• Non- Maleficence:
Doctors want to save patient’s and baby life who are in an
emergency

• Autonomy :
The doctors respect the patient’s decision

• Prima Facie : Non- Maleficence

 4 Box Method
Medical Indications

• 28 years old pregnant women with gestational

aga 36-37 week G1P0000Ab000.
• with tension headache, nausea and vomiting
Client Preference
symptoms, blood pressure is 160/90 mmHg.
suddenly the patient was seizure
• The patient receives the action
• The patient case was emergency
recommended by the doctor
• SpOG will do cito section caesarea to save the
mother and baby

Quality Of Life
Contextual Features
• With cito section caesarea will save mother and
• There is no relationship between the socio-
baby, but if the cito section caesarea isn’t done
economic conditions of patients in making
immediately, it can cause fetal distress
treatment decisions
 Professionalism

• Accountability : Doctors always prioritize patients with emergency

conditions.
• Alturism : Doctors are very concerned about the patient's
condition.
• Duty : The doctor follows a medical procedure.
• Respect for others : Doctors always try to understand the patient's
condition.
• Humanity : Doctor have empathy for patients
Ordinary or Extraordinary

ORDINARY
 CASE 2
A 32 years old male patient come to the
emergency unit RST Dr. Soepraoen with pain complaints
on the sweet fingers after the traffic accident. The doctor
did a physical and support examination and got a close
fracture 1/3 medial digiti four manus dextra, then the
doctor put neighbouring on the right finger and
suggested surgery immediately, but the patient refused
and asked to go home because the patient did not have
the cost if the surgery was carried out. The doctor only
gave analgesic medicine to take home.
 Beneficence
Criteria Yes No
1. Prioritizing altruism (helping selflessly, willing to sacrifice) √

2. Guaranteeing the basic values of human dignity √

3. Looking at the patient / family and something not to the √

advantage of the doctor
4. Trying to make the benefits more than the evil. √

5. Responsible √

6. Ensure a good minimum human life √

7. Restriction Goal-Based √
 Beneficience

Criteria Yes No
8. Maximizing the satisfaction of happiness / patient √
preferences
9. Minimize adverse consequences. √

10. Obligation to help emergency patient √

11. Respect the patient's rights as a whole √

12. Do not withdraw honoraria beyond appropriateness √

13. Maximizing the highest satisfaction overall √

14. Develop the profession continuously √

15. Providing nutritious yet inexpensive medicine √

16. Applying the Golden Rule Principle √

 Non Maleficence

Criteria YES NO
1. Helping emergency patient √
2. The conditions for describing these criteria are: √
• The patient is in a dangerous condition.
• Doctors are able to prevent harm or loss.
• The medical action proved effective
• Benefits for patient > doctor's loss (only experiencing
minimal risk).
3. Treat injured patient √
4. Do not kill patient (do not do euthanasia) √
5. Not insulting √
6. Do not view patient as objects √
7. Treating disproportionately √
 Non Maleficence

Criteria Yes No

8. Do not prevent patient dangerously √

9. Avoid misrepresentation of patient √

10. Do not endanger the patient's life due to negligence √

11. Does not give life spirit √

12. Does not protect patient from attacks √

13. Do not do white collar in the health field √

 Autonomy

Criteria yes No

1. Respecting the right to self-determination, respecting the √

dignity of patient.
2. Do not intervene in patient in making decisions (under √
elective conditions)
3. Put on the line √

4. Appreciate privacy. √

5. Keep personal secrets √

6. Appreciate patient rationality. √

7. Carry out informed consent √

 Autonomy

8 Allowing adult patients and competent to make their own √

decisions.

9 Do not intervene or obstruct patient autonomy. √

10 Prevent other parties from intervening in patients and making √

decisions, including, including the patient's own family.

11 Patiently waiting for the decision to be taken by the patient in a √

non-emergency case.

12 Don't lie to the patient even for the benefit of the patient. √

13 Maintain relationship (contract) √

 Justice

No Criteria Yes No
1 Enact everything universally √

2 Take the last portion of the dividing process he has done. √

3 Giving equal opportunities to individuals in the same position. √

4 Respecting patients' health rights (affordability, equality, √

accessibility, availability, quality)
5 Appreciate the legal rights of patients. √
6 Respect the rights of others. √
7 Maintain vulnerable groups (the most disadvantaged) √

8 Do not abuse. √
 Justice

9 Wise in macro allocations. √

10 Provide a contribution that is relatively the same as the patient's √

needs

11 Request patient participation according to ability. √

12 The obligation to distribute profits and losses (costs, expenses, √

sanctions) fairly

13 Return rights to the owner at the right time and competent. √

14 Does not give heavy burden unevenly without valid reasons √

15 Respect the rights of the population who are equally susceptible to √

diseases / health problems.

16 Does not distinguish patient services on the basis of SARA, social √

status etc.
 NON-
AUTONOMY
MALEFICIENCE

NON-
PRIMA FACIE
MALEFICIENCE
Ethical priciples
• Non- Maleficence:
The doctor suggested the patient to take a surgery
treatment so the patient didn’t suffer

• Autonomy :
The doctors respect the patient’s decision

• Prima Facie : Non- Maleficence

 4 Box Method
Medical Indications

• A 32 years old male.

• with pain complaints on the sweet fingers after
Client Preference
the traffic accident
• The diagnose is fracture 1/3 medial digiti four
The patient is the decision
manus dextra
maker
• The case was acute disease
• The doctor suggested surgery immediately

Contextual Features
Quality Of Life
• There is relationship between the socio-
• The patient have to take surgery treatment. If
economic conditions of patients in making
he doesn’t, infection or contracture can happen
treatment decisions
 Professionalism

• Accountability : Doctor explain the patient condition

• Alturism : Doctors are very concerned about the patient's
condition.
• Duty : The doctor follows a medical procedure.
• Respect for others : Doctor decides to give supporting medicines to
decrease the symptoms
• Humanity : Doctor have empathy for patients
Ordinary or Extraordinary

ORDINARY