TUGAS ETIKA KEDOKTERAN

Sultony Alfin A
18710097

Pembimbing
dr. Meivy isnoviana, S.H, M.H
 CASE 1
A woman about 65 years old came to the
eye poly delievered by her daughter with
her both eyes could not see since 1 year
ago. At the beginning it comes with
progresive decreased vision in the right eye
until she cant see, followed by left eye. She
never goes to the doctor before. And then
after the opthalmologist checked it, the
patient diagnosed with matured cataract
ODS so the patient need operations for her
both eyes to bring the vision back.
 Operations are gradually done, first done on
the right eye firstly, then a few months later
performed surgery on his left eye.
But the patient refuses to perform subsequent
surgery on the left eye due to cost problems, so
that the patient only agrees to one of his eyes in
operation as long as the patient can see again
even with one eye. Then the doctor explains the
risks that occur if cataracts in the other eye are
not taken. But the patient still refused and finally
the doctor approved the patient's request so that
only surgery on one eye only.
 BENEFICIENCE

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. Try to make more benefits compared to bad. √

5. Responsible √

6. Ensure a good minimum human life √

7. Limitatin Goal-Based √
 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: √

a) The patient is in a dangerous condition.
b) Doctors are able to prevent harm or loss.
c) The medical action proved effective
d) 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 √
 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 √
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. √
Maintain relationship (contract) √
JUSTICE

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. √
 Criteria Yes No
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.
 4 BOX METHOD
1. Medical indication
Female patients aged 65 years came to the eye with a
complaint of his right and left eye could not see since 1
years ago.
2. Quality of life
The doctor conducts inspections and plans to perform
surgery actions on both patients ' eyes. After surgery is
expected the vision in both patients ' eyes can be normal
again.
3. Client preference
The age of the patient is quite age, the right to fully
autonomy in the patient's hands, the patient is able to
provide informed consent, the patient is entitled to
treatment and service.
4. Contextual feature
Patients are not participants of BPJS.
 Prima facie
Autonomy
Respecting the right of patients taking
the option of not performing surgery on
the other eye
 PRINSIP PROFESIONALISME

Excelence Yes
Doctors maintain high service quality
Accountability Yes
The Doctor is responsible for the patient while still providing
education to the patient about the Risks that occur in the event
of surgery.
Alturisme Yes
The doctor prioritizes the patient's health to ask the patient to
undergo surgery on both eyes.
Duty Yes
Doctors do their job in accordance with the procedure, which for
the diagnosis of cataract Matur will be better when performed
surgery, in accordance with the operational standards of the
procedure.
Respect Yes
The doctor respects the patient's decision by only performing
surgery on one eye of the patient.
Humanity No
 CASE 2

9-month-old baby came to the Hospital on Thursday. Patients present

with heat, coughing for 1 week, cold chills, and heavy breathing
(dypsneu). On this indication the doctor keeps the emergency room
in the patient's PICU room. After the doctor guarded the patient's
family about the patient's condition, the child's father refused to
enter the patient in the PICU room and chose to be treated in a
regular inpatient room. After being given a re-explanation of the
condition of the patient, the patient's family finally wanted to be
treated in the PICU room, but because there were other patients
with PICU emergency, they became full. After being given
treatment in the emergency room, the patient's family finally
wanted to be treated in the inpatient room with the patient being
given oxygen. At 23:00 the patient arrived in the inpatient room
and the condition of the patient worsened. Around 6:00 a.m. the
patient died in the inpatient room. Grateful, the patient's family
accepts the condition of his child who has left the family forever
 BENEFICIENCE

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. Try to make more benefits compared to bad. √

5. Responsible √

6. Ensure a good minimum human life √

7. Limitatin Goal-Based √
 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:

a) The patient is in a dangerous condition. √
b) Doctors are able to prevent harm or loss. √
c) The medical action proved effective
d) 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 √
 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 √
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. √
Maintain relationship (contract) √
JUSTICE

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. √
 Criteria Yes No
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.
 4 BOX METHOD OF CLINICAL ETHICS

Medical Indications Client Preferences

Patients present with the decision is in both

cold acral, decreased parents. The doctor
consciousness, and gives education
Quality of Life Contextual Features
heavy breathing
(dypsneu).
he patient cannot be saved Is there a relationship between
doctor Can minimize the patient's socio-economic
complications during treatment conditions in making treatment
decisions? There are, economic
conditions
Ethics dilemma

Beneficence
Non Maleficence

Prima Facie : Non Maleficence

 PRINCIPLE
PROFESIONALISME

Altruism: yes
Duty: There
Respect for others: yes
Accountable: Yes
Humanity: yes
THANK YOU