THE REVIEW

ETHICOMEDICOLEGAL ASPECT
OF ACCUPUNCTURE IN MEDICAL
PRACTICE
TINJAUAN ASPEK ETIKOMEDIKOLEGAL
PADA PRAKTIK AKUPUNKTUR MEDIK

Soetedjo

Vice Chairman of The Central of MKEK ( 2015-2018)

Presented in Up Gradding Doctor Capacity
of Accupuncture Medical Services
Jakarta, February 7th, 2017
 SEKAPUR SIRIH

• Ass Wr Wb,
• Properous regards to all of us, and Good morning
• Ladies and Gentlemen
• First of all, I would like to thank to God, who has given us hints
and guidance also wealthy, healthy and safety, so we can attend
this meeting to day.
• The second, thanks to coordinating committee who has given me
a good chance to be speaker, in the topic about : THE
ETHICOMEDICOLEGAL ASPECT OF ACCUPUNCTURE IN
MEDICAL PRACTICE. This topic is very important to be
discussed, because doing by doctors.
 THIS TOPIC IS VERY IMPORTANT TO
BE DISCUSSED, BY MANY REASONS

1. To day many high interests to discuss the

ethicomedicolegal aspect than before.
2. This problems rising not only by development of high
science and high technology, but also, changed of
the political, law and social cultural in our society.
3. The question is how the review of the
ethicomedicolegal aspect of medical accupuncture ?
 DEVELOPMENT OF
MEDICAL ACCUPUNCTURE
1. Ilmu pengobatan akupunktur berasal dari negeri
Tirai Bambu Cina dan sudah berkembang sejak
4000-5000 tahun yang lalu.
2. Sejak jaman Dinasti Tang ( 265-960) sampai Dimansti Ming
(960- 1644) akupunktur berkembang bersama ilmu-ilmu lain.
3. Pada abad XX akupunktur berkembang menyesuaikan diri
dengan ilmu kedokteran modern, dan sejak 1955 telah
menjadi mata pelajaran ilmu kedokteran di Cina.
4. 1962. Tim Ahli Akupuntur dari Cina didatangkan
untuk mengobati Presiden Soekarno.
(Rajin M, Masruroh, Ghofar; 2015)
 DEVELOPMENT OF
MEDICAL ACCUPUNCTURE IN
INDONESIA
4. 1963, Menteri Kesehatan RI Prof. Dr. Satrio,
meresmikan Tim risert akupunktur di bagian Ilmu
Penyakit Dalam RS CM Jakarta.
5. 1975. Bermunculan organisasi pengobat akupunktur seperti:
IAI ( Ikatan Akupunktur Indonesia), PAI (Persatuan
Akupunktur Indonesia), INI ( Ikatan Naturopati Indonesia),
6. 1986. ( 5-6 Des ). Munas Akunkputuris Indonesia,
Ketiga organisasi tersebut melebur menjadi PAKSI
( Persatuan Akupunkturis Seluruh Indonesia).
(Rajin M, Masruroh, Ghofar; 2015)
 DEVELOPMENT OF
MEDICAL ACCUPUNCTURE IN
INDONESIA
7.1990. didirikan LP3A ( Lb. Penelitian &
Pengembangan Pelayanan Akupunktur) di
Surabaya.
8. 1996 . LP3A, kerjasama dengan Victoria University
( Australia), dalam pengembangan SDM dan Risert
tentang Akupunktur.
9. 1996. Permenkes No. 1186 tentang Pemanfaatan
Akupuntur di Sar-kes.
10. 1999. Dr. Koosnadi Saputro, dr. SpR, memperoleh
gelar: Doktor Akupunktur pertama di Indonesia.
 DEVELOPMENT OF
MEDICAL ACCUPUNCTURE IN
INDONESIA

11. Dalam perkembangannya RSCM mendidik tenaga

dokter akupunktur yang memenuhi persyaratan
ijazah yang diakui, sampai sekarang. Akhirnya
kelompok dokter akupunktur ini diakui oleh PB IDI
lewat Muktamar IDI, sebagai Organisasi Seminat
dengan nama HIDAMI atau Himpunan Dokter
Akupunktur Medik Indonesia, dengan ketuanya
saat ini
Dr. H Sukarto, SpKP.
(Direktori IDI 65 tahun, 2015).
 THE LIMITATION
OF REVIEW /DISCUSSION
1. Secara juridiksi, bahasan atau diskusi ini hanya
pada Ethicomedicolegal Dokter Akupunktur
Medik, yang telah mempunyai organisasi
seminat ( HIDAMI: Himpunan
Akupunktur Medik Indonesia)
2. Untuk pelaku Akupunktur non- dokter telah
mempunyai pula organisasi akupunktur yang
lain, yaitu PAKSI: (Persatuan Akupunturis
Seluruh Indonesia).
 THE DIFFERENCE OF

ACCUPUNCTURE MEDICINE
1. FROM THE EAST. 1. FROM THE WEST
2. BOK / POHON ILMU. 2. B O K, DIFFERED.
3. CLASSICAL 3. “ADVANCE/ MODERN
ACCUPUNCTURE. ACCUP.
( NON DOCTOR), ( DOCTOR)
4. FROM CLASSICAL TO 4. EVIDENCE BASE=
EVIDENCE BASE. MODERN.
5. ACCUPUNCTURE HAS 5. = THE WEST -> TO
LEARNED BY THE WEST. LEARN THE EAST.
 THE DIFFERENCE OF
ACCUPUNCTURE MEDICAL ACCUPUNCTURE

6. ACTION BY NON- 6. BY DOCTOR; GEN/

DOCTOR. SPECIALIST.
7. BY COURSE AND 7. MEDICAL FACULTY/
D3 EDUCATION. SPECIALIST EDUC.

8. PURE OR DRY NEEDLING 3. THE ALL, PLUS HIGH

TECHNICAL
ACCUPUNCTURE AND ACCUPUNCTURE;
ACCUPRESURE. ELECTRIC ACCUP, LASER
ACCUP, SONO ACCUP,
AQUA ACCUP.
 THE IMAGE OF
ACCUPUNCTURIST DOCTOR
1. HE/SHE IS A DOCTOR, of course to think and work hard in
accordance with Physician oath and Medical Code ( KODEKI).
2. HE/SHE IS A ACCUPUNTURIST, of course he/she
also allow to discipline / ethical prosedures of
accuncputurisme.
3. IN ACCUPUNCTURE MEDICAL SERVICE, he/she always ask
hem/her self, WHO IS HE/SHE to face patient illness, sickness
or their diseases.
4. HOW ACCUPUNTURIST DOCTOR TO ACT
GENERAL OF TRILOGY COMPULSION :
Diagnosis, Threatment, n Prognosis.
5.
 HOW DOES ACCUPUNTURE – DOCTOR
TO FACE HIM/HER SELF.
(MAY CONTEMPLATION)

A.FIXED AS A DOCTOR, Accupuncture practice

for me as my bonus.( BPJS Era).
B. DOUBLE, MEDICAL PRACTICE, as a medical
service and also do as Accupuncture practice. ( May be
for Non-BPJS patient).
C. PATIENTS MAY CHOOSE. SERVICE by Medical
doctor, or Accupuncturist services, or Both.
D. HOW ABOUT IF PATIENT WANT ACCUPUNCTURE
SERVICE, but by doctor who has BPJS facility. (?).
 THE BOARD OF CONDUCT (DEWAN
ETIK) HIDAMI

1. HIDAMI, perlu kiranya mempunyai Dewan etik atau

sejenisnya.
2. Dewan etik HIDAMI berfungsi PEMBINAAN, dan TIDAK
BERFUNGSI KEMAHKAMAHAN, JADI tidak bisa
SECARA RESMI memberikan SK pelanggaran etik
anggotanya. TUGAS TSB TUGAS MKEK.
3. Dewan Etik HIDAMI atau Peer goup, berfungsi
sebagai Saksi Ahli, manakala ada anggotanya
diadukan pada IDI/ MKEK SESUAI TINGKATAN
4. Dewan etik HIDAMI menyusun Special ethic ATAU Etika
khusus berhubungan dengan ke akunk- punturan .
 The Wisdom Words of
Clinical practice

Medical accupuncture (doctors), have two

lamps of knowledge and understanding
to enter the body of their patients. GREAT.
 PATIENTS (?)
1. Peoples who hope their medical problem
saved by doctor, that...
2. In general they don’t fully understand about
medical science, and accupuncturisme but they
feel illness, sickness and (suffering of) disease,
and....unfortunatly...
3. They haven’t capability to control performance
and doctors attitude, so that they included
(as vulnerable group).
4. Because they were in vunerable group , they
need protections, by Moral, ethic, medical
regulations, by HIDAMI and MKEK /IDI.
5. Included Medical oath, Medical code,
Accupuncture code, Disciplin and Laws.
1. Man is Creature of God creation, with biologic system
very outstanding complex. And just only a little part of
this system capable of mastered by human intelligence,
as docotrs. Patients are unique creature in (constantly
changing & growing).

2. Patients as a human have : a. Physiological

demands; b. Social and psychological demands;
and c. Intellectual and spiritual demands.
 WHAT WILL YOU DO ?
IF PATIENT ‘S DEMANDS....

To be Listened, to Sympathy,
Medication*, Note of sickness (MR),
The Truth, no Harm, Told what to do,
Professinalisme, Feel better, a Cure,
Comfort, a Chat, Advice he/she
understands, the Answer, Agenda what
they want.
 IF, THE REASONS OF THE
PATIENTS TO GO TO THE
DOCTORS ...LIKE THESE.
They feel ill their physically, They
feel ill mentally, They need advices,
They want time off work, They don’t
know who make them healthy, They are
lonely, They have marital/ family
problem, And may be any Legal
reasons.
 THE AIM OF TREATMENT

1.To cure the disease *. Menyembuhkan penyakit.

2. To health promotion or preventive medicine. Promosi
kesehatan atau pencegahan penyakit.
3.To maintain or to increase QOL. Mempertahankan atau meningkatkan
QOL.

4.To Prevent of death that has not been in time.** Mencegah

kematian yang belum waktunya.
. (Johnson, et al, Dahlan S.)
 THE AIM OF TREATMENT

.
5 To maintain functional state or compromise
condition. Mempertahankan status fungsional atau menjaga
kondisi kompromistis
6. Education and consulting according condition
and prognosis. Edukasi serta konseling, kaitannya dengan
kondisi dan prognosis.
7. To protect severity or dangerous during
caring***. Mencegah memberat /bahaya selama dlm
perawatan.
8. Hopice care. Membimbing kematian dgn tenang .
8. (Johnson, et al, Dahlan S.)
 AS
ASWE
WEKNOW
KNOW
THE
THE ONE
ONEOF
OF THE
THE IMPORTANT
IMPORTANTTASK
TASKOF
OFTHE
THE
DOCTOR
DOCTORIS
ISCLINICAL
CLINICALCASE
CASEMANAGEMENT
MANAGEMENT,,
THAT
THATCONSIST
CONSISTOFOFTRILOGY
TRILOGYCOMPULSIONS
COMPULSIONS
WITH
WITHEXTENTION
EXTENTIONININMORAL,
MORAL, ETHICS,
ETHICS,AND
AND
LAWS.
LAWS.
 TRILOGY COMPULSIONS OF
CLINICAL CASE MANAGEMENT
1. Diagnosis: ( 2 kind of methode)
How to recognize the cause of symptom, sign, and
syndrome to determine, what kind of diseases.
2.Treatment: ( 2 kind of methode)
To reduce and eliminate the symptom, to make
recover and better again, and also to restore sense of
well-being.
3.Prognosis: ( 2 kind of methode)
Estimating the extent of patients suffering from
remain treated or not.
(Curran, W; Dahlan S)
The question is: What’s the most difficult?
And, Especially in Medical accupuncture?
 THE DIAGNOSIS
1. The effortS of the doctor as the most
difficult, so that effort can produce 3
possibilities,
2 . Those are:
o a. Correct diagnosis;
o b. Misdiagnosis (salah diagnosis);
o c. Undiagnosis (tidak dapat didiagnosis).

The quetion is: How to build Dx,

in Medical Accupuncture?. Gold standar?
 MISDIAGNOSIS
MISDIAGNOSIS
(AS COMPARISON)
The
Thenumber
numberof ofmisdiagnosis
misdiagnosisinin advanced
advancedcountry
countrystill
still
high
high, ,around
around17%.
17%.
Even
Evenin
inEmergency
Emergencyunit
unit(UGD)
(UGD)reach
reach 2020%%--40
40%.
%.

Misdiagnosis
Misdiagnosis isiscaused
causedby by::
oo 1.1.Mistake
Mistake/ /error
error by
bydoctor.
doctor.
oo 2.2.Mistake
Mistakeby byspecialist
specialist/ /Consultant
Consultant
oo 3.3.Mistake
Mistakebybylaboratory
laboratoryfinding
findingf/medical
f/medical
equipment
equipment
oo 4.4. Patient
Patientconstribution;
constribution;through
throughmany
manyways.
ways.****
****
(Curran,
(Curran,W,
W,J,J,1980)
1980)
 MISDIAGNOSIS
MISDIAGNOSIS

Should
Shouldbebeunderstood
understood::
1.1.That
Thatall
allmisdiagnosis
misdiagnosis isisnot
not malpractice,
malpractice,although
although
misdiagnosis
misdiagnosiswillwillbe
beproduced
producedinaccurate
inaccuratetreatment.
treatment.

2.2.Catagories
Catagories as
asmalpractice
malpractice ififmisdiagnosis
misdiagnosisproduce
produceby
by
mistake
mistakeororcarelessness,
carelessness, in
inprosedure
prosedureapplication
applicationof
of
diagnosis.
diagnosis.

The Q : Is that true medical accupuncture

without Misdiagnose?
 WHY
WHY DO
DOWE
WENEED
NEEDLABORATORY
LABORATORY
EXAMINATION
EXAMINATION//MEDICAL
MEDICALEQUIPMENT?
EQUIPMENT?

Because
Becausenot
notall
allmedical
medicalinformation
information
about
aboutpatient
patientcan
canbe
beobtained
obtained only
only by
by
anamnesis
anamnesisand
andphysical
physicalexaminatiom.
examinatiom.
The Q is : How about in Medical accupuncture?
Using medical equipment? Or without.
 THE LABORATORY FINDING AND
MEDICAL EQUIPMENT ARE NEEDED TO:

1. Help the true diagnosis, of course need Gold Standard

2. To detemine stadium, severity and progress of the
disease. Memastikan stadium
3.Prognosis estimation, with or without treatment.
4.To know the effect of treatment.
5. To know the improvement of therapy that has been
given.
6. To determine clinical wisdom. .
 HIGH TECHNOLOGY
1. There are many High- tech equipment to help doctors
to make diagnosis.

2. The main purpose high-tech equipment just only to :

oTo increase accuracy.
oTo decrease the uncomfordable and the risk .
oTo widen the view of making diagnosis. .
(Gibbons, T, B, 1980, Dahlan S )

3. So, The High-tech equipment just only to decrease and

not to remove the number of misdiagnosis.
 NEED NOTICE
BE CAREFUL

 To diagnose with High sensitive test, may produse more

Misdiagnosis, of course may have more alarm.
 The result of light test may be decide as false positive .

(Sandars, J, 2007)
 THE EFFORT TO HAVE DIAGNOSIS,
BY CONSULTANT DOCTOR IS
VERY IMPOTANT, WHY?
BECAUSE
BECAUSE::::
““NO
NODOCTOR
DOCTORCAN
CANBE SPECIALISTIN
BESPECIALIST INALL
ALL
AREAS
AREASOF
OFMEDICINE.”
MEDICINE.”
CONSULTATION
CONSULTATIONNEEDNEEDIN
INTHE
THEFRAME
FRAME::
oo ERECTING
ERECTINGOFOFDIAGNOSIS
DIAGNOSIS;;
oo SPECIFICATION
SPECIFICATIONOF
OFPROGNOSIS;
PROGNOSIS;
oo DECISION
DECISIONOF
OFTREATMENT
TREATMENT AND
ANDANOTHER
ANOTHERCLINICAL
CLINICAL
WISDOM.
WISDOM.
How about in medical accupunctur?
 CONSULTATION

The request primary doctor to consulting doctor to give

opinion and recomendation about patient
problem.

Often called: Consultation only

Consultation needed, by many reasons :
1. Primary doctor doubtful or may be do not
understand enough the problem area.
2. Primary doctor need confirmation / recomendation.
 RESPONSIBILITY OF
THE CONSULTAN DOCTOR

Consultant doctor just responsible as a moral, and

ethical only to recomendation he/she has been
given.

DPJP responsible in moral, ethical and in legal, to all

wisdom of treatment, included recomendation
from consulting doctor as a part of its reference.

Of course primary doctor can agree or not with that, or

must be careful to application.
 HOW
HOWABOUT
ABOUT IF
IF PATIENT
PATIENT
NEED
NEEDREFERRAL
REFERRAL??

1.1.LIMITATION
LIMITATIONOF OFTHE
THEDOCTORS,
DOCTORS,IN:
IN:
a.a. COMPETENCY;
COMPETENCY;OR OR
b.
b. CLINICAL
CLINICALPRIVILEGE
PRIVILEGE THEIR
THEIRHAVE.
HAVE.
2.2. LIMITATION
LIMITATIONOFOFTHE
THEHOSPITAL,
HOSPITAL,ESPECIALY
ESPECIALY IN:
IN:
a.a. MEDICAL
MEDICALSTAFF;
STAFF;
b.
b. HOSPITAL
HOSPITALEQUIPMENT
EQUIPMENTININTHE
THEHOSPITAL.
HOSPITAL.
 REFERRAL
Refferal is request DPJP ( primary doctor) to Referral
doctor to handle special problem as a part or all.

It’s called consultation with management, because

consultas doctor also give treatment.

DPJP or referral doctor have responsibility of moral, ethic

and legal to their clinical wisdom respectively.
 SECOND OPINION
The Second opinion is request by another doctor to review
his/ her patient that is being managed. That is more
patient right and just according regulation, than the right
of his/ her doctor ( DPJP).
Second opinion, can be use to corfirmation the first
diagnosis relationship with treatment that still going
on, although the opinion of the second doctor can
also makes difficulty to the first doctor ( DPJP).

o Better do as soon as their can to avoid delay of the

treatment.
 CLINICAL ETHICS
Is Practical disciplin that served structural approach,
useful to introduction, analysis, and to be done ethical
isues in medical clinic.

The referrence are :

1. Medical Indication.
2. Patient Preferences ( for ex : DNR).
3. Quality of Life.
4. Contextual Features.
(Jonsen, Siegler dan Winslade, 2006)
 .
WHEN MEDICAL ACCUPUNCTURE
HAVE MALPRACTICED(?)
WHEN CALL WITH :
1. MALPRACTICE , Malparaktik.
2. NEGLIGENCE,Kelalaian,hukum, mgd sifat pelaku.
3. ERROR JUDGEMENT. Kesalahan penilaian
4. ACCIDENT, MISFORTUNE, Kecelakaan medik
5. SCHULD IN CRIMINAL LAW, Kesalahannya hrs jelas
6. NEGLIGENCE IN CIVIL LAW, Melanggar kew. hkm
7. NEGLIGENCE IN CRIMINAL LAW , Kealpaan sehingga pasien
cacat/ meninggal.
CATATAN : PERLU DIRUMUSKAN OLEH
DEWAN ETIK HIDMI. !!!
 ACCUPUNCTURE
MEDICAL MALPRACTICE
1. Malpractice, is general term, should not be in
yuridical conotation.
2. Mal is wrong, practice is doing/ management, so this
meaning is wrong doing or wrong management.
3. In the profession, (as ACCUPUNCTURIST), wrong
management so called with Professional
Accupuncture Misconduct.
4. According to the profession involved norm, ethical and law, the
wrong doing in Medical profession by ethical view called :
Ethical malpractice, and by law called: Yuridical
malpractice.
A.DEFINITION OF
MALPRACTICE (1)
 B. DEFINITION OF
MALPRACTICE (2)
2. Malpractice is wrong doing; (law)
improper treatment of patient by medical
attendant; illegal action for one own
benefit while in position of trust.
@ Tindakan yang salah ( secara hukum), pengobatan yang tidak patut pada
pasien oleh petugas medis; tindakan melanggar hukum untuk satu keuntungan
pribadi dalam posisi kepercayaan.
 C. YURIDICAL
MALPRACTICE

 1. ADMINISTRATIVE MALPRACTIVE
 2. CIVIL MALPRACTICE
 3. CRIMINAL MALPRACTICE
 1. ADMINISTRATIVE
MALPRACTICE

If Accupuncturist medical doctor

violated Goverment administration
law.
For examples:
a. Practice without Registration Letter and/ Lisence.
b. Managed patient not in according Lisence/
previllage.
c. Practice with invalid Lisence.
d. Not written patients in Medical record.
 2. CIVIL MALPRACTICE
If Accupuncturist medical doctor didn’t give a
good prestation according their agreement.
In this case, doctor can be sued by basically Civil-malpractice,
for giving immaterial-compensation, although just only feel
worry while waiting her/ his attandance.
3. For example :
a. Negative act to do according agreement.
b. To do according agreement but late.
c. To do according agreement but uncomplete.
d. To do according agreement, is not supposed to do. .
 3. CRIMINAL MALPRACTICE
If we meet formulas of criminal offense.
1. Those action, positive act or negative act shall
constitute actus reus ( perbuatan tercela).
2. Has been done with wrong attitude ( mens rea) :
dengan sikap bathin yang salah,
For examples :
Intensional ( kesengajaan),
Recklessnes ( kecerobohan),
Negligence ( kealpaan)
 II. MEDICAL
NEGLIGENCE

Negligence has been defined as “

Conduct which below the standard,
established by law for protection of
the others againt unreasonable risk
of harm.”
 THE ELEMENTS OF
MEDICAL NEGLIGENCE
 The plaintiff must establish the following
elements:
1. (D1): Duty of care. That a duty of care was owned by
the physician to the patient.
2. (D2): Direlection of duty. That the physician violated
the applicable standar of care.
3. D3).: Damage. That plaintiff suffered a compensable
injury.
4. (D4): Direct causation. That such injury was caused
in fact and proximately caused by the substandard conduct.
 MEDICAL NEGLIGENCE
( IN ENGLISH: 5)
1. Malfeasance : Execution of an unlawful or improper act
( Tindakan yg bertentangan hukum/ tidak patut)
2. Misfeasance : The improper performance of act
( Pelaksanaan tindakan yang tidak benar)
3. Nonfeasance : The failure to act when there is a duty to act
( Tidak melakukan tindakan yang sebenarnya ada kewajiban)
4. Maltreatment : Improper or unskillful treatment
( Sembarangan)
5. Criminal negligence: Reckless disregard for safety another
( Sifat acuh tak acuh, dengan sengaja, tak peduli keselamatan
orang lain).
 III. MANY KINDS OF
ERROR

1. DIAGNOSTIC ERROR
2. TREATMENT ERROR
3. PREVENTIVE ERROR
4. OTHERS
 III. MANY KINDS
OF ERROR (1)
1. Diagnostic Error:
a. Mistakes and late diagnosis.
b. Not use the diagnosis test of which has been
recommended.
c. The use test which has been out of date..
d. Not do any action on the test resut on the
monitoring.
Salah/terlambat, tak direkomendasikan,kedaluwarsa , tak berbuat apa2
 III. MANY KINDS
OF ERROR (2)
2. Treatment Error:
a. Error of treatment process, working or test
procedure.
b. Error in giving treatment.
c. Error of dosage measured or giving medicine.
d. Avoidable delay, keterlambatan yang dapat dicegah .
e. Commits to acts are not in right or nor indicated.

Proses/ tes prosedur, pemberian,dosis, terlambat, tak ada indikasi

 MANY KINDS
OF ERROR (3)
3. Preventive Error:
a. Not provide prophylactic treatment.
b. Not enough monitoring conduct or follow up of
therapy and the medical action have been given.

Tidak cukup melakukan monitoring atau follow up terhadap terapi dan

Leape et al, Quality Review Bulletin, 1993

 III. MANY KINDS
OF ERROR (4)

4. Others:
 a. Communication failure, kegagalan komunikasi.
 b. Equipment failure, kegagalan peralatan
 c. Failure of anothers systems,
kegagalan dari sistem- sistem lainnya
 IV. ABANDONMENT
( PENELANTARAN)

 The elements of Abandonment :

1. There is doctor-patient relationships.
2. The relationship cut by doctor without patient or
family agreement.
3. There is continuing needs of medicine for patient.
4. And the abandonment cause damage or patient death.
 IV. ABANDONMENT
( PENELANTARAN)

1. Refuse to cure by doctor, after he/she takes

examination to the patient.
2. Refuse to hold the case that he/she has agree to cure.
3. Doctor don’t pay attention or follow-up to his/ her
patient.
4. Don’t serve of substitute doctor at the time he/she can
not visit.
 THE THREAT OF ABANDONT IN
CRIMINAL LAW

 Thearticle number 304 Criminal Law

( KUHP) : Everyone with intentional cause or let
people in misery, was he/she shall give life, caring or
maintenance this people, because regulation for
him/her or according agreement, sentenced to
imprionment for two years and eight months or fines
maximally four thousands five hundreds rupiah.
 DOCTORS SHOULD BE CAREFUL
WITH THE TERM NEGLIGENCE
MAPRACTICE

 VERY VERY IMPORTANT THAT PHYSICIAN

SHOUL BE AVOIDED OR REFUSED
RECOGNITION OF NEGLIGENCE OR
(KEALPAAN / KELALAIAN.), BECAUSE THIS TERM IS
LEGAL TERM.
 THE THREAT OF
CRIMINAL LAW
 Many peoples are very unhappy if his or her problem
According
have drawn to the law sphere.
Articles number 359, 360, 361
Indonesian Criminal Act
( KUHP),
 Article number 359 said that : Everyone by
their negligence cause death another people will be
threat by criminal law maximally five years or prison
maximally one year.
 MAKING HEAVY DAMAGING
THE THREAT OF CRIMINAL LAW ARE:

 Article number 360 Indonesian Crime

Act (KUHP) : Everyone by their negligence cause
another person heavy damage, threat by criminally act
maximally five years or jail maximally one year. And
when people lost their job in a perode of time, threat by
criminal act maximally in nine years or jail maximally
six months.
 Article number 361 said, If criminal action happen
in the time of to do job, so criminal threat added with
one- third of preason time.
 DOCTOR’S SELF PROTECTION
1. (M) ENGABDIKAN PROFESI dengan jujur sesuai perannya;
2. (U) SAHAKAN bekerja sesuai kompetensi, kewenangan, dan
clinical privileges;
3. (K) ETAATAN PADA Sumpah dokter, ETIKA , KODEKI,
Disiplin dalam menjalankan profesi; termasuk standar
layanan dan SPO;
4. (I) NFORMED CONSENT, termasuk menghormati HAM dan
Rahasia kedokteran.
6. (D) EFENSIVE MEDICINE. Kalau perlu.
7. (HI) NDARI Medical error (diagnostic errors, treatment
errors, preventive errors, dan others).
 MALPRACTICE
PROPHYLAXIS
o Refuse to take the case (when you suspect medico-
legal trouble may develop).
o Never guarantee a cure.
o Watch the time factor.
o Watch the reverse time factor.
o Keep up with the advance of medicine.
o Do not be too advance.
o Do not experiment.
o Get the patient’s informed consent for all procedures.
o Good housekeeping.
o Employ at least ordinary skill and care at all times.
o When in doubt, seek consultations.
o Cooperate with your profession.
o Watch your patient relations.
o Watch your public relationss
(Morris, Moritz, Dahlan S)
 THE RESUME
1. THE ETHICMEDICOLEGAL ASPECT OF ACCUPUNCTURE
MEDICAL DOCTOR, HAS TWO SIDE, FACE FROM
MEDICAL PRACTICE AND ACCUPUNCTURE PRACTICE.
2. ACCUPUNCTURIST DOCTORS SHOUD BE MASTERING,
MEDICAL ETHIC, ETHICAL OF ACCUPUNTURE,
MEDICAL DISCIPLINE, AND MEDICAL LAW.
3. DO IN COMPETENCY THEIR HAVE, GOOD INFORMED
CONSENT, POLITE AND GOOD COMMUNICATION, AND
LEGAL OF MEDICAL PRACTICE, ARE NEEDED FOR
PROTECTING THEIR PRACTICE.
4. ADVICE ABOUT MALPRACTIC PROPHYLAXIS IN
GENERAL, HAS PRESENTED. ( HOPEFULLY USEFUL)
THE VIOLATION OF LIGHT
ETHICAL CONDUCT
DOCTOR MAASTERING MEDICAL CODE
ISN’T ENOUGH

DAFTAR PUSTAKA,
 Dahlan S. Hukum kesehatan , Rambu-rambu bagi dokter. Badan Penerbit Universitas
Diponegoro. Semarang. 1999.
 Dahlan S . Clinical case management. Ceramah etik dalam Rapat MKEK Pusat PB IDI,
Jakarta 2012.
 Beauchamp & Childdree. Principles of Biomedical Ethics 4 ed, Oxfford University, New
York. 1994.
 Soetedjo. Etikomedikolegal. Badan Penerbit Universitas Diponegoro. Semarang 2011.
 Guwandi J. Sekitar gugatan Malpraktik Medik, Balai Penerbit Fakultas Kedokteran
Universitas Indonesia,Jakarta.2010.
 Reimechisel T & Williams M., Approach to Ethical Problem Solving in Practical ethics in
Clinical Neurology.Wolter Kluwer/ Lippincott Williams & Wilkins . Philadelphia . 2012.
 Rajin M, Masruroh, Gofar A; Panduan babon Akupunktur.Penebit Indoliterasi. Jogya.
2015.
 PB IDI. 65 tahun, Direktory Ikatan Dokter Indonesia. 2015.