INFORMED

CONSENT
MARTURIA DRIFANY 22710017
 What is “Informed Consent”

• Informed consent is a principle in medical ethics and medical law

that a patient should have sufficient information before making
their own free decisions about their medical care.
• Informed Consent process supposes two movements: (1) to
provide information in order to obtain a positive feedback; (2) to
have the consent and the permission from the patient to perform
treatments, surgery or other medical procedures.
 The Informed Consent contains two major elements

Comprehension and free consent.

1. Comprehension is awareness and understanding about the patient’s
medical condition and possibilities
2. Free consent is an intentional and voluntary act that authorizes
someone else to act in certain ways. This consent also includes
voluntariness, which means the willingness of patient to undergo
treatment; capacity, when the patient is able to understand nature of
treatments; and knowledge, sufficient information as to nature of
treatment disclosed to the patie
 Who can get Consent?

• This is the general rule, for adults and competent, people who
can understand the information, can ask more information, can
accept or refuse treatments. But the pediatric practice is an
exception from the general rule.
• Here patients are not competent, from legal point of view to
accept or to refuse treatments and physicians need to provide all
medical information to legal representative, who are, in the most
of part of cases, the parents of the patients
 Case Report
Harapan Bunda Hospital stated that it had evidence
that the medical treatment for baby Edwin Timothy
Sihombing was in accordance with the procedure and
based on the approval of the family. However, this is
different from the statement of Edwin's parents.
Edwin's mother, Romauli Manurung, said that she had
never signed any paperwork regarding the medical
treatment of Edwin's finger.
"When it was cut, no letter was signed. During the
meeting, we spoke verbally. The results were read. At
that time there was no signature at all, the letter was
read by the board of directors if later if the index finger
could not heal it would be amputated," said Romauli at
Harapan Bunda Hospital, Pasar Rebo, East Jakarta,
Thursday (11/4/2013).
"My position was behind the nurse. I saw that when doctor wanted to cut,
the blood out, I couldn't stand it and cried. After the doctor finished I asked
the doctor, he said because the tissue was dead so it had to be cut and
removed to accelerate tissue growth. even explained after he cut my son's
finger," Romauli admitted.
Previously, the hospital had denied committing malpractice by amputating
baby Edwin's index finger. The medical action was carried out by the
Harapan Bunda Hospital doctor after a statement of approval from the
family.
"We have evidence of informed consent (statement letter-ed) to take this
action," said Mira, a public relations officer at Harapan Bunda Hospital by
telephone, Wednesday (10/4/2013).
 ETIC DILEMA

Otonomi Non-maleficence
 4 BOX METHOD OF CLINICAL ETHICS

MEDICAL INDICATION CLIENT PREFERENCE

The patient's index finger turned
blue and swollen The patient was not able to make a
Patient lost his finger after decision, therefore the decision was
ampuation made by the patient's parents.

QUALITY OF LIFE CONTEXTUAL FEATURE

The patient's parents said there The patient's family asked the
was no signed letter regarding hospital to pay if the patient's finger
the amputation of the patient's was amputated
finger.