GROUP 15

Modul PBL
“Medical Humanities,
Ethics
and Proffesionalism”

Tutor : Dr. dr. Sri Vitayani Muchtar, Sp.KK

Members of Group 15
Innal Hamda (11020150019)
Nisrina Nur Azisah (11020150026)
Diah Rindayani Hasbi (11020150028)
Alvi Kamal Fikri (11020150043)
Maftuhatul Afiah (11020150061)
Desi Triutami Saleh (11020150068)
Donita Rian Utami (11020150080)
Muhammad Fuad Alamsyah (11020150113)
A. Muh. Fadilah M (11020150126)
Gita Refina Rahmadini (11020150130)
Muhammad Fauzan (11020150151)
SCENARIO
 “The woman who was forced to offer her kidney”
Physician:
This was a case of a woman of 22 years of age who came to donate a kidney
for our patient who was supposedly her brother. She was a good match, but I
strongly suspected that she was not related and was either being coerced or being
paid to donate the kidney. We have a policy against doing transplants from
unrelated donors. We make it very clear that we will consider a transplant only if
the donor is related to the recipient and is not doing it for gain. I asked her several
times but she said that she was his sister. I still had my suspicions, so I sent her to
a psychiatrist for assessment. She was of subnormal intelligence and did not
understand the procedure.
 We could have refused to do the operation here, but they would have gone to
some other center and had it done anyway. So, we carried out the operation. Much
later, we learned that she was a paid, distantly related person who was possibly
forced by her family. We are trying to avoid that this becomes a commercialized
process of buying and selling goods in the market.
We have pioneered the process of renal transplantation in the country and
we have found that our results are comparable to the advanced centers in the
West. A very important cornerstone of our policy is that we do not accept unrelated
donors. Many hospitals in our country allow unrelated donations. The demand for
transplants is far greater than available donors can meet. We do not have a
government-approved cadaver organ harvesting policy. So the patients have to rely
on willing relatives or buy it in the market. It would cost the recipient a big sum of
money and then there is the cost of life-long immunosuppression.
Some people can afford this and they create a demand for kidneys from unrelated
willing donors. The donors desperately need the money and the doctors tell them
they can manage with one kidney. Innocent people, underprivileged, unrelated or
distantly related, are coerced or even tricked into giving a kidney. Sometimes they
don't even know it. They may not be given any money or less than what was
promised. This is not new; we have had quite a few reports already. The
implications are very serious as have been seen in many developing countries.
We had another case where the donor was clearly a first cousin of the
patient and was apparently willing. We had some vague feeling about her and sent
her for psychiatric assessment. They found that she had subnormal intelligence and
had no clue about the issue, the procedure and what it meant for her. We refused.
The patient and his family, and even the donors' parents were upset with us.
DIFFICULT WORD
AND KEYWORD
Difficult Word :
• Transplant
• Subnormal intelligence
• Immunosuppression
• Psychiatrist
• Policy
• Donors
• The operation
Keyword :
• A woman 22 years old who came to donate a
kidney for our patient who was supposedly her
brother
• She was of subnormal intelligence and did not
understand the procedure
• Psychiatrist assessment
• We carried out the operation
• She was paid and distantly related person who
was possibly forced by her family
Keyword :
• A very important cornerstone of our policy is that we
do not accept unrelated donors
• Difficult to have a willing donors
• We have pioneered the process of renal
transplantation in the country and we have found
that our results are comparable to the advanced
centers in the West.
• The demand for transplant is big but the donors is
less
• The donor’s parents were upset with us.
Identification of Problems
Questions :
- Analyze the case above based on the principles
of:
• Medical Humanity Aspects
• Medical Ethics Aspects
• Medical Professional Aspects

- How do you see the case in the perspective of

Islam (all the aspects in the view of Quran and
Sunnah)
Answer :
- Analyze the case based on the principles of:
• Medical Humanity Aspects
• Medical Ethics Aspects
• Medical Professional Aspects

- The Aspects in the view of Quran and

Sunnah
•Medical Humanity Aspect
Humanities provide a forum for the birth of the
intrinsic meaning of the values of humanism.
Humanism itself is aimed at reviving a sense of the
flow of humanitarian/ aspire to a better association.
There is also the opinion of humanism as an attitude /
behavior regarding human attention with emphasis
on compassion and the dignity of the individual.

Reference: Bahan Ajar untuk mahasiswa Fakultas Kedokteran UMI, Makassar

Angk.2007
Textual :
• We could have refused to do the operation here,
but they would have gone to some other center
and had it done anyway.
• She was subnormal intelligence and did not
understand the procedure.
• It would cost the recipient a big sum of money.
• The implications are very serious as have been
seen in many developing countries.
Contextual :
Humanism expressed an appreciation to the patient
as an individual; show compassion and understand the fear
and anxiety within the patient; declare a communication
means to the patient as an individual rather than as a
disease. Furthermore, he said, humanism in medicine is
more of an ethic. More than just refrain from doing things
that harm the physical and mental patients due to neglect
themselves. More than just written in the Hippocratic oath.
Humanism is a positive action, such as compassion is not
just feeling sorry for the suffering of others but to help by
giving advice or actions that alleviate suffering
Analyze :

First Case “Doctor save the patient live but

do harm to the donor”

Why?????
Analyze :

Humanities
Aspects
Analyze :

Second “Doctor do harm to the patient

case but save the donor”

Why?????
Analyze :

Humanities
Aspects
•Medical Ethics Aspect
Department of Education and Culture (1988),
ethics is:
1. The science of what is good, what is bad and
the rights and obligations of moral
2. set or a set of principles or values pertaining
to morals 3. The value of right and wrong that
adopted a group or society
Textual :
• We have a policy against doing transplants
from unrelated donors
• She was of subnormal intelligence and did not
understand the procedure.
• A very important cornerstone of our policy is
that we do not accept unrelated donors
Contextual :
Paragraph 15
• Before the approval of transplantation tools and human
tissue or given by living donors, potential donors are
concerned beforehand was told by his doctors including
the consultant doctor about the surgery, consequences,
and the possibilities that can occur.
• Doctors as referred in verse (1) must be certain, that the
prospective donor concerned has been fully aware of
the meaning of the notice.
Analyze :
Based on paragraph 15

Government regulation first case the

doctor guilty because even if he knows that the
donator has mental illness and it is not
appropriate to doing the transplantation but he
still going this on.
•Medical Proffesionalism Aspect
Poerwopoespito & Utomo (2000: 266), says
that professionalism means understanding that
puts the profession as a major focal point in
one's life. People who embrace the ideology of
professionalism always shown a professional
attitude in work and in everyday life.
Textual :

• So I sent her to a psychiatrist for assessment.

• We are trying to avoid that this becomes a
commercialized process
Contextual :
As a professional doctor, he knows that the
procedure to doing this transplantation, he
know the law well and also all regulations, so
that is why in first and second case the doctor at
the very first time examine the donor by sent her
to the psychiatry
Contextual :
For living donors, there are several requirements that are
set, among others:

• Age over 18 years • No diabetes

• Mental and Physical Health
• Normal blood pressure
• Not too fat
• No abnormalities of kidney
stones
• Organize the same blood
type
• Not Cancer
• Do not have vascular disease
Analyze :

First Case

Based on those regulation we do believe

that the doctor is a professional because the
doctor sent the donor to the psychiatrist
Analyze :
Second case
And also the hospital and the doctor are trying
to avoid that this transplantation becomes a
commercialized process. what we are seeing here is
the hospital and the doctor doing their
professionalism because they obey the rule and also
all the regulateon on ethic code
Paragraph 17
It is forbidden to commercialized any part or tissue of human body.
 The Aspects in the view of Quran
and Sunnah
Transplant Law :

Prohibit Transplantation of organs

Allowing Transplantation of organs

 Prohibit Transplantation of organs
1. Transplantation of organs while still alive.
Al-Qur’an

ْ ‫َــ سكمتـَـقــتلس سوا َو‬

َ‫ل‬ َْ ‫اَنـــُْفس‬
"And do not kill yourselves, Allah is most merciful to you"
(Q.S. An-Nisa ': 4: 29)

2. Organ transplants while in a coma.

Hadith the prophet Muhammad (pbuh) "There should not be doing the
job that brings kemudlaratan and there should be no kemudlaratan"
 Prohibit Transplantation of organs

3. Organ transplants when the state has died.

There are a few commands of the Qur'an and Hadith

that forbid. Among the well-known hadith, namely:
"Breaking bones corpse someone equally sinful and break
bones break with that person when he was still alive"
 Allowing Transplantation of organs
1. Al-Qur’an
Surah Al-Maidah, verse 32

"And He who saved a life, then as if he saved the life of all human beings.
and hath come unto them the Apostles We (brought) descriptions are
clear, then many of them thereafter seriously exceed the limits in
mischief on earth. "
 Allowing Transplantation of organs

2. Hadith
Hadith of the Prophet Muhammad (pbuh):
"all people repent you to Allah, because Allah does not put a
disease, but he also laid the cure, other than one disease,
namely being old." (Reported by Ahmad, Ibn Hibbaan and al-
Hakim of Osama Ibn Shuraih)
CONCLUSION
 According to the rules of bioethics and humanities

In the organ transplant will be involved physicians,

donor families and recipients with their families. There is a
procedure that must be understood by everyone involved
in organ transplantation. May be made, provided in
accordance with the indications, as a last resort, there is
agreement, and the religion of Islam requires that organs
should not be traded. Suggestions for this discussion is that
if he wanted to do organ transplants (kidney), apart from
the aspects of bioethics / humanities, legal and religious
aspects must also be considered.
 According to terms of Ethics

Transplantation is the last attempt to help a

patient with failure of one of the main functions of
the organs. These actions must be performed if there
are indications, KODEKI based on several articles in
which article 15, article 16,article 17 and many more
that need to obey by the doctor
 According to terms of Professionalism

Professionalism means understanding that puts the

profession as a major focal point in one's life. Professionalism
always shown a professional attitude in work and in everyday
life. Based on those regulation we do believe that the doctor is
a professional.
And also the hospital and the doctor are trying to avoid
that this transplantation becomes a commercialized process.
what we are seeing here is the hospital and the doctor doing
their professionalism because they obey the rule and also all
the regulation on ethic code
 According to Qur’an and Sunnah

Transplantation is a very tricky thing in taking the

appropriate action, as many opinions against and in support of
the implementation of the transplant with a variety of different
reasons. from the description above discussion, it can be
concluded that the law enforcement organ transplantation
depends on the reason why it should do so. if the reason does
not support the activities of the transplant is strictly prohibited
and haram, and illegal.