Bioetik

Janeta Trifani
18710024
 Case 1
A woman named Mrs. Hanifa, sued the Director of RSUD Dr. Moh
Saleh Probolinggo and BPJS Probolinggo branch on the grounds
that the hospital (first defendant) did not immediately provide
services and first aid to her husband. Because, the hospital was
based on the BPJS regulation as the second defendant. Ms.
Hanifa's husband (Sudarman) suffered from this internal
complication, was scheduled to be controlled at the Hospital on
Wednesday 24 October 2018. At that time, the routine medication
that was accepted for its expiration date had run out, so it must be
repeated to request referral to the puskesmas. Although Sudarman
explained his condition, the RSUD still refused to carry out
treatment on the grounds that there must be the latest referral
from the puskesmas. In the middle of the trip to the puskesmas
Sudarman felt dizzy and unable to travel, so he decided to take a
break, but Sudarman was even unconscious. And was taken to the
Tongas District Hospital, Probolinggo.
 beneficence
No 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 adverse effect. √

5 Responsible √

6 Ensure a good minimum human life √

7 Restriction Goal-Based √

8 Maximizing the satisfaction of happiness / patient preferences √

No Criteria Yes No

9 Minimize adverse consequences. √

10 Obligation to help emergency patients √

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-Malficence
No Criteria Yes No

1 Helping emergency patients √

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 patients> doctor's loss (only experiencing
minimal risk).

3 Treat injured patients. √

4 Do not kill patients (do not do euthanasia) √

5 Not insulting √
6 Do not view patients as objects √

7 Treating disproportionately √

8 Do not prevent patients dangerously √

9 Avoid misrepresentation of patients √

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

11 Does not give life spirit √

12 Does not protect patients from attacks √

13 Do not do white collar in the health field √

 Justice
No Criteria Yes No

1 Give 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. √
No 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.
 Autonomy
No Criteria Yes No

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

dignity of patients.

2 Do not intervene in patients in making decisions (under √

elective conditions)

3 Be honest √

4 Appreciate privacy. √

5 Keep personal secrets √

6 Appreciate patient rationality. √

7 Carry out informed consent √

No Criteria Yes No

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) √

 ethical dilemma
o Beneficience
o Justice

Prima Facie = Justice

 4 box method

Q
u
ality
o
f
L
ife:
T
h
e
p
atie
n
tis
i
n

w
ea
k

a
n
d

p
ai
n
.
Key principles of profesionalism
• Accountability : +
• Alturism :-
• Duty :+
• Respect for other : +
• Humanity : -
Ordinary or Exstraordinary

Extraordinary
Case 2
A female patient be carried by her husband and
mother went to the skin and sex sickness clinic at
Dr. Moh Saleh Probolinggo Hospital, after being
examined the doctor advised the female patient to
be hospitalized. Because the patient's illness must
be taken care of and at the hospital, the patient
and family of the patient agree to hospitalize in
the bougenville class 2 room. After approximately
2 days of hospitalization, the patient wants to go
home because of cost (general patient).
 Benefience
No 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 adverse effect. √

5 Responsible √

6 Ensure a good minimum human life √

7 Restriction Goal-Based √

8 Maximizing the satisfaction of happiness / patient preferences √

No Criteria Yes No

9 Minimize adverse consequences. √

10 Obligation to help emergency patients √

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-Maleficience
No Criteria Yes No

1 Helping emergency patients √

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 patients> doctor's loss (only experiencing minimal
risk).

3 Treat injured patients. √

4 Do not kill patients (do not do euthanasia) √

5 Not insulting √
6 Do not view patients as objects
7 Treating disproportionately √
8 Do not prevent patients dangerously √

9 Avoid misrepresentation of patients √

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

11 Does not give life spirit √

12 Does not protect patients from attacks √

13 Do not do white collar in the health field √

 Justice
No Criteria Yes No
1 Give 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. √
No 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.
 Autonomy
No Criteria Yes No

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

dignity of patients.

2 Do not intervene in patients in making decisions (under √

elective conditions)

3 Be honest √

4 Appreciate privacy. √

5 Keep personal secrets √

6 Appreciate patient rationality. √

7 Carry out informed consent √

No Criteria Yes No

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) √

ethical dilemma
o Autonomy
o Non-Malefience

Prima facie = Autonomy

n
t e
m d
rs.-
w f
it o
r
h h
axil o
a s
b p
sce italz
c o
h n
r
o b
n y
ic d
o
ct
o
r

4 box method

Q
u
ality
o
f
L
ife:
t
h
e
p
atie
Key principles of profesionalism
• Accountability : Doctors is responsible
for giving the best advice
• Alturism : doctors have provided the
best service
• Duty : doctors have done very
well
• Respect for other : very well
• Humanity : doctor have done very well
Ordinary or Exstraordinary

Ordinary
THANK YOU