DAN
KODE ETIK KEDOKTERAN INDONESIA
HERMANSYAH
FAKULTAS KEDOKTERAN
UNIVERSITAS SRIWIJAYA
Lafal sumpah dokter sesuai dengan Deklarasi Geneva (1948) telah diterjemahkan
ke dalam Bahasa Indonesia oleh majelis Pertimbangan Kesehatan dan Syara Departemen
Kesehatan RI dan Panitia Dewan Guru Besar Fakultas Kedokteran Universitas Indonesia.
Lafal sumpah ini diucapkan pertama kali oleh lulusan Fakultas Kedokteran UI pada tahun
1959. lafal sumpah ini kemudian dikukuhkan dengan Peraturan Pemerintah No. 26 tahun
1960.
Tiap pembuatan atau nasehat yang mungkin melemahkan daya tahan makhluk
insani, baik fisik maupun psikik, tidak boleh diberikan kecuali untuk kepentingan
penderita.
Upaya dokter dalam pelayanan kedokteran ialah menyembuhkan pasien, atau
mengurangi penderitaannya dan setidak-tidaknya menggembirakannya, jika harapan
untuk sembuh telah tipis. Selain itu harus diperhatikan bahwa penderitaan fisik dengan
faktor psikik sangat erat, oleh karena itu pendekatan yang dilakukan seharusnya holistik.
Dokter harus mampu mempertebal keyakinan pasien bahwa ia dapat sembuh dan
mengalihkan perhatian pasien yang depresi atau cemas ke hal yang memeberi harapan
dan menimbulkan optimisme.
Sejak awal sejarah umat manusia, sudah dikenal hubungan kepercayaan anatra dua
insan yaitu manusia penyembuh dan penderita. Dalam zaman modern, hubungan ini
disebut transaksi atau kontrak terapetik antara dokter dan pasien. Hubungan ini dilakukan
secara konfidensial, dalam suasana saling percaya mempercayai dan hormat
menghormati.
Kewajiban Umum
Kewajiban dokter terhadap penderita
Kewajiban dokter terhadap teman sejawat
Kewajiban dokter terhadap diri sendiri
1. Kewajiban Umum
Tiap perbuatan atau nasehat yang mungkin melemahkan daya tahan makhluk
insani, baik jasmani maupun rohani, hanya diberikan untuk kepentingan penderita.
Setiap dokter harus senantiasa berhati-hati dalam mengumumkan dan
menerapkan setiap penemuan teknik atau pengobatan baru yang belum diuji
kebenarannya.
Seorang dokter hanya memberi keterangan atau pendapat yang dapat dibuktikan
kebenarannya.
BY
HERMANSYAH
Hippocrates OATS
Word Medical Association (WMA)
Declaration of Geneva 1948
Patients must be able to trust doctors with their lives and well-being. To justify
that trust, we as a profession have a duty to maintain a good standard of practice
and care and to show respect for human life. In particular as a doctor you must :
Make the care of your patients your first concern.
Treat every patient politely and considerately.
Respect patients dignity and privacy.
Act quickly to protect patients from risk if you have good reason to believe that
you or a colleague may not be fit to practice.
Avoid abusing your position as a doctor
Work with colleagues in the ways that best serve patients interests.
In all matters you must never discriminate unfairly against your patients or
colleagues. And you must always be prepared to justify your actions to them.
Mrs. S is a married 35 year old Hindu woman expecting her fourth child. She has 3
daughters and on several occasions has expressed her desire to have a son. Because of her
age she is referred for amniocentesis to rule out genetic anomalies. A healthy female fetus
is reported, whereupon Mrs. S request a termination of pregnancy. The pregnancy is now
at 20 weeks. Mr. and Mrs. S are referred for counseling.
For Hindus and Sikhs the single most important ethical consideration surrounding
the start of life is their belief karma, that the fetus is not developing into a person but,
rather, is already a person from the moment of conception. Abortion at any stage of fetal
development is thus judged to be murder. However, abortion is accepted by Hindus ans
Sikhs if essential to preserve the life of the mother. Furthermore, the religious prohibition
of abortion is sometimes at odds with the cultural preference for sons. For Mr. and Mrs.
S, the desire for a son outweighs the stance of their religion against abortion.
Case 2. Islam
An 18 year old Muslim man sustains severe head injures in a traffic accident while
riding his motorcycle. He is declared brain dead. The transplant coordinator approaches
the grieving mother to obtain consent for organ donation. At first the patient mother is
shocked at this approach. She then politely says that she would like to wait for her family
to arrive before making decision.
Case 3. Islam
A 38 year old muslim woman is found to have a rapidly growing carcinoma of the
breast. She requires surgery and postoperative chemotherapy. She is 5 weeks into her first
pregnancy and is advised to terminate the pregnancy before the chemotherapy.
The general Islamic view is that, although there is some from of life after
conception, full human life, with its attendant rights, begins only after the ensoulment of
the fetus. On the basis of interpretations of passages in the Qur’an and of sayings of the
Prophet, most Muslim scholars agree that ensoulment occurs at about 120 days after
conception, other scholars, perhaps in the minority, hold that it occurs at about 40 days
after conception.
Case 4. Chinese
Mr. Y is a 75 year old Chinese Canadian who has been admitted to the intensive
care unit because of respiratory failure. He has a long history of respiratory problems.
Mechanical vebtilation is started. Mr. Y is oriented to time, person and place. He spends
much of his time reading and enjoys his family’s visits. Attempts to wean him from the
ventilator have failed, consequently, he is facing a situation of permanent dependence on
the breathing machine.
In the Confucian social hierarchy, the elderly sick person can expect to be cared for
by his or her family. The patient is relieved of a large share of personal responsibility,
including decision-making, even though he or she may be rational and competent.
Furthermore, from a Confucian point of view, which is governed by the rule of filial piety
and protection, a parent should not be given the news of a terminal illness. It is
considered morally inexcusable to disclose any news that may cause further harm to
one’s parent.