Anda di halaman 1dari 34

Etik berasal dari Yunani

ETHOS
yang baik, yang
layak.

Etik Kedokteran
Prinsip2
moral atau asas2 akhlak yg harus
diterapkan oleh para dokter dalam
hubungannya dengan pasien,
teman sejawatnya & masyarakat
umumnya.

Sumpah Hippokrates (460 377 S.M)


Deklarasi Jenewa (1948)
Lafal Sumpah Dokter Indonesia (1960)
International Code of Medical Ethics
Kode Etik Kedokteran Indonesia
Pernyataan-pernyataan (Deklarasi)
Ikatan Dokter Sedunia.

4
I
II
III
IV

KELOMPOK KEWAJIBAN DOKTER :


Kewajiban umum dokter
Kewajiban terhadap penderita
Kewajiban terhadap teman sejawat
Kewajiban terhadap diri sendiri

1. Setiap dokter harus menjunjung tinggi,


menghayati & mengamalkan Sumpah
Dokter.
2. Seorang dokter harus senantiasa
melakukan profesinya menurut ukuran
yang tertinggi.
3. Dalam melakukan pekerjaan
kedokterannya tidak untuk kepentingan
pribadi.
4. Hal2 yg tidak layak dilakukan dokter
memuji diri sendiri, menerapkan
pengetahuannya dlm segala bentuk tanpa
kebebasan profesi, menerima imbalan
selain daripada yg layak sesuai jasanya
kecuali dengan keikhlasan penderita.

5.
6.

7.

8.

Mengutamakan kepentingan
penderita.
Hati2 dengan penemuan teknik atau
pengobatan baru yg belum diuji
kebenarannya.
Seorang dokter hanya memberi
keterangan atau pendapat yg dapat
dibuktikan kebenarannya.
Pelayanan kesehatan paripurna.

Setiap dokter harus senantiasa mengingat


akan kewajibannya melindungi hidup mahluk
insani.
Sesuai standar pelayanan medik, bila tidak
mampu menangani pasien wajib merujuk
kepada dokter lain yg ahli dlm penyakit tsb.
Memberikan kesempatan kepada penderita
berhubungan dgn keluarga dll.
Merahasiakan segala sesuatu yg
diketahuinya tentang seorang penderita
bahkan penderita sampai meninggal dunia.
Kewajiban memberikan pertolongan darurat.

1.

2.

Setiap dokter memperlakukan


teman sejawatnya sebagaimana
ia sendiri ingin diperlakukan.
Setiap dokter tidak boleh
mengambil alih penderita dari
teman sejawatnya tanpa
persetujuannya.

Pasal 10
Setiap dokter wajib bersikap tulus
ikhlas dan mempergunakan segala ilmu
dan ketrampilannya untuk kepentingan
pasien. Dalam hal ini ia tidak mampu
melakukan suatu pemeriksaan atau
pengobatan, maka atas persetujuan
pasien, ia wajib merujuk pasien kepada
dokter yang mempunyai keahlian
dalam penyakit tersebut.

Setiap dokter harus memelihara


kesehatannya, supaya dapat bekerja
dengan baik.
Setiap dokter hendaknya senantiasa
mengikuti perkembangan ilmu
pengetahuan dan tetap setia kepada
cita-citanya yg luhur.

A fellow member of a profession, staff,


or academic faculty; an associate
from French collgue, from Latin
collga one selected at the same time
as another, from com- together +
lgre to choose
Synonim: partner/mitra

Rules or codes of medical ethics


Mutual respect and understanding
Friendship

1.
2.

3.

4.
5.

between student and


teacher;
between doctors in the
same discipline (either
specialists or GP) ;
between general
practitioner (GP) and
consultant;
between two doctors in
different specialities;
between the doctor and
his doctor-patient.

to teach his students all he knows, freely and


without thought for remuneration. (Hipocratic
oath)
The professionally sound and ethically upright
teacher is in the best position to appear as a
role model for his impressionable pupils.
There is no age bar to the process of learning
and it does not matter whom one learns from.
It should not be surprising that one day the
student may indeed be teaching his own
professor in the course of conferences,
seminars and workshops.

cheerfully render professional services to


his physician-colleagues and their
immediate family members without seeking
monetary compensation. However, there is
no rule that a physician should not charge
another colleague for his services
The immediate family consists of parents,
spouse and children.
Dependants include non-earning members
of the family dependent upon the doctor for
their survival.

Doctors

may criticise one another, but only


face-to-face and in complete confidence. To
criticise a colleague in front of a patient is
both damming and dangerous and can never
be justified.
the utmost care and tact be maintained when
listening to patients complaining about how they
have been treated or handled by other doctors.
a doctor is urged to expose incompetent or corrupt,
dishonest or unethical conduct on the part of
members of the profession without fear or favour as
these are against the best interests of patients.

a practitioner in whatsoever form of


practice, should take positive steps to
satisfy himself that a patient who
applies for treatment or advice is not
already under the active care of
another practitioner before he accepts
him.
a practitioner should not accept as a
patient any patient whom he has
attended as a consulting practitioner, or
as a deputy for a colleague.

Physician belong to a profession that has traditionally functioned in an


extremely hierarchical fashion.
Consultations are encouraged in cases of serious illnesses, especially in
doubtful or difficult conditions.
The rights of the patient to ask for a second opinion should be respected.
With the rapid growth in scientific knowledge and its clinical applications,
medicine has become increasingly complex. Individual physicians cannot
possibly be experts in all their patients diseases and potential treatments
and they need the assistance of other specialist physicians and skilled
health professionals such as nurses, pharmacists, physiotherapists,
laboratory technicians, social workers and many others. Physicians need to
know how to access the relevant skills that their patients require and that
they themselves lack.
The attending doctor may certainly suggest the names of the consultants of
his choice but even then, in the event of a difference of opinion between
him and patient or his relatives of the patient, the choice of the latter
should prevail.
In the event of irreconcilable difference of opinion between the two doctors,
the circumstances should be impartially and frankly explained to the patient
concerned. It is now up to the patient to decide which of these he will follow
or, indeed, whether he will seek further advice from a new consultant.

a cooperative model of decisionmaking has replaced the authoritarian


model that was characteristic of
traditional medical paternalism.
As members of the medical profession,
physicians have traditionally been
expected to treat each other more as
family members than as strangers or
even as friends.
The WMA Declaration of Geneva
includes the pledge, My colleagues
will be my sisters and brothers.

For example, where fee-for-service was the


principal or only form of remuneration for
physicians, there was a strong tradition of
professional courtesy whereby physicians
did not charge their colleagues for medical
treatment.
This practice has declined in countries
where third-party reimbursement is
available. Besides the positive requirements
to treat ones colleagues respectfully and to
work cooperatively to maximize patient
care, the WMA International Code of
Medical Ethics contains two restrictions on
physicians relationships with one another:
(1) paying or receiving any fee or any other
consideration solely to procure the referral
of a patient; and (2) stealing patients from
colleagues.

The attendance of the practitioner should cease when the


consultation is concluded, unless the patient has dispensed with the
services of his first doctor and engaged those of another.
In no case should the consultant treat the patient alone or hand him
over to his assistant or admit him to a nursing home or hospital
without the knowledge of the the referring physician or injure the
latters position in any respect. (Emergencies form an exception to
this rule. In such an event, the consultant should inform the
referring physician at the first opportunity after the crisis has been
tided over.)
When a consultant sees a patient in his rooms at the request of a
medical practitioner, it is his duty to write to the latter, stating his
opinion on the case and the line of treatment he thinks should be
adopted. He should not see this patient again without a fresh note
from the first doctor.
A doctor called upon in an emergency must treat the patient, but
after the crisis, the consultant must retire in favour of the original
attendant of the patient.

Obtain

the opinion of an appropriate colleague


acceptable to your patient if diagnosis or treatment is
difficult or obscure, or in response to a reasonable
request by your patient.
When referring a patient, make available to your
colleague, with the patient's knowledge and consent, all
relevant information and indicate whether or not they
are to assume the continuing care of your patient
during their illness.
When an opinion has been requested by a colleague,
report in detail your findings and recommendations to
that doctor.
Should a consultant or specialist find a condition which
requires referral of the patient to a consultant in
another field, only make the referral following
discussion with the patient's general practitioner except in an emergency situation.

In the Hippocratic tradition of medical ethics,


physicians owe special respect to their teachers.
The Declaration of Geneva puts it this way: I will give to

my teachers the respect and gratitude which is their due.


Although present-day medical education involves multiple
student-teacher interactions rather than the one-on-one
relationship of former times, it is still dependent on the
good will and dedication of practising physicians, who often
receive no remuneration for their teaching activities.
Teachers have an obligation to treat their students
respectfully and to serve as good role models in dealing
with patients.
Students concerned about ethical aspects of their education
should have access to such mechanisms where they can
raise concerns.

The obligation to report incompetence,


impairment or misconduct of ones colleagues
is emphasised in codes of medical ethics. For
example, the WMA International Code of
Medical Ethics states that A physician
shall... strive to expose those physicians
deficient in character or competence, or who
engage in fraud or deception.
On the one hand, a physician may be
tempted to attack the reputation of a
colleague for unworthy personal motives,
such as jealousy, or inretaliation for a
perceived insult by the colleague.

A physician may also be reluctant to


report a colleagues misbehaviour
because of friendship or sympathy
Despite these drawbacks to reporting
wrong doing, it is a professional duty of
physicians. Not only are they responsible
for maintaining the good reputation of the
profession, but they are often the only
ones who recognise incompetence,
impairment or misconduct.

Reporting colleagues to the disciplinary authority


should normally be a last resort after other
alternatives have been tried and found wanting.
The first step might be to approach the colleague
and say that you consider his or her behaviour
unsafe or unethical. If the matter can be resolved
at that level, there may be no need to go farther.
If not, the next step might be to discuss the
matter with your and/or the offenders supervisor
and leave the decision about further action to that
person. If this tactic is not practical or does not
succeed, then it may be necessary to take the
final step of informing the disciplinary authority

Medicine is at the same time a highly


individualistic and a highly cooperative
profession.
On the one hand, physicians are quite
possessive of their patients.
The weakening of medical paternalism has
been accompanied by the disappearance of
the belief that physicians own their patients.
Physicians will have to be able to justify their
recommendations to others and persuade
them to accept these recommendations. In
addition to these communication skills,
physicians will need to be able to resolve
conflicts that arise among the different
participants in the care of the patient.

Ideally, healthcare decisions will


reflect agreement among the
patient, physicians and all others
involved in the patients care.
However, uncertainty and diverse
viewpoints can give rise to
disagreement about the goals of care
or the means of achieving those goals.
Limited healthcare resources and
organisational policies may also
make it difficult to achieve consensus

Dr. C, a newly appointed anaesthetist in a


city hospital, is alarmed by the behaviour of
the senior surgeon in the operating room.
The surgeon uses out-of-date techniques
that prolong operations and result in greater
post-operative pain and longer recovery
times. Moreover, he makes frequent crude
jokes about the patients that obviously
bother the assisting nurses. As a more junior
staff member, Dr.C is reluctant to criticize
the surgeon personally or to report him to
higher authorities. However, he feels that he
must do something to improve the situation.

Dr. C is right to be alarmed by the behaviour


of the senior surgeon in the operating room.
Not only is he endangering the health of the
patient but he is being disrespectful to both
the patient and his collegeous. Dr.C has an
ethical duty not to ignore this behaviour but
to do something about it.

As a first step, he should not indicate any support for the


offensive behaviour, for example, by laughing at the jokes.
If he thinks that discussing the matter with the surgeon
might be effective, he should go ahead and do this.
Otherwise, he may have to go directly to higher authorities
in the hospital. If they are unwilling to deal with the
situation, then he can approach the appropiate physician
licencing body and ask it to investigate.

1.
2.
3.
4.

Sejak terwujudnya praktek kedokteran


Masyarakat mengetahui beberapa
sifat mendasar & melekat pada diri
seorang dokter yg baik & bijak yaitu :
Kemurnian niat
Kesungguhan kerja
Kerendahan hati
Integritas ilmiah & moral yg tidak
diragukan

THANK
YOU
YA!!!!!