LATAR BELAKANG
Latar Belakang
Kejadian cheating atau academic
dishonesty pada mahasiswa di perguruan
tinggi menunjukkan angka yang tinggi,
dengan variasi antara 30% sampai dengan
96%.
Menurut American Council on Higher
Education, cheating semakin meningkat
dengan variasi antara 40% sampai dengan
60% bahkan 80%. Cheating yang dilakukan
dalam pendidikan dokter di perguruan
tinggi, ternyata juga pernah dilakukan pada
pendidikan sebelumnya atau waktu SMA.
Latar Belakang
Menurunnya
standar profesional
dalam pelayanan kesehatan akibat
pengelompokan pasien berdasarkan
strata (GMC, 2001)
Profil
Lulusan Kedokteran Tuntutan
Pasar
The Five-Star
Doctor
Care Provider
Decision Maker
Communicator
Community Leader
Manager
LATAR BELAKANG
NICO L
Pokok Bahasan
Pengertian Profesi
Pengertian......(lanjutan)
Ciri Profesi:
SELF REGULATION
SELF GOVERNING
SELF DISCIPLINING
PROFESI
A profession is any group sharing a
special body of knowledge, standards of
education and practice, professional
associations, and an ethical framework
based in a social contract that permits a
high degree of self-regulation.
On that view, ethics is an important
descriptor for a profession, but ethics is
not its essential and indispensable
defining feature.
Pekerjaan vs Profesi
Occupation
Kebutuhan pokok, 4
tujuan :
Profession
Gaji
Jenis Profesi
Pengertian Profesional
Profesional
Pengertian
profesionalisme
PROFESSIONALISM
Professionalism
Professionalism is the basis of medicine's
contract with society.
It demands placing the interests of patients
above those of the physician, setting and
maintaining standards of competence and
integrity, and providing expert advice to
society on matters of health.
Essential to this contract is public trust in
physicians, which depends on the integrity
of both individual physicians and the whole
profession
Definition
Elements of
Professionalism
Altruism is the essence of
professionalism. The best interest of the
patients, not self-interest, is the rule.
Accountability is required at many levels
- to individual patients, society and the
profession
Excellence entails a conscientious effort
to exceed normal expectations and make
a commitment to life-long learning
Elements of
Professionalism
Duty is the free acceptance of a commitment to
service.
Honour and integrity are the consistent regard
for the highest standards of behaviour and
refusal to violate ones personal and
professional codes.
Respect for others (patients and their families,
other physicians and professional colleagues
such as nurses, medical students, residents,
subspecialty fellows, and self) is the essence of
humanism"
KEY PRINCIPLES OF
PROFESSIONALISM
( ABIM 1994 )
1.
2.
3.
4.
5.
6.
EXCELLENCE
ACCOUNTABILITY
DUTY
ALTRUISM
RESPECT
HUMANITY
a.
b.
c.
d.
COMPASSION
EMPATHY
HONOR
INTEGRITY
Atribut/Elemen
Professional Behavior (ABIM)
1.
2.
3.
4.
5.
6.
Altruism
Accountability
Excellence
Duty
Honor/ Integrity
Respect
Atribut/Elemen
Professional Behavior (AAMC,
2002)
1.
2.
3.
4.
5.
6.
7.
8.
Altruism
Honor and Integrity
Caring and Compassion
Respect
Responsibility
Accountability
Excellence and Scholarship
Leadership
Atribut/Elemen
Professional Behavior (KKI, 2006)
1.
2.
3.
4.
5.
6.
7.
8.
Atribut/Elemen
Professional Behavior (Castellani, 2006)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Autonomy
Altruism
Interpersonal competence
Personal morality
Professional dominance
Technical competence
Social contract
Social justice
Lifestyle
Commercialism
Atribut/Elemen
Professional Behavior (Indonesia)
Ali (2010)
Gotong royong
Berakhlak mulia
Berbudi pekerti luhur
Bermoral utama
UGM Character
1. Altruism and advocacy
2. Respect and empathy
3. Honor and integrity
4. Long live learner
5. Communicate effectively
6. Responsibility and accountability
PROFESSIONALISM
True professionalism means the pursuit
of excellence, not just competence
Professionalism is predominantly an
attitude, not a set of competencies
A real professional is a technician who
cares
Professional is not a label you give
yourself. Its a description you hope
others will apply to you
Maister DH: True Professionalism, The Free Press, 1997
Professionalism
Altruism
Respect for
others
Accountability
Ethics
Competence
Honor and
Integrity
Excellence
Duty
ALTRUISM
ACCOUNTABILITY
HUMANISME
EXCELLENCE
PROFESIONALISM
PROFESSIONALISM
COMPETENCE
KNOWLEDGE AND
SKILLS
PHYSICAL AND
MENTAL FITNESS
CONDUCT /
ATTITUDE
EMPATHY
DUTY OF CARE
COLLEGIAL
RESPONSIBILITY
TEACHING
LEARNING
METHOD
CURRICULU
M DESIGN
DEVELOPING
PROFESSIONAL
ISM FOR THE
FUTURE
DOCTOR
(Passi, 2010)
STUDENT
SELECTION
ROLE
MODELI
NG
ASSESSM
ENT
METHODS
KNOWLEDGE
COMPETENCE
BASED
CURRICULUM
SKILLS
PROFESSIONA
L BEHAVIOR
Praktik Kedokteran
KARAKTERISTIK PRAKTIK
KEDOKTERAN
PROBABILITAS
PELUANG BIAS & UNKNOWN
HUBUNGAN DOKTER-PASIEN BERDASAR
UPAYA : KONTRAK TERAPEUTIK
(INSPANNINGSVERBINTENNIS)
DEFINISI
PROFESIONALISME KEDOKTERAN
PROFESIONALISME KEDOKTERAN
DITUNJUKAN MELALUI KOMPETENSI KLINIS,
KETERAMPILAN KOMUNIKASI DAN
PEMAHAMAN TERHADAP ETIK DAN HUKUM
YANG MENJADI DASAR DIBENTUKNYA
ASPIRASI TERHADAP DAN PENERAPAN
PRINSIP2 PROFESIONALISME (EXCELLENCE,
HUMANISM, ACCOUNTABILITY, ALTRUISM)
Kontrak Sosial
DOKTER
- Memberikan kemampuan
terbaik
- Tanggung jawab moral
Profesionalisme
MASYARAKAT
Pengakuan atas:
- kemampuan dokter
- keberadaan dokter
Qomarudin Sukri, 04
AKUNTABILITAS PROFESI
Kontrak
antarabetween
kelompok
profesi dengan
The contract
professions
and
masyarakat
umum. simple.
society is relatively
Profesi diberi monopoli dalam menggunakan
The
professions
are
granted
a
monopoly
keahliannya dalam pelayanan kpd
over the usedengan
of a body
of knowledge, as
masyarakat,
menimbang
well as considerable
autonomy,
otonominya,
prestige dan
imbalan prestige,
finansialnya
and financial rewards on the
Dan
sebaliknya that
profesi
harus
understanding
they
will menjamin
guarantee
kompetensi
mereka,
memberikan
layanan
competence,
provide
altruistic service,
yang
altruistik,their
berperilaku
yangmorality
bermoraland
dan
and
conduct
affairs
with
berintegritas
integrity
Ethico-legal System
Agus Purwadianto, 2005
MEDICAL INDICATION
CONTEXTUALITY
Health
Health Personnel
Personnel
Health
Health Facilities
Facilities
Health
Health system
system
BALLANCING
CONFLICT OF INTEREST
Law
Law as
as
social
social engineering
engineering
Medical
Goals
PROFESSIONALISM
Responsibility
Ethics
Accountability
Discipline
Liability
Community
QUALITY OF LIFE
Patients
Safety
Professional
Dignity
SOCIAL CONTRACT
Patient/Client
Family
BEST INTEREST,
PREFERENCES,
Value of
Health (Micro)
PUBLIC
TRUST
Etik
Berkaitan dengan penalaran,
pembenaran dan konflik moral diri
pribadi, dalam membuat keputusan
etis
Disiplin
Berkaitan dengan konflik antara
individu dan peer-groupnya
Hukum
Berkaitan dengan konflik antara
individu dan masyarakat (publik) atau
dengan peraturan atau dengan
individu lain
ETHICS
THE DISCIPLINE DEALING WITH WHAT IS
GOOD AND BAD AND WITH MORAL DUTY
AND OBLIGATION (Websters).
ETHICS OFFERS CONCEPTUAL TOOLS TO
EVALUATE AND GUIDE MORAL DECISION
MAKING
MEDICAL ETHICS IS A DISCIPLINE /
METHODOLOGY FOR CONSIDERING THE
IMPLICATIONS OF MEDICAL TECHNOLOGY /
TREATMENT AND WHAT OUGHT TO BE (Univ
of Washington School of Medicine)
Kehormatan
profesi
Kualitas moral
Organisasi profesi
MKEK
Sanksi etik
Disiplin
Hukum
Perilaku
pelayanan / standar
pelayanan
Pelanggaran
standar profesi
(benar salah)
Kualitas profesi
Konsil join
commission
Anggota profesi
Masyarakat
Profesi
Sanksi disiplin
Norma hukum
Pelanggaran
norma hukum (benar
salah)
Kedamaian
(mencegah
mengatasi konflik)
Perdata-pidana
Pengadilan :
Hakim
Jaksa/penggugat
Terdakwa/tergugat
Sanksi hukum
Disiplin profesi :
Suatu perangkat pengaturan tentang sikap dan
perilaku serta tindakan manusia yang terwujud
dari faktor-faktor intern manusia dan kaidah luar
yang memmpengaruhinya.
Aturan-aturan dan/atau ketentuan penerapan
keilmuan dalam pelaksanaan, pelayanan yang
harus diikuti oleh dr dan drg (PerKonsil 17/2006)
Patokan :
standar profesi
standar operational procedure
Pengawasan internal
Hukum
Sekumpulan kaidah atau norma yang
memuat perintah / larangan yang jika
diabaikan / dilanggar dapat dikenakan
sanksi
Administratif, ganti rugi, denda, kurungan,
penjara
kodeki
Etik
Ilmiah /
Disiplin
Hukum
Konflik etiko
mediko legal
Doktrin, KUHP, Perdata
Administratif
Clinical
Judgment &
Competencies,
SOP, SPM
Ethico-legal System
Agus Purwadianto, 2005
MEDICAL INDICATION
CONTEXTUALITY
Health
Health Personnel
Personnel
Health
Health Facilities
Facilities
Health
Health system
system
BALLANCING
CONFLICT OF INTEREST
Law
Law as
as
social
social engineering
engineering
Medical
Goals
PROFESSIONALISM
Responsibility
Ethics
Accountability
Discipline
Liability
Community
QUALITY OF LIFE
Patients
Safety
Professional
Dignity
SOCIAL CONTRACT
Patient/Client
Family
BEST INTEREST,
PREFERENCES,
Value of
Health (Micro)
PUBLIC
TRUST
Charter on
Medical Professionalism
Fundamental Principles:
Principle of primacy of patient welfare
Principle of patient autonomy
Principle of social justice
Professional
Responsibilities
Commitment to professional competence
Commitment to honestly with patient
Commitment to patient confidentiality
Commitment to maintaining appropriate
relations with patients
Commitment to improving quality of care
Professional
Responsibilities
Commitment to improving access to care
Commitment to a just distribution of finite
resources
Commitment to scientific knowledge
Commitment to maintaining trust by
managing conflict of interest
Commitment to professional responsibilities
Please visit : www.professionalism.org
Goal of
Medicine
Professional
Dignity
Elements of
Ethicolegal System
Patients
Safety
Professionalism
Bonafide
Maintain technical
expertise
competency Self-regulation
Liability
Discipline =
accountability
College
CME/CPD
Prof organization
Code of ethics/peer review
Respectable status
Prof insurance/MDU/MPS
Accountability
Konflik Etikolegal (KEL)
Liability
Medical
Negligenc
Sengketa
e
Medik
Threat of Professionalism
At present, the medical profession is
confronted by an explosion of technology,
changing market forces, problems in health
care delivery, bioterrorism, and
globalization.
Physicians are experiencing frustration as
changes in the health care delivery
systems in virtually all industrialized
countries threaten the very nature and
values of medical professionalism.
ANCAMAN PROFESIONALISME
DI INDONESIA
Sistem Pendidikan Kedokteran yg mahal
Sistem Pembiayaan yg fee for service
Sistem Pelayanan Kedokteran yg for
profit: komoditi ekonomi
Sistem liberalisasi pengadaan obat/alkes
Masyarakat yang semakin materialistik
Peraturan yang tidak lengkap
collegiality
Cruess SR et al: MJA 2002 177 (4): 208-211
SYSTEM REFORM:
PATIENT SAFETY, CLINICAL GOVERNANCE, RISK
MANAGEMENT, CLINICAL PATHWAYS, SISTEM
PEMBIAYAAN YANDOK, dll
ATTITUDE REFORM:
CHARTER ON MEDICAL PROFESSIONALISM,
GOOD MEDICAL PRACTICE, PENDIDIKAN ETIK &
HUMANIORA DI FK, PENDISIPLINAN
PRAKTIK KEDOKTERAN
YG DIANJURKAN
Mampukah
Profesionalisme
mencegah malpraktik?
PERLUNYA PRAKTIK
KEDOKTERAN DIATUR
ETIKA PERILAKU
DISIPLIN PROFESI
HUKUM PUBLIK
Etika vs
Moralitas
Beretika =
Bermoral??
Apa pendapat
Anda thd kasus ini
menurut
pengetian etik vs
moralitas?
Bermoral = Beretika
Oh, pantesan,
katanya gue dihisterektomi
Belajar Mandiri
KESIMPULAN
Profesionalisme dari seorang dokter berarti suatu standart sikap,
ketrampilan, dan keilmuan yang harus dimiliki dokter untuk dapat
dipakai dalam bekerja di masyarakat.
Profesionalisme dokter ditunjukkan dengan beberapa aspek yang
harus dimiliki dengan penghayatan sebagai bagian dari
konsekuensi pekerjaannya atau profesinya sebagai dokter. Aspekaspek itu adalah
aspek keilmuan atau disebut sebagai aspek disiplin
aspek etika
aspek hukum
Kepatuhan kepada Profesionalisme akan mencegah malpraktik