HAK PASIEN DAN KELUARGA DALAM

MENERIMA ASUHAN PASIEN DI MASA

PANDEMI COVID-19

BUDI SAMPURNA
KOMPARTEMEN HUKUM ADVOKASI DAN MEDIASI PP PERSI
POKOK BAHASAN
• KEKHUSUSAN PANDEMI
• KAIDAH DASAR BIOETIKA DAN HAK PASIEN
• HAK PASIEN YG HARUS DIPERTAHANKAN DAN HAK
PASIEN YG HARUS MENGALAH
KEKHUSUSAN PANDEMI
• Bahaya Penularan dan Kematian
• Distancing, APD, cuci tangan, testing,
• Isolasi (non voluntary admission), Pembatasan
• Status Kedaruratan Kesehatan Masyarakat:
• hak masyarakat banyak vs hak Individu
• Pencegahan vs kebebasan otonomi
• Penggunaan Alasan Kedaruratan
• Keterbatasan Sumber Daya:
• Utilitas dan manfaat sumber daya maksimal
• Fairness Distribution belum tentu mampu laksana
 KAIDAH DASAR BIOETIKA: AUTONOMY

• RIGHTS TO SELF-DETERMINATION:
• Informed consent, refusal,

• PRIVACY:
• Tracing, testing, reporting, referring,

• CONFIDENTIALITY:
• Data untuk surveillance, data untuk klaim ke pemerintah,

• PENDAMPINGAN OLEH KELUARGA

• Oleh alasan safety, hak ini dibatasi

• ASUHAN YANG SESUAI KEPENTINGAN PASIEN

• Patient best interest vs ketersediaan
KAIDAH DASAR BIOETIKA: NON-
MALEFICENCE
• PATIENT SAFETY:
• Hanya approved medicine/devices vs kedaruratan
• PENCEGAHAN PENULARAN:
• Kesiapan APD vs Pelayanan Cepat dan Bermutu
• Distancing /Pemisahan, Hand-hygiene vs Mutu Komunikasi
• Consultation / referral vs Telemedicine
• KOMUNIKASI-INFORMASI-EDUKASI
• limited information, limited alternatives, limited time vs Komunikasi dan
Edukasi efektif
KAIDAH DASAR BIOETIKA: BENEFICENCE

• MEMPEROLEH INFORMASI
• Informasi terbatas,
• LAYANAN BERMUTU SESUAI STANDAR
• Non approved medicine and devices, keterbatasan SDM
• LAYANAN YANG ADIL DAN NON DISKRIMINATIF
• Keterbatasan sumber daya,
• lansia dan ko-morbiditas
• best practice, standard of care vs kedaruratan, ketersediaan
KAIDAH DASAR BIOETIKA: JUSTICE
• FAIR ACCESS
• Yankes Primer relative merata, Yankes sekunder dan Tertier tidak
merata, termasuk yg khusus Covid-19
• FAIR DISTRIBUTION
• Sumber Daya untuk Covid-19 tidak merata
• DISCRIMINATION
• Lansia, Orang dengan Ko-morbid,
• PUBLIC VS INDIVIDU
• Privasi, kerahasiaan vs Surveilans

Veracity: waive copayment, overbill, provide unnecessary services, etc

 HAK PASIEN UU 44/2009

• memperoleh informasi mengenai tata tertib dan peraturan

yang berlaku di Rumah Sakit;
• memperoleh informasi tentang hak dan kewajiban pasien;
• memperoleh layanan yang manusiawi, adil, jujur, dan
tanpa diskriminasi;
• memperoleh layanan kesehatan yang bermutu sesuai
dengan standar profesi dan standar prosedur operasional;
• memperoleh layanan yang efektif dan efisien sehingga
pasien terhindar dari kerugian fisik dan materi;
 HAK PASIEN UU 44/2009
• mengajukan pengaduan atas kualitas pelayanan yang
didapatkan;
• memilih dokter dan kelas perawatan sesuai dengan
keinginannya dan peraturan yang berlaku di Rumah Sakit;
• meminta konsultasi tentang penyakit yang dideritanya kepada
dokter lain (second opinion) yang mempunyai Surat ijin Praktik
(SIP) baik di dalam maupun di luar rumah sakit;
• mendapatkan privasi dan kerahasiaan penyakit yang diderita
termasuk data-data medisnya;
• memberikan persetujuan atau menolak atas tindakan yang akan
dilakukan oleh tenaga kesehatan terhadap penyakit yang
dideritanya;
 HAK PASIEN UU 44/2009
• mendapat informasi yang meliputi diagnosis dan tata cara
tindakan medis, tujuan tindakan medis, alternatif tindakan, risiko
dan komplikasi yang mungkin terjadi, dan prognosis terhadap
tindakan yang dilakukan serta perkiraan biaya pengobatan;
• didampingi keluarganya dalam keadaan kritis;
• menjalankan ibadah sesuai agama atau kepercayaan yang
dianutnya selama hal itu tidak mengganggu pasien lainnya;
• memperoleh keamanan dan keselamatan dirinya selama dalam
perawatan di Rumah Sakit;
 HAK PASIEN UU 44/2009
• mengajukan usul, saran, perbaikan atas perlakuan Rumah
Sakit terhadap dirinya;
• menolak pelayanan bimbingan rohani yang tidak sesuai dengan
agama dan kepercayaan yang dianutnya;
• menggugat dan/atau menuntut rumah sakit apabila rumah sakit
diduga memberikan pelayanan yang tidak sesuai dengan
standar baik secara perdata ataupun pidana; dan
• mengeluhkan pelayanan rumah sakit yang tidak sesuai dengan
standar pelayanan melalui media cetak dan elektronik sesuai
dengan ketentuan peraturan perundang-undangan.
JAGA HAK PASIEN
• PRIVACY: diri pasien, informasi kesehatan (batasi hanya di
lingkungan petugas),
• VISITATION: ingat agar hak pasien respected, protected, promoted
• DISCRIMINATION: Lindungi pasien pediatri, geriatric, disabilities,
• ENVIRONMENT OF CARE AND LIFE SAFETY: Bersih, K3,
• PATIENT CARE: protocol disesuaikan, pain management, fall
prevention, dll
• INFECTION PREVENTION AND CONTROL: APD, hand hygiene,
distancing, cegah penularan nosokomial
FAMILY PRESENT ?
PERTIMBANGAN
• Is there widespread, active community transmission or not?
• How available is Personal Protective Equipment (PPE) such as masks, gowns
and
• gloves for use by both staff and family members?
• How adequate are local testing capabilities? Is reliable rapid point-of-care
testing available for Care Partners?
• Is staffing adequate to responsibly manage family’s presence?
• Does the physical layout of the space allow for appropriate physical
distancing?
• Do restrictions to family presence and participation create a safety, clinical or
emotional risk to the patient or resident that outweighs that of COVID-19?
HUMAN RIGHTS
• states cannot derogate to non-derogable rights, among which
the right to life, prohibition of torture and ill treatments,
prohibition of slavery, and no punishment without law
• Tracing, testing, treatment,
• isolation, no family visit,

• Older persons have the same rights as others, so do

the people with co-morbidities, and these must be
equally protected during the pandemic
LINDUNGI HAK PASIEN
1. Hospitals should display details of the
charges for various procedures, government
fixed package rates for COVID-19 at a
conspicuous location in private hospitals,
such as the reception area, entrance etc.

OXFAM Submission to National Human Rights Commission’s Committee, India

LINDUNGI HAK PASIEN

2. The information regarding availability

of beds being displayed at a
conspicuous location in or outside
hospital as well as on digital media like
website or Apps and must be accurate
and in real time.

OXFAM Submission to National Human Rights Commission’s Committee, India

LINDUNGI HAK PASIEN
3. The government must institute a formal
grievance redressal mechanism to ensure
timely redress of formal complaints against
hospitals. A live publically-accessible database
should be maintained of all the complaints
received. The process of redress must include
members from civil society to ensure
transparency.
OXFAM Submission to National Human Rights Commission’s Committee, India
LINDUNGI HAK PASIEN
4. The Hospitals should ensure the relatives of
COVID patients are updated on the condition
of the patients on a daily basis, at least. The
information provided to them should be in
simple language, understandable to them.
Moreover, video-conferencing facilities should
be organised to allow relatives to speak to
their family members admitted in hospitals.
OXFAM Submission to National Human Rights Commission’s Committee, India
LINDUNGI HAK PASIEN
5. Hospitals must ensure dignity of deceased
by handing dead body to relatives
immediately or providing dignified final rites
as per the recommended guidelines.

6. The state needs to ensure access to

ambulances as a critical prerequisite to ensure
access to healthcare.
OXFAM Submission to National Human Rights Commission’s Committee, India
CATATAN AKHIR
• The virus does not discriminate; but its
impacts do.
• Ensure that any emergency measures,
including states of emergency, are legal,
proportionate, necessary and non-dis-
criminatory, have a specific focus and
duration, and take the least intrusive
approach possible to protect public health