STANDARD dan ETIKA PROFESI

Soenarto Sastrowijoto
Center for Bioethics & Medical Humanoties
Fakultas Kedokteran Universitas Gadjah Mada
Yogyakarta
2006

UU Praktek Kedokteran No. 29 Tahun

2004
Ketentuan Umum
1. Praktek Kedokteran 9. Sarana Pelayanan
2. Dokter dan Dokter Gigi Kesehatan
3. Konsil Kedokteran Indonesia 10.Pasien
4. Sertifikat Kompetensi 11.Profesi Kedokteran
5. Registrasi 12.Organisasi Profesi
6. Registrasi Ulang 13.Kolegium
7. Surat izin Praktek 14.Majelis Kehormatan
8. Surat Tanda Registrasi Dokter Disiplin
Kedokteran
15.Menteri
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PROFESI KEDOKTERAN/KED. GIGI

Satu pekerjaan
Keilmuan, kompetensi
Pendidikan berjenjang
Kode etik
Melayani masyarakat

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STANDARD
A degree or level of requirement, excellence, or
attaintment.
Synonym : Standard, benchmarch, Criterion, gauge
measure, touchstone, yardstick.

Standard Operating Procedure (SOP)

Establisehed procedurre to be followed in carryiing out a given
operation, or in a given situation

ETIKA, ETHICS, BIOETHICS, HEALTH ETHICS ,

MEDICAL ETHICS, CLINCAL ETHICS

Basic Moral /Ethical Principles.

1. Respect for persons (others)

2. Beneficence, non- maleficence

3. Justice

ETHICS - Health /Medical Services - patients

- Health/ Medical Research - research
participant
- Health /Medical Education - students
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PROFESSIONALISM (in medicine)

Constituting those attitudes and behaviors that serve to

maintain patient interest above physicians self interest
To profess = to proclaim something publicly
Physician : - to be competent to help the patient
- to have the patients best interest in mind
STUDENT graduate oath physician employed.
Without oath skilled worker.
Profession : - Formal education - Schorly journal
- Standards - High Social Status
- Disciplinary mechanism - Protected - State regulation
- market pressure

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HISTORY OF PROFESSIONALISM

Three Kinds of Practitioners

1. The impostor in physicians robes
(Penipu yang lihai ditutup jubahnya)
2. The Vainglorious pretender
(Sombong, besar kepala, berpura-pura)
3. Those endowed with
the true virtue of healer
(Penyembuh yang baik/bijak)

Characa 120-162 AD.

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Ancient Hindu, Confucian, Hippocratic, William Osler etc.

An ancient couplet (Sanskrit)
A physician is the elder brother of Yama, the lord of death,
because Yama takes away only your life, but the physician
takes away your life and all your money
Plato-2 types of doctor-patient relationship
1. The physician never listens from the slave any account of
his complaints, no asks any, he gives some empiric
treatment with an air of knowledge in the brusque fashion
of a dictator, and then is off in haste to the next ailing
clave
2. In constasted for free citizens
The physicians treats their disease in a scientific way and
takes the patient and his family into confidence. He never
gives prescriptions until he has won the patients trust and
when he has done so, he aims to produce complete
restoration to health by persuading the patient to comply8
with the therapy.

CLINICAL ETHICS
In Medical Services

Basics Ethical Principles

1. Medico legal Perspective
2. An approach for specific cases
3. The Ethics Work-up
4. Resolution Clinical Ethical Disagreement
5. Preventive Ethics

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 Clinical Cases
1. Informed Consent
2. Health care Proxy /Living will
3. End of life
4. Physician assisted dying
5. Autopsy consent
6. Organ Donation
7. Competence
8. Truth Telling
9. Confidentiality
10. Interaction with peers
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11. Diffecult Relationship with Patient

12. Disability
13. Interactions with supervisors
14. Conflict of interest
15. Mistake
16. Sex
17. Gift
18. Language Differences
19. Cultural Differences
20. Money /Managed Care
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ETHICAL AND REGULATORY ASPECTS

of Clinical Research

I. Scandal and Tragedies of Research with Human

Participants: Nuremberg, the Jewish chronic
Diseases Hospital, Beecher, and Tuskegee.
II. Ethical and Regulatory Guidence for Research
with Human
III. The Ethics of Clinical Trial Design
1. The Distinction between Research & Treatment
2. RCT
3. The Role of Placebos in Clinical Research
4. The Ethics of Phase I Research
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IV. The Ethic of Research Participant
Recruitment
1. Justification
2. Access to research
3. Payment of Research Participant
V. Informed Consent in Research
VI. Clinical Research with special Population
1. Impaired Person
2. Children
3. Captive population : Soldiers, Prisoners, Students

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VII. Special Topic in Research Ethics

1. Genetic Research
2. Stored Human Biological specimen
3. Human Embryo and stem cells
4. Drug challenge and Drug washout studies
5. Research with communities
6. International Research
VIII. Behaviour of Clinical Investigators + Conflict of
Interest
IX. Scientific Misconduct
1. Altering data : Fraud, Fabrication, and Falcification
2. Rules of authorship
3. Problems in the Publication of Research Methods and Findings
X. Challenges to the Institution Review Board
System
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