TUGAS BIOETIKA

COKORDA GEDE ARI DANANJAYA

18710046
KELOMPOK I2
SIDOARJO
 C ASE 1

• 70-year-old man who was unconscious and received hospital ICU treatment in
Florida, United States. These nameless patients have a history of chronic
pulmonary disease, diabetes mellitus or diabetes, and atrial fibrillation or an
irregular and fast beating heartbeat. In addition, the medical also found high blood
alcohol levels. on the patient's chest there is a "Do Not Resuscitate" tattoo. The
condition of the patient is very concerning. Low tension. The acidity of the blood
is high, with a pH of 6.81 .. The doctor is ready to help but the tattoo on the chest
makes the team of doctors confused to determine the steps. Confusion is
increasing because the man does not have a family. Initially, the medical team then
took steps to ignore tattoo writing and immediately do first aid. Patients were
given empirical antibiotics, received fluids, and treated with Bilevel Positive
Airway Pressure (BPAP) to help them breathe. Finally, after seeing the patient's
history, an ethics consultant suggested to respect the tattoo writing. The reason, the
tattoo is considered as the life choice of the patient.
 BENEFICIENCE

CRITERIA YES NO

1. Prioritizing altruism (helping selflessly, willing to sacrifice) √

2. Guaranteeing the basic values of human dignity √

3. Looking at the patient / family and something not to the advantage of the doctor √

4. Try to make more benefits compared to bad. √

5. Responsible √

6. Ensure a good minimum human life √

7. Limitatin Goal-Based √
 Criteria Yes no

8. Maximizing the satisfaction of happiness / patient preferences √

9. Minimize adverse consequences. √

10. Obligation to help emergency patient √

11. Respect the patient's rights as a whole √

12. Do not withdraw honoraria beyond appropriateness √

13. Maximizing the highest satisfaction overall √

14. Develop the profession continuously √

15. Providing nutritious yet inexpensive medicine

16. Applying the Golden Rule Principle √

 NON MALEFICENCE

Criteria Yes No

Helping emergency patient √

The conditions for describing these criteria are:

• The patient is in a dangerous condition. √
• Doctors are able to prevent harm or loss. √
• The medical action proved effective √
• Benefits for patient > doctor's loss (only experiencing minimal risk). √
Treat injured patient √

Do not kill patient (do not do euthanasia) √

Not insulting √

Do not view patient as objects √

Treating disproportionately √
 Criteria Yes No

Do not prevent patient dangerously √

Avoid misrepresentation of patient √

Do not endanger the patient's life due to negligence √

Does not give life spirit √

Does not protect patient from attacks √

Do not do white collar in the health field √

 AUTONOMY
Criteria Yes No

Respecting the right to self-determination, respecting the dignity of patient. √

Do not intervene in patient in making decisions (under elective conditions) √

Put on the line √

Appreciate privacy. √

Keep personal secrets √

Appreciate patient rationality. √

Carry out informed consent √

Allowing adult patients and competent to make their own decisions. √

Do not intervene or obstruct patient autonomy. √

 Criteria Yes No

Prevent other parties from intervening in patients and making decisions, √

including, including the patient's own family.

Patiently waiting for the decision to be taken by the patient in a non- √

emergency case.

Don't lie to the patient even for the benefit of the patient. √

Maintain relationship (contract) √

 JUSTICE
Criteria Yes No

Enact everything universally √

Take the last portion of the dividing process he has done. √

Giving equal opportunities to individuals in the same position. √

Respecting patients' health rights (affordability, equality, accessibility, √

availability, quality)
Appreciate the legal rights of patients. √

Respect the rights of others. √

Maintain vulnerable groups (the most disadvantaged)

Do not abuse. √
 Criteria Yes No

Wise in macro allocations.

Provide a contribution that is relatively the same as the patient's needs √

Request patient participation according to ability.

The obligation to distribute profits and losses (costs, expenses, sanctions)

fairly
Return rights to the owner at the right time and competent.

Does not give heavy burden unevenly without valid reasons

Respect the rights of the population who are equally susceptible to diseases /
health problems.
Does not distinguish patient services on the basis of SARA, social status etc.
 4 BOX METHOD OF CLINICAL ETHICS

Medical Indications Client Preferences

The patient has a history of chronic pulmonary patient comes in an unconscious state
disease, diabetes mellitus, and fibrillation. In addition,
the medical also found high blood alcohol levels.

Quality of Life Contextual Features

The patient dies when the doctor stops resuscitation there is no relationship between the socioeconomic
conditions of patients in making treatment decisions
Dilema etik : Beneficence vs Autonomy

- Beneficience :Doctors try to help patients in the treatment process.

- Autonomy :Appreciate the patient's right to self-determination

Prima facie :
Autonomy
 PRINCIPLE
PROFESIONALISME

• Duty: doctors try to help patients

• Alturism: doctors initially try to attach importance to patients
• Respect for others: yes
• Accountable:Yes
• Humanity: yes
 CASE 2

• 9-month-old baby came to the Hospital ED on Thursday at 14.00 WIB. Patients

present with heat, coughing for 1 week, cold chills, and heavy breathing
(dypsneu). On this indication the doctor keeps the emergency room in the patient's
PICU room. After the doctor guarded the patient's family about the patient's
condition, the child's father refused to enter the patient in the PICU room and
chose to be treated in a regular inpatient room. After being given a re-explanation
of the condition of the patient, the patient's family finally wanted to be treated in
the PICU room, but because there were other patients with PICU emergency, they
became full. After being given treatment in the emergency room, the patient's
family finally wanted to be treated in the inpatient room with the patient being
given oxygen. At 23:00 the patient arrived in the inpatient room and the condition
of the patient worsened. Around 6:30 a.m. the patient died in the inpatient room.
Grateful, the patient's family accepts the condition of his child who has left the
family forever
 BENEFICIENCE

Criteria Yes No

1. Prioritizing altruism (helping selflessly, willing to sacrifice) √

2. Guaranteeing the basic values of human dignity √

3. Looking at the patient/family and something not to the advantage of the √

doctor
4. Try to make more benefits compared to bad. √

5. Responsible √

6. Ensure a good minimum human life √

7. Limitatin Goal-Based √
 Criteria Yes No

8. Maximizing the satisfaction of happiness / patient preferences √

9. Minimize adverse consequences. √

10. Obligation to help emergency patient √

11. Respect the patient's rights as a whole √

12. Do not withdraw honoraria beyond appropriateness √

13. Maximizing the highest satisfaction overall √

14. Develop the profession continuously √

15. Providing nutritious yet inexpensive medicine √

16. Applying the Golden Rule Principle √

 NON MALEFICENCE
Criteria Yes No

Helping emergency patient √

The conditions for describing these criteria are:

• The patient is in a dangerous condition. √
• Doctors are able to prevent harm or loss. √
• The medical action proved effective
• Benefits for patient > doctor's loss (only experiencing minimal risk). √
Treat injured patient √

Do not kill patient (do not do euthanasia) √

Not insulting √

Do not view patient as objects √

Treating disproportionately √
 Criteria Yes No

Do not prevent patient dangerously √

Avoid misrepresentation of patient √

Do not endanger the patient's life due to negligence √

Does not give life spirit √

Does not protect patient from attacks √

Do not do white collar in the health field √

 AUTONOMY
Criteria Yes No

Respecting the right to self-determination, respecting the dignity of patient. √

Do not intervene in patient in making decisions (under elective conditions) √
Put on the line √
Appreciate privacy. √
Keep personal secrets √
Appreciate patient rationality. √
Carry out informed consent √
Allowing adult patients and competent to make their own decisions. √
Do not intervene or obstruct patient autonomy. √
Prevent other parties from intervening in patients and making decisions, including, √
including the patient's own family.
Patiently waiting for the decision to be taken by the patient in a non-emergency case. √

Don't lie to the patient even for the benefit of the patient. √
Maintain relationship (contract) √
 JUSTIC
E
Criteria Yes No

Enact everything universally √

Take the last portion of the dividing process he has done. √

Giving equal opportunities to individuals in the same position. √

Respecting patients' health rights (affordability, equality, accessibility, availability, √

quality)
Appreciate the legal rights of patients. √

Respect the rights of others. √

Maintain vulnerable groups (the most disadvantaged) √

Do not abuse. √
 Criteria Yes No

Wise in macro allocations. √

Provide a contribution that is relatively the same as the patient's needs √

Request patient participation according to ability. √

The obligation to distribute profits and losses (costs, expenses, sanctions) fairly √

Return rights to the owner at the right time and competent. √

Does not give heavy burden unevenly without valid reasons √

Respect the rights of the population who are equally susceptible to diseases / √
health problems.
Does not distinguish patient services on the basis of SARA, social status etc. √
 4 BOX METHOD OF CLINICAL ETHICS
Medical Indications
Patients present with cold acral,
decreased consciousness, and heavy
breathing (dypsneu).
Quality of Life
he patient cannot be saved
doctor Can minimize complications during treatment
Client Preferences
the decision is in both parents. The
doctor gives education
Contextual Features
Is there a relationship between the patient's socio-
economic conditions in making treatment decisions?
There are, economic conditions
 Dilema Etik

• Beneficence
• Non Maleficence

• Prima Facie : Non Maleficence

 PRINCIPLE PROFESIONALISME

• Altruism: yes
• Duty:There
• Respect for others: yes
• Accountable:Yes
• Humanity: yes