Introduction to Indonesian Code of Ethics
Transcript of Introduction to Indonesian Code of Ethics
-
8/12/2019 Introduction to Indonesian Code of Ethics
1/21
Introduction to
Code of EthicsAn Interactive Lecture
Leonardi A Goenawan
-
8/12/2019 Introduction to Indonesian Code of Ethics
2/21
What do you know about Ethics?
The Science of Human Duty
A particular system of principles & rulesconcerning duty, whether true or false
Rules of practice in respect to a singleclass of human actions; as, political orsocial ethics; medical ethics.
-
8/12/2019 Introduction to Indonesian Code of Ethics
3/21
According to Philosophy 1
Ethics is a major branch of philosophy,encompassing right conduct and good life.It is significantly broader than the
common conception of analyzing right andwrong. A central aspect of ethics is "thegood life", the life worth living or life that
is simply satisfying, which is held by manyphilosophers to be more important thanmoral conduct
-
8/12/2019 Introduction to Indonesian Code of Ethics
4/21
According to Philosophy 2
Ethics is the formal study of moral standardsand conduct. For this reason, the study of ethicsis also often called "moral philosophy." What is good? What is evil?
How should I behave - and why?
How should I balance my needs against the needs ofothers?
These are some of the questions asked in the field of
ethics, a branch of philosophy which has some of themost immediate and obvious consequences for howwe live our lives.
-
8/12/2019 Introduction to Indonesian Code of Ethics
5/21
Moral or Ethics ?
Ethic:A set of moral principles; a theory or system of moral values; The principles of conduct governing an individual or
a group;A guiding philosophy;A consciousness of moral importance;A set of moral issues or aspects (as rightness);
Ethics is usually regarded as more universal in nature.People from all cultures share the same ethics. Itcontains the idea of distinguishing what is right fromwrong, and striving to do what is right.
-
8/12/2019 Introduction to Indonesian Code of Ethics
6/21
Moral or Ethics ?
Moral:
Relating to principles of right and wrong in behavior;
Expressing or teaching a conception of right behavior;
Conforming to a standard of right behavior; Capable of right and wrong action;
Morality may be more local in nature, more culturespecific.
There are many cultural practices which are moral orimmoral depending where they are practiced.
-
8/12/2019 Introduction to Indonesian Code of Ethics
7/21
Why medical ethics is important?
Physicians deal with saving humans life.
Patients want dedicated physicians theycan trust.
Physicians want to feel good aboutthemselves and what they do.
-
8/12/2019 Introduction to Indonesian Code of Ethics
8/21
THE MEDICAL ECOSYSTEM
- Enlarging Circle of Influence
DOCTOR PATIENT
Disease DiagnosisHealth Promotion
Disease Prevention Therapy
Medical InsuranceManaged Care
Hospital
Laboratories
Pharmaceutical
Industry
Patients Family,
Culture, Religion
Patients Work, Employer
Other Doctors
Paramedics
Clinic
Management
Public Health
Medical
ResearchMedical
Students
CME,
CPD
Doctors
Employer
DoctorsFamily
Doctors
Employee
Practice
Management
MDO
Medical Council
The LAWGovernment
Bodies
Medical
Charities
Patient
Organisation
Alternative
Medicine
Press, Media
National Community
International Community
Natural Disasters
Political
Upheaval, War
-
8/12/2019 Introduction to Indonesian Code of Ethics
9/21
THE PRINCIPLES IN MEDICALETHICS
The Principle of Non-Maleficence
The Principle of Beneficence
The Principle of Autonomy The Principle of Veracity
The Principle of Confidentiality (or
Fidelity) The Principle of Social Responsibility and
Justice
-
8/12/2019 Introduction to Indonesian Code of Ethics
10/21
The Principle of Non-Maleficence
First do no harm
Sanctity of life
Calculated risk or risk benefit
-
8/12/2019 Introduction to Indonesian Code of Ethics
11/21
The Principle of Beneficence
Do only that which benefits the patient
Patients welfare as the first consideration
Care consideration competence The obligation to provide and accept
beneficial treatment
-
8/12/2019 Introduction to Indonesian Code of Ethics
12/21
The Principle of Autonomy
Right to information and selfdetermination
Free and informed consent
Free will and accord - intentionalparticipation in treatment
Respect and dignity maintained
The right of an individual to choosebetween various alternatives presented tothem
-
8/12/2019 Introduction to Indonesian Code of Ethics
13/21
The Principle of Veracity
Truth telling
Obligation to full and honest disclosure
-
8/12/2019 Introduction to Indonesian Code of Ethics
14/21
The Principle of Confidentiality
Based on loyalty and trust
Maintain the confidentiality of all personal,
medical and treatment information Information to be revealed with consent and
for the benefit of the patient
Except when ethically and legally required Disclosure should not be beyond what is
required
-
8/12/2019 Introduction to Indonesian Code of Ethics
15/21
The Principle of Justice andSocial Responsibility
Actions are consistent, accountable andtransparent
Not to discriminate on age, sex, religion,race, position or rank
Greater good of society
Respect of the Law Equity and distribution of burden &
benefits
-
8/12/2019 Introduction to Indonesian Code of Ethics
16/21
Principle of Double-Effect
The act itself must be morally good or at leastindifferent.
The agent may not positively will the bad effect
but may merely permit it. If he could attain thegood effect without the bad effect, he should doso. The bad effect is sometimes said to beindirectly voluntary.
The good effectmust be produced directly bythe action, not by the bad effect. Otherwise, theagent would be using a bad means to a goodend, which is never allowed.
-
8/12/2019 Introduction to Indonesian Code of Ethics
17/21
Principle of Double-Effect
The good effect must be sufficiently desirable tocompensate for the allowing of the bad effect. Informing this decision many factors must be weighed andcompared, with care and prudence proportionate to theimportance of the case. Thus, an effect that benefits or
harms society generally has more weight than one thataffects only an individual; an effect sure to occurdeserves greater consideration than one that is onlyprobable; an effect of a moral nature has greaterimportance than one that deals only with material things
St Thomas Acquinas. New Catholic Encyclopedia, vol 4, 1967 (internet edition).
-
8/12/2019 Introduction to Indonesian Code of Ethics
18/21
What is an Ethical Dilemma?
A conflict between moral imperatives, i.e., whatis the right thing to do?
What is medically right vs. patient preference
Jehovahs Witnesses and transfusions
What is preferred by patient vs. proxy decision maker
Rights of minor vs. legal guardians
What is best for patient vs. what is best for society
Commitment laws, notification of sexual partners of patientswith HIV
-
8/12/2019 Introduction to Indonesian Code of Ethics
19/21
How to Analyze an Ethics Case
Whatis being proposed? What are the medical issues? Risks, benefits, alternatives Case and statutory law
Whoare the stakeholders? Patient, family, medical staff, hospital, state Cultural and religious concerns Are possible consultants to medical, legal, and ethical issues
Whendoes this need to be done? Emergency exceptions to informed consent
Whyis an ethical dilemma being created? Conflicts between decision makers, law and ethics
How can this be resolved? Meeting(s), consultation(s)
-
8/12/2019 Introduction to Indonesian Code of Ethics
20/21
Withdrawing vs. Withholding Care
Withdrawing care
Decision to remove an active intervention
that is already being provided to a patient
Withholding care
Decision not to provide an activeintervention to a patient
-
8/12/2019 Introduction to Indonesian Code of Ethics
21/21
Withdrawing vs. Withholding Care
In medical ethics today, there is no distinction madebetween withdrawing and withholding care.
In the past, withholding was considered ethicallysuperior to withdrawing.
Most recently, ethicist are espousing the positionthat withdrawing is ethically superior to withholding,since a trial of treatment gives information on itsefficacy for the particular patient.