Group 2 presents for plenary disccussion:

Pak Budi yang awam

Guruh Aryo Seno Astrid Avidita Cut Putri Shara Fiska Rahmawati Indah Nurul M. Iqbal Donarika W. Maria Ulfah Nuzulia NiMatina R. Prindjati P. Sandhy Hapsari A. (H2A010023) (H2A010007) (H2A010010) (H2A010017) (H2A010025) (H2A010026) (H2A010032) (H2A010036) (H2A010042) (H2A010046)

Faculty of Medicine Muhammadiyah Semarang University 2013

 Anton is a religious doctor, he became Mr Budis family doctor since they were married. Mr Budi and his wife have been married for 12 years and they have been blessed with 2 children, the first child aged 10 years and the second one 5 years old. Mrs Budi was pregnant her third child and she regularly went to the dr Anton. When her pregnancy reach 15 weeks, both of her children infected by rubella virus. Consider that rubella may cause fetal disorder, dr. Anton suggested that two of her children were treated in hospital or at grandma's or relativess house and not living with his mother. When Mr Budi ask was its related with his wife's pregnancy, dr Anton just explain that it just an advise so Mr Budi not exhausted because of busy taking care of her sick children. But dr. Anton didnt aware mr budi about the risk of rubella transmission being suffered by his children to his wife who is pregnant and it can make defects in his unborn fetus. Dr anton did not want to add burden on mr and mrs budi. For several days mrs budi have fever and symptoms that similar like her children disease, so Mr. Budi bring his wife to see dr Anton. After examination, dr Anton conclude that it is rubella disease. Then dr anton gives proper care mrs budi, but he did not tell any possible defects in the fetus because he feared mr and mrs budi would have an abortion.

Define Objective Learning

Rubella Medical law Ethics

Rubella

Rubella transmission in pregnant women:

first trimester, fetal infection rates are near 80% late second trimester its dropping to 25% and increasing again in the third trimester from 35% at 2730 weeks gestation nearly 100% beyond 36 weeks gestation.

Issues Related to Health Care

Provision of health services The rights and obligations of patients (Medical practice legislation number 29 of 2004: chapter 50 and 51) Rejection and termination of health services Quality of life Definition of death Definitions of health and disease Paternalism in health care Informed consent Conduct code of professionalism Research ethics Clinical ethics

PATIENT RIGHTS
Chapter 52 1. Obtain a full description of the medical treatment referred in paragraph (3) of chapter 45, that is:
Diagnosis and medical treatment procedures; The purpose of medical action is taken; Other alternatives action and risks; Risks and complications that may occur, and Prognosis if the action taken.

2. 3. 4. 5.

Ask the opinion of another doctor or dentist; Getting medical care as needed Refuse medical treatment, and Gets the contents of the medical record.

Patient obligations
Chapter 53 1. Provide complete and honest information about health issues; 2. Comply with the advice and guidance physician or dentist; 3. Comply with applicable provisions in health care facilities; 4. Provide benefits for services received.

Right of doctor
Right doctor based Medical practice legislation Number 29 of 2004. Chapter 50
1. obtain legal protection 2. carry out duties in accordance with professional standards and standard operating procedures 3. provide medical care according to professional standards and standard operating procedures 4. obtain a complete and honest information from the patient or his family 5. and receive payment for services

Duty doctor
duty doctor based Medical practice legislation Number 29 of 2004 Chapter 51
1. 2. 3. 4. provide medical services in accordance with professional standards and standard operating procedures as well as the medical needs of patients referring patients to other doctors or dentists who have expertise or skills better, if not able to perform an examination or treatment keep secret everything he knows about the patient, even after the patient has died perform first aid on the basis of humanity, except when he was sure no one else is in charge and able to do so, and increase knowledge and keep abreast of medicine or dentistry.

5.

Duty Doctor
Health legislation Number 36 of 2004:
Chapter 7. Every person has the right to obtain health information and education about a balanced and responsible Chapter 8. Everyone has the right to obtain information about her health data, including measures and treatments that have been or will be received from a health

Basic principles of ethics

Beneficence Non maleficence Justice Autonomy

Beneficience
Principles that a doctor do good, respect for human dignity, the physician must also see to it that patients treated in a health state. Beneficience provides a sense of ease and bring pleasure to the patients take positive steps to maximize the result better than a bad thing
characteristic features :
prioritize altruism Looking at the patient or family is not an act not only benefits a doctor Ensuring that good or better benefits than the ugliness Guarantee either a minimum of human life Maximization of overall patient rights Applying the Golden Rule Principle, which is doing a good thing as the other person wants provide prescription letter

Non maleficence
Is a principle that a doctor does not do anything that aggravates the patient and choose the best treatment with little risk for patient. Ancient expression first, do no harm still apply and must be followed. Characteristic features : Helping emergency patients Treating patients whose wounds Do not kill the patient not regard patient as an object Protect patients from attack Patient has many more benefit than doctors losses No harm to patients due to negligence Not doing White Colar Crime

Justice
justice is a principle of doctor treats equally and fairly to the happiness and comfort for the patient. Differences in the level of economic, political, social position, nationality and religion can not change the attitude of doctors towards patients. Characteristic features : Treat everything universally Respect the health rights of patients Appreciate the legal rights of patients

Autonomy
This principle explains a physician to respect human dignity. Every individual must be treated as human beings have the right to self-determination. In this case the patient was given the right to think logically and make his own decisions. Terms somebody can make his own decisions in Indonesia: Adult (over 21 years of age or married) Not unconscious Have a good mental state and not lose competent

Abortion, according to Health legislation number 36 of 2009

Chapter 75 1. 2. Any person prohibited from having an abortion Prohibition as referred to paragraph (1) may be waived by:
Emergency medical indications detected early age pregnancy, which threaten both of life of the mother and/or fetus, which suffered severe genetic diseases and / or birth defects, or can not be repaired making it difficult for the baby to live outside the womb, or Pregnancy caused by rape which can cause psychological trauma for rape victims

3.

4.

Action referred to in paragraph (2) may only be made after going through counseling and / or pre-action and post-action counseling that conducted by competent and authorized counselor. Further provisions about emergency medical indications and rape, as referred to in paragraph (2) and (3) is regulated by the Government.

Abortion, according to Health legislation number 36 of 2009

Chapter 76 1. 2. 3. 4. 5. 6. Abortion as referred to in chapter 75 can only be done: Before pregnancy approaches 6 (six) weeks counted from the first day of last period, except in case of medical emergencies; By health workers who have the skills and have the certificate authority specified by the minister; With the approval of the concerned pregnant women; With the husband's permission, except for rape victims, and Health care providers are eligible which has been appointed by the Minister.

THANK YOU..