LEARNING ONJECTIVES

Aimed competency: Conducting ethical justification in every professional activities as a medical doctor.
Topic : The Relevancy and the Dynamics of Development of Medical Professional Ethics. Lecture objectives: 1. Understanding the relevancy of the existency of medical professional ethics. C3, A1, P1 2. Understanding the concept of biomedical ethics concept in relation to medical professional ethics. C3, A1, P1 3. Understanding the determinant of bioethics development: empirical experiences, philosophic and sosciologic studies, and religions norms. C3, A1, P1 4. Understanding the role and the position of professional organization in medical professional 3 ethics codification. C3, A1, P1

Mankind Activities

Ethics

Moral good-bad Arts Nice-bad

Knowledge right-wrong

Meaning
Moral dimension of the activities value system: good or bad morality

Morality for a specific ectivitiies/ community ethics

morality for medical professional Medical professional ethics = Medical Ethics
3

COMPETENCY

Specific privilege

Earned the life

Medical Profession
Competency dedicated his/her life public trust appreciation specific privilege authority autonomy recognized profession

Medical Profession
3

RELEVANCY Medical Profession Medical Ethics

Specific privilege reciprocal commitment by the profession a social contract quality care updated competency honorable care medical profession ethics ethical codes and guidelines

medical ethics
3

COMPETENCY

Specific privilege

Earned the life

Professional Ethics
3

RELEVANCY Medical Ethics

Medical Ethics: A moral commitment by the medical profession, that they will honor the specific privilege trusted by the community by rendering honorable quality medical care. Medical ethics code: the moral references in rendering honorable medical care.
3

Other MEANING

A Study
Philosophical study Moral philosophy Ethics philosophy
What should be adopted

Theoretical Ethics - Normative Ethics Prescriptive Ethics

3

Other MEANINGS

A study
Sociologic study

Empirical practices Community morality

Applied Ethics Descriptive ethics

3

DEVELOPMENT

Biomedical Sciences Medical Technologies

Rapid development ample choice more sophisticated team approach complicated system Widening the scope of ethical problems
3

DEVELOPMENT

Biomedical Sciences Medical Technologies

Rapid development Object subject: human - mankind The study outcome of the study influence human dignity More expensive Team approach - System
development of the dimensions/ intensity 3 of ethical problems

DEVELOPMENT Dimensions and intensity

before: focus mainly on patient safety and interest

More complicated moral issue on: Social justice Human dignity Respect of life

BIOMEDICAL ETHICS CONCEPT Integration all dimensions

BIOMEDICAL ETHICS BIOETHICS

Compilation all aspects of biomedical ethics development But still in the context of health
study on ethical, social, laws on other issues related to medical cares and biomedical sciences

A scientific discipline
Medical ethics is a part of bioethics. Medical professional should comply to bioethics 3

DEVELOPMENT OF BIOMEDICAL ETHICS

Four media:
1.Empirical experiences 2. Sociologic studies

3. Philosophy studies
4. Religion norms
3

EMPIRICAL EXPERIENCES

Medical practice:
Rapidly develop

Moral conduct of doctors

Accepted morality Compilation New ethical guideline
3

SOCIOLOGIC STUDIES

Medical practice:
Varied practiced morality

Practiced
Sociologic studies Generalization Suggested ethical norms
3

PHILOSOPHIC STUDIES

Moral philosophy
Moral theory Bioethics principle

Recommended norms

Theoritical ethics
3

Science philosophy

Sciences

right wrong nature

Moral Philosophy

Moral norms

good bad endeavor

THEORY Utilitarian
Good - bad ~ Consequences

Multiple consequences studies Rule Utilitarian Act Utilitarian

3

THEORY Deontology - Kantianism

Good - Bad ~ Ratio - thinking Maxim = moral responsibility
Positive duties Negative duties multiple dimension
3

THEORY Individualism
Good - Bad ~ Individual right freedom to decide - liberalism Positive/ negative right
Individual person vs Community Individual responsibility
3

THEORY Communitarian
Good - Bad ~ Communal morality community responsibility X liberalism

THEORY Ethics of care - Feminism

Good - Bad ~ Emotional binding Moral commitment Caring Loving Inner binding Inter relationship Reciprocal needs
3

RELIGION
Religion norms

Interpretation

Practical aspects

Ethical codes
3

Varied medium
Dynamics of thinking and practices Varied norms
Universalisme vs Relativisme Basic principle: universal Praxis: relative
3

CODIFICATION
Medical ethics - World World Medical Association

International Code of Medical Ethics (London 1948 revision)

+ Declaration
3

CODIFICATION
Medical ethics - Indonesia Peer Group Professional Organization MKEK IDI

Compilation Codification KODEKI

Fatwa - Pendapat
3

CODIFICATION
Biomedical study - World
Nurenberg Code 1947 Autonomy Risk Scientific foundation Helsinki Declaration 1967 cccc Written protocol risk managable WHO-CIOMS 1982-1983-1991 Ethical Review Committee USPH Belmont Report 1978-cccc Animal study
3

CODIFICATION
Biomedical study - Indonesia
FKUI - Indonesian Dean - 1987 Pedoman Etik Penelitian Kedokteran Indonesia

Badan POM - 2000 Cara Uji Klinik yang Baik Komnas Etik Penelitian Keseh. 2004 Pedoman Etik Penelitian Kesehatan Indonesia 3

CODIFICATION
Hospital ethics
Based on medical ethics Pioneered by the doctor Adopted by the government PERATURAN MENTERI KESEHATAN No.24/Menkes/SK/XII/1988. Developed by peer group - PERSI KODERSI-2001
3

DEVELOPMENT Regulation and enforcement

Community morality

Profession
System State

Ethics
bylaws laws

CLOSING REMARK
Bioethics - dynamics Focal point: professional conducts
Altruism Holly tradition of medical profession i. Believe in God. ii. Pure goal iii. Holly character iv. Humble v. Seriousness vi. Scientific and social integrity 3 vii. Peer spirit