BHP Professionalisme Kedokteran

8/9/2019 BHP Professionalisme Kedokteran

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PROFESIONALISMEKEDOKTERANT. Ibnu Alferraly, dr. SpPA - Aliandri, dr. SpTHT

Divisi Bioetika-Humaniora-Medikolegal-ProfesionalismeMEU – FKUSU20 2


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SISTEMATIKAMeninjau kembali malpraktik danketidakpuasan pasien

Pemahaman pr !esi nalismeseba"ai sarana pen#e"ahanmalpraktik

$$ praktik ked kteranmenunjan" pr !esi nalisme


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KETIDAKP$ASAN PASIENDAN MALPRAKTIK


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ALASAN MENINGKATNYA KETIDAKPUASANPASIEN

Menin"katn%a pendidikan dan kesadaran atashak & aserti!

Menin"katn%a pen"harapan atas hasil tindakan

medis

K mersialisasi ' depr !esi nalisasi upa%a la%ananked kteran

Penin"katan bia%a la%anan & int leransi thdketidaksempurnaan

Pr m si ahli hukum ' uupk !"# S $% &&'


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Hillary Rodham Clinton and Barack Obama :

Making Patient Safety the Centerpieceof Medical Liability efor!(#e) Engl * Med +, .2 )))/ne m/org Ma1 2,% 200 3

Malpractice suits often resultwhen an unexpected adverseoutcome is met with a lack of

empathy from physicians anda withholding of essentialinformation.


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"#TI$A"P%ASA&

Kelalaian

Tidak Etis

Mahal

Fasilitas

Sistem

Informasi

Kompetensi

KTD

Perhatian

Violatio

Organisasi

H

uman Fa4tors


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Multi-Causal Theory Swiss Cheese

diagra (Reas n) *++*,


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Co!!unication proble!'(. Inade)uate infor!ation flo*+. Hu!an proble!'

. Patient-related i''ue'. rgani/ational tran'fer of kno*ledge0. Staffing pattern'1*ork flo*2. Technical failure'

3. Inade)uate policie' and procedure'(AHRQ Publication No. 04-R 00!" #$c$mb$r %00&. '

Mo't Co!!on oot Cau'e' of Medical #rror'


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KESALA-ANdili5at dari sisi 5ukum

SENGA!A " D#LUS$◦ Den"an niat . tujuan◦ Den"an kepastian akan terjadi◦ Den"an kemun"kinan akan terjadi

KELALAIAN " CULPA &◦ LATA & /r ss Ne"li"en#e◦ LE0IS & ke#il


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MALPRAKTEK

1INTENTIONAL2 (se#ara sadar,◦ PROFESSIONAL MISCONDUCTS

NE/LI/EN3E◦ MALFEASANCE, MISFEASANCE,

NONFEASANCE

LA3K OF SKILL◦ DI 4A5A- STANDAR KOMPETENSI◦ DI L$AR KOMPETENSI


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PROFESSIONAL MIS3OND$3T

PELAN//ARAN DISIPLIN PROFESI◦ Pelan""aran standar se#ara sen"aja

(Deliberate Violation ,◦ PELAN//ARAN PERILAK$ PROFESI

PIDANA $M$M&◦ Pemb h n"an (!raud . misrepresentasi,◦ Keteran"an palsu◦

Penahanan pasien◦ 4uka rahasia ked kteran tanpa hak◦ Ab rsi ile"al◦ Euthanasia◦ Pen%eran"an seksual


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LA3K OF SKILL

KOMPETENSI K$RAN/ ATA$ DI L$ARKOMPETENSI . KE5ENAN/AN◦ Serin" menjadi pen%ebab error atau

kelalaian◦ Serin" dikaitkan den"an k mpetensi

institusi◦ Kadan" dapat dibenarkan pada situasi6

k ndisi l kal tertentu (locality rule, limitere!ource! ,

Tuntutan dapat berupa kelalaian


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KELALAIAN MEDIK

7enis tuntutan %" terserin"

4ukan kesen"ajaan

Tidak melakukan %" seharusn%a

dilakukan) melakukan %" seharusn%atidak dilakukan leh ran"8 %"sekuali9kasi pada situasi dan k ndisi%" identik


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PROFESIONALISME SE4A/AISARANA PEN3E/A-ANMALPRAKTIK


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PROFESIA pr !essi n is an% "r up sharin" aspe#ial b d% ! kn :led"e) standards !edu#ati n and pra#ti#e) pr !essi nal

ass #iati ns) and an ethi#al !rame: rkbased in a s #ial # ntra#t that permits ahi"h de"ree ! sel!6re"ulati n;

On that


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AK$NTA4ILITAS PROFESIDIDASARKAN PADA 1KONTRAK SOSIAL2

The # ntra#t bet:een pr !essi ns ands #iet% is relati


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Pr !essi nalism

Pro"e!!ionali!m i! t#e ba!i! o"me icine$! contract %it# !ociety& It demands pla#in" the interests !

patients ab


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Elements !Pr !essi nalism

Altruis is the essen#e !pr !essi nalism; The best interest !the patients) n t sel!6interest) is therule;A%%ou&ta'ility is re@uired at man%le


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Elements !Pr !essi nalism

Duty is the !ree a##eptan#e ! a# mmitment t ser


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PROFESSIONALISM

True pr !essi nalism means thepursuit ! e(%elle&%e &ot .ust%o +ete&%e

Pr !essi nalism is +redo i&a&tlya& attitude ) n t a set !# mpeten#iesA real pr !essi nal is a te#hni#ian:h %aresPr !essi nal is n t a label % u "i


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Paul Starr & Pr !essi nalism

3 "niti


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PROFESSIONALISM

3OMPETEN3E◦ KNO5LED/E AND

SKILLS◦

P- SI3AL ANDMENTAL FITNESS3OND$3T .ATTIT$DE◦ EMPAT-◦ D$T OF 3ARE◦ 3OLLE/IAL

RESPONSI4ILITEthi%s - I&tegritydu%atio& / Trai&i&g


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Threat ! Pr !essi nalism

At present) the medi#al pr !essi n is# n!r nted b% an e?pl si n !te#hn l "%) #han"in" market ! r#es)pr blems in health #are) deli


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AN3AMAN PROFESIONALISME DIINDONESIA

Sistem Pendidikan Ked kteran %"mahalSistem Pembia%aan %" !ee ! rser


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AN3AMAN PROFESI KEDOKTERANG P$4LI3 MISTR$ST

publi# per#epti n that medi#ine!ailed t sel!6re"ulate in a :a% that

#an "uarantee # mpeten#e ) and thatit put its :n interest ab


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Re6


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3harter n

Medi#al Pr !essi nalismFundamental Prin#iples&

Prin#iple ! prima#% ! patient:el!arePrin#iple ! patient aut n m%Prin#iple ! s #ial justi#e

Annals of Internal Medicine, Vol 136 Issue 3, 5 Feb 2002

http:// !annals!or"/c"i/content/full/136/3/2#3


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Pr !essi nalResp nsibilities

3 mmitment t pr !essi nal# mpeten#e

3 mmitment t h nestl% :ith patient3 mmitment t patient# n9dentialit%

3 mmitment t maintainin"appr priate relati ns :ith patients

3 mmitment t impr


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Pr !essi nalResp nsibilities

3 mmitment t impr


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Mampukah Pr !esi nalismemen#e"ah malpraktikJ


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Pr !essi nalism

6om:eten4eEt5i4s

Altruism

Accountability

Excellence

Duty

Honor andIntegrity

Respect forothers


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PERL$N A PRAKTIK

KEDOKTERAN DIAT$R

ETIKA PERILAK$DISIPLIN PROFESI-$K$M P$4LIK


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Paul 4arach, M$, MPH, %ni5 of Mia!i Medical School

E5 disini tertulis ;a5)ake adian kesala5an medis diruma5 sakit ini sangat tinggi


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APA KATA $NDAN/8

Pasal a%at (*, $$ N 8 tahun*++8 tentan" Kesehatan & 1!etia'oran( ber#a) ata! (anti ru(i a)ibat

)e!ala#an atau )elalaian yan(ila)u)an tena(a )e!e#atan 2;

Pasal $$ N 8+ tahun 8tentan" Praktik Ked kteran & 1 o)teran o)ter (i(i ber#a) mem'erole#

'erlin un(an #u)um !e'an*an(

mela)!ana)an tu(a! !e!uai en(an


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IT%LAH 67 $IS#4%T 84 TT M LI #THICS9

4#L%M C%"%P %&T%" S# A&7 P :#SI &AL,HA %S $ITAM4AH $#&7A& 8"#P#$%LIA&

"#PA$A PASI#& $A& P :#SI9

MINIMAL DOKTER -AR$SSEPERTI APAJ

DOKTER 7AN/AN MELAK$KAN&KESALA-AN

KELALAIAN TAK SES$AI STANDAR PROFESI TAK SES$AI S;O;P;


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KESIMP$LAN

Praktik %an" baik adalah praktik%an" sesuai den"an peraturanperundan"6undan"an&◦

K mpeten dan ber:enan"◦ Sikap pr !esi nal&◦ Sesuai etika dan standar◦ Patuh pada disiplin pr !esi

Kepatuhan kepadaPr !esi nalisme akan men#e"ah

malpraktik


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