LEARNING OBJECTIVES

Aimed competency: Conducting ethical justification in every clinical decisions and activities in rendering honorable quality care. Topic :Relevancy and dynamics of biomedical ethics development
Lecture objectives: 1. Understanding the relevancy of the existency of medical profession ethics. C3, A1, P1 2. Understanding the meaning of biomedical ethics concept. 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 profession ethics codification. C3, A1, P1

RELEVANCY Medical Profession Ethics

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

RELEVANCY Medical Profession Medical Ethics

Social contract reciprocal commitment by the profession quality care updated competency honorable care medical profession ethics ethical codes and guidelines medical ethics

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.

Ethics

Moral good-bad
Arts Nice-bad

Knowledge right-wrong

Mankind Activities

Mankind Activities
Moral facts

Moral implications
Impact to human being/ humanities

Moral issues Moral judgment

Competency References =Moral ity Proactive

Moral decision Modification of activities

MEANING
Moral dimension of activities value system: good or bad morality Morality for a specic ectivitiies/ community ethics Medical ethics = morality for medical profession

MEANING A Study Philosophical study Moral philosophy Ethics philosophy

What should be adopted

Theoretical Ethics - Normative Ethics Prescriptive Ethics

MEANINGS A study
Sociologic study

Empirical practices Community morality

Applied Ethics Descriptive ethics

DEVELOPMENT

Biomedical Sciences Medical Technologies

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

DEVELOPMENT Widen Scope different ethics references

Different health professionals: Nursing ethics Pharmacist ethics etc Health care dilivery system: Hospital ethics Decision maker ethics etc Biomedical study: Health research ethics ethics etc

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 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 medical ethics development But still in the context of health
study on ethical, social, laws on other issues related to medical cares and biomedical sciences Medical ethics is part of bioethics A scientific discipline

DEVELOPMENT OF BIOMEDICAL ETHICS

Four media:
1.Empirical experiences 2. Sociologic studies

3. Philosophy studies
4. Religion norms

EMPIRICAL EXPERIENCES

Medical practice:
Rapidly develop

Moral conduct of doctors

Accepted morality Compilation New ethical guideline

SOCIOLOGIC STUDIES

Medical practice:
Varied practiced morality

Practiced
Sociologic studies Generalization Suggested ethical norms

PHILOSOPHIC STUDIES

Moral philosophy
Moral theory Bioethics principle

Recommended norms

Theoritical ethics

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

THEORY Deontology - Kantianism

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

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

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

RELIGION
Religion norms

Interpretation

Practical aspects

Ethical codes

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

CODIFICATION
Medical ethics - World World Medical Association

International Code of Medical Ethics (London 1948 revision)

+ Declaration

CODIFICATION
Medical ethics - Indonesia Peer Group Professional Organization MKEK IDI

Compilation Codification KODEKI

Fatwa - Pendapat

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

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. 2010 Pedoman Etik Penelitian Kesehatan Indonesia

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

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 vii. Peer spirit