Bioethic Task

Adviser :
dr. Meivy Isnoviana, SH. MH

Presented by:

Cefianus Sidaya Tandirura

FORENSIC AND MEDICOLEGAL MEDICINE DEPARTMENT OF

MEDICAL FACULTY OF UNIVERSITY OF WIJAYA KUSUMA
SURABAYA
2019
Case 1

A doctor at the RSUD Kab. Kediri received a middle-

aged male patient, looked in pain, staggered and kept
coughing in front of him. The patient was accompanied
by his daughter. The doctor was reluctant to do
anamnesa and immediately examined the patient. When
the child asks about his father's illness, the doctor only
advises his father to take the medicine regularly, but the
doctor advises his child to ask the pharmacy officer
where the drug is taken. Feeling belittled, the father and
son came out of the doctor's room without greeting and
their faces looked dissatisfied.
Beneficience
Criteria Yes No

Prioritizing altruism (helping selflessly, willing to sacrifice) √

Guaranteeing the basic values of human dignity √

Looking at the patient / family and something not to the √

advantage of the doctor

Trying to make more benefits compared to bad √

Responsible √

Ensure a good minimum human life √

Goal-Based Restriction √
Beneficience

Criteria Yes No

Maximizing the satisfaction of happiness / patient √

preferences

Minimize adverse consequences. √

Obligation to help emergency patient √

Respect the patient's rights as a whole √

Do not withdraw honoraria beyond appropriateness √

Maximizing the highest satisfaction overall √

Develop the profession continuously √

Providing nutritious yet inexpensive medicine √

Applying the Golden Rule Principle √

Non Maleficience
Criteria Yes No

Helping emergency patient √

The conditions for describing these criteria are:

• The patient is in a dangerous condition. √
• Doctors are able to prevent harm or loss.
• The medical action proved effective
• Benefits for patient > doctor's loss (only experiencing
minimal risk).

Treat injured patient √

Do not kill patient (do not do euthanasia) √

Not insulting √

Do not view patient as objects √

Treating disproportionately √
Non Maleficience

Criteria Yes No

Do not prevent patient from danger √

Avoid misrepresentation of patient √

Do not endanger the patient's life due to negligence √

Does not give life spirit √

Does not protect patient from illness √

Do not do white collar in the hospital √

Autonomy
Criteria Yes No

Respecting the right to self-determination, respecting the √

dignity of patient.

Do not intervene in patient in making decisions (under √

elective conditions)

Honest √

Appreciate privacy √

Keep patient medical records √

Appreciate patient rationality √

Carry out informed consent √

Autonomy

Criteria Yes No

Allowing adult patients and someone competent to make √

their own decisions.

Do not intervene or obstruct patient autonomy. √

Prevent other parties from intervening in patients and √

making decisions, including, including the patient's own
family.

Patiently waiting for the decision to be taken by the patient √

in a non-emergency case.

Don't lie to the patient even for the benefit of the patient. √

Maintain relationship (contract) √

Justice

Criteria Yes No

Do equally √

Take the last portion of the dividing process he has done. √

Giving equal opportunities to individuals in the same √

position.
Respecting patients' health rights (affordability, equality, √
accessibility, availability, quality)

Appreciate the legal rights of patients. √

Respect the rights of others. √

Maintain vulnerable groups (the most disadvantaged) √

Do not abuse. √
Justice

Criteria Yes No
Wise in macro allocations. √

Provide a contribution that is relatively the same as the √

patient's needs

Request patient participation according to ability. √

The obligation to distribute profits and losses (costs, √

expenses, sanctions) fairly

Return rights to the owner at the right time and competent. √

Does not give heavy burden unevenly without valid reasons √

Respect the rights of the population who are equally √

susceptible to diseases / health problems.

Does not divide patient services on the basis of SARA, social √

status etc.
Ethical Dilemma

The doctor does not

In treating respect the patient's
patients, the autonomy and the
doctor is very doctor does not do the
disproportionate Prima informed consent
and avoids Facie properly, the doctor
misrepresentation immediately checks the
Autonomy
of the patient. patient without doing
anamnesia first.
4 BOX METHOD OF CLINICAL ETHICS
 Profesional Principles:

 Alturism: None, the doctor seem to underestimate

the patient.
 Duty: Yes, the doctor still check and provide therapy
to the patient.
 Respect for others: None, the doctor do not respect
the patient by not giving the patient’s rights.
 Accountable: None, the doctor hands over his duty
to explain about patient’s illness to the pharmacy
officer.
 Humanity: None, the doctor did not seem to care
about the patient's condition.
Ordinary Extraordinary:
Ordinary
The doctor does not want to anamnesa and provide
explanations to the patient and their families so that
the patient and their families feel dissatisfied and do
not get the rights as patients.
Case 2

A doctor at the RSUD Kab. Kediri received a middle-

aged male patient, looked in pain, staggered and kept
coughing in front of him. The patient was accompanied
by his daughter. The doctor was reluctant to do
anamnesa and immediately examined the patient. When
the child asks about his father's illness, the doctor only
advises his father to take the medicine regularly, but the
doctor advises his child to ask the pharmacy officer
where the drug is taken. Feeling belittled, the father and
son came out of the doctor's room without greeting and
their faces looked dissatisfied.
•Terimakasih