introduction to indonesian code of ethics

8/12/2019 Introduction to Indonesian Code of Ethics

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Introduction to

Code of EthicsAn Interactive Lecture

Leonardi A Goenawan


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What do you know about Ethics?

The Science of Human Duty

A particular system of principles & rulesconcerning duty, whether true or false

Rules of practice in respect to a singleclass of human actions; as, political orsocial ethics; medical ethics.


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According to Philosophy 1

Ethics is a major branch of philosophy,encompassing right conduct and good life.It is significantly broader than the

common conception of analyzing right andwrong. A central aspect of ethics is "thegood life", the life worth living or life that

is simply satisfying, which is held by manyphilosophers to be more important thanmoral conduct


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According to Philosophy 2

Ethics is the formal study of moral standardsand conduct. For this reason, the study of ethicsis also often called "moral philosophy." What is good? What is evil?

How should I behave - and why?

How should I balance my needs against the needs ofothers?

These are some of the questions asked in the field of

ethics, a branch of philosophy which has some of themost immediate and obvious consequences for howwe live our lives.


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Moral or Ethics ?

Ethic:A set of moral principles; a theory or system of moral values; The principles of conduct governing an individual or

a group;A guiding philosophy;A consciousness of moral importance;A set of moral issues or aspects (as rightness);

Ethics is usually regarded as more universal in nature.People from all cultures share the same ethics. Itcontains the idea of distinguishing what is right fromwrong, and striving to do what is right.


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Moral or Ethics ?

Moral:

Relating to principles of right and wrong in behavior;

Expressing or teaching a conception of right behavior;

Conforming to a standard of right behavior; Capable of right and wrong action;

Morality may be more local in nature, more culturespecific.

There are many cultural practices which are moral orimmoral depending where they are practiced.


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Why medical ethics is important?

Physicians deal with saving humans life.

Patients want dedicated physicians theycan trust.

Physicians want to feel good aboutthemselves and what they do.


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THE MEDICAL ECOSYSTEM

- Enlarging Circle of Influence

DOCTOR PATIENT

Disease DiagnosisHealth Promotion

Disease Prevention Therapy

Medical InsuranceManaged Care

Hospital

Laboratories

Pharmaceutical

Industry

Patients Family,

Culture, Religion

Patients Work, Employer

Other Doctors

Paramedics

Clinic

Management

Public Health

Medical

ResearchMedical

Students

CME,

CPD

Doctors

Employer

DoctorsFamily

Doctors

Employee

Practice

Management

MDO

Medical Council

The LAWGovernment

Bodies

Medical

Charities

Patient

Organisation

Alternative

Medicine

Press, Media

National Community

International Community

Natural Disasters

Political

Upheaval, War


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THE PRINCIPLES IN MEDICALETHICS

The Principle of Non-Maleficence

The Principle of Beneficence

The Principle of Autonomy The Principle of Veracity

The Principle of Confidentiality (or

Fidelity) The Principle of Social Responsibility and

Justice


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The Principle of Non-Maleficence

First do no harm

Sanctity of life

Calculated risk or risk benefit


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The Principle of Beneficence

Do only that which benefits the patient

Patients welfare as the first consideration

Care consideration competence The obligation to provide and accept

beneficial treatment


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The Principle of Autonomy

Right to information and selfdetermination

Free and informed consent

Free will and accord - intentionalparticipation in treatment

Respect and dignity maintained

The right of an individual to choosebetween various alternatives presented tothem


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The Principle of Veracity

Truth telling

Obligation to full and honest disclosure


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The Principle of Confidentiality

Based on loyalty and trust

Maintain the confidentiality of all personal,

medical and treatment information Information to be revealed with consent and

for the benefit of the patient

Except when ethically and legally required Disclosure should not be beyond what is

required


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The Principle of Justice andSocial Responsibility

Actions are consistent, accountable andtransparent

Not to discriminate on age, sex, religion,race, position or rank

Greater good of society

Respect of the Law Equity and distribution of burden &

benefits


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Principle of Double-Effect

The act itself must be morally good or at leastindifferent.

The agent may not positively will the bad effect

but may merely permit it. If he could attain thegood effect without the bad effect, he should doso. The bad effect is sometimes said to beindirectly voluntary.

The good effectmust be produced directly bythe action, not by the bad effect. Otherwise, theagent would be using a bad means to a goodend, which is never allowed.


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Principle of Double-Effect

The good effect must be sufficiently desirable tocompensate for the allowing of the bad effect. Informing this decision many factors must be weighed andcompared, with care and prudence proportionate to theimportance of the case. Thus, an effect that benefits or

harms society generally has more weight than one thataffects only an individual; an effect sure to occurdeserves greater consideration than one that is onlyprobable; an effect of a moral nature has greaterimportance than one that deals only with material things

St Thomas Acquinas. New Catholic Encyclopedia, vol 4, 1967 (internet edition).


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What is an Ethical Dilemma?

A conflict between moral imperatives, i.e., whatis the right thing to do?

What is medically right vs. patient preference

Jehovahs Witnesses and transfusions

What is preferred by patient vs. proxy decision maker

Rights of minor vs. legal guardians

What is best for patient vs. what is best for society

Commitment laws, notification of sexual partners of patientswith HIV


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How to Analyze an Ethics Case

Whatis being proposed? What are the medical issues? Risks, benefits, alternatives Case and statutory law

Whoare the stakeholders? Patient, family, medical staff, hospital, state Cultural and religious concerns Are possible consultants to medical, legal, and ethical issues

Whendoes this need to be done? Emergency exceptions to informed consent

Whyis an ethical dilemma being created? Conflicts between decision makers, law and ethics

How can this be resolved? Meeting(s), consultation(s)


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Withdrawing vs. Withholding Care

Withdrawing care

Decision to remove an active intervention

that is already being provided to a patient

Withholding care

Decision not to provide an activeintervention to a patient


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Withdrawing vs. Withholding Care

In medical ethics today, there is no distinction madebetween withdrawing and withholding care.

In the past, withholding was considered ethicallysuperior to withdrawing.

Most recently, ethicist are espousing the positionthat withdrawing is ethically superior to withholding,since a trial of treatment gives information on itsefficacy for the particular patient.

introduction to indonesian code of ethics

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