relevansi dan dinamika pengembangan etik kedokteran
DESCRIPTION
relevanTRANSCRIPT
LEARNING OBJECTIVESAimed 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
RELEVANCYMedical Profession Ethics
Competency dedicated his/her life public trust
appreciation specific privilege
authority autonomy
recognized profession Medical Profession
Social contract
RELEVANCYMedical 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
RELEVANCYMedical 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 Ethics
scientific
scientific estheti
cs
estheti
cs
Mankind Activities
Arts Nice-bad
Knowledge right-wrong
Moral good-bad
Mankind Activities
Moral implicationsImpact to human being/ humanities
Moral issues
Moral judgment
Moral decision
Modification of activities
Moral facts
Competency
References=Moral ity
Proactive
MEANING
Moral dimension of activities value system: good or bad morality
Morality for a specic ectivitiies/ community ethics
Medical ethics = morality for medical profession
MEANINGA Study
Philosophical studyMoral philosophy Ethics philosophy
What should be adopted
Theoretical Ethics - Normative EthicsPrescriptive Ethics
MEANINGSA study
Empirical practices Community morality
Applied Ethics – Descriptive ethics
Sociologic study
Biomedical SciencesMedical 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 etcHealth care dilivery system: Hospital ethics Decision maker ethics etc Biomedical study: Health research ethics ethicsetc
DEVELOPMENT
Biomedical SciencesMedical 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
before: focus mainly on patient safety and interest
More complicated moral issue on: Social justice Human dignity Respect of life
DEVELOPMENTDimensions and intensity
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
MoralPhilosophy
Sciences
Moral norms
rightwrongnature
goodbad
endeavor
THEORYUtilitarian
Good - bad ~ Consequences
Multiple consequences studies
Rule Utilitarian Act Utilitarian
THEORYDeontology - Kantianism
Good - Bad ~ Ratio - thinking Maxim = moral responsibility
Positive dutiesNegative duties multiple dimension
THEORYIndividualism
Good - Bad ~ Individual right freedom to decide - liberalism Positive/ negative right
Individual person vs Community Individual responsibility
THEORYCommunitarian
Good - Bad ~ Communal morality community responsibility X liberalism
THEORYEthics of care - Feminism
Good - Bad ~ Emotional binding Moral commitment Caring – Loving – Inner binding Inter relationshipReciprocal needs
RELIGION
Religion norms
Practicalaspects
Interpretation
Ethical codes
Varied medium
Dynamics of thinking and practices
Varied norms
Universalisme vs Relativisme
Basic principle: universal
Praxis: relative
CODIFICATIONMedical ethics - World
World Medical Association
International Code of Medical Ethics(London – 1948 revision)
+ Declaration
CODIFICATIONMedical ethics - Indonesia
Peer GroupProfessional Organization
MKEK IDI
Compilation Codification KODEKI
Fatwa - Pendapat
CODIFICATIONBiomedical 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
CODIFICATIONBiomedical study - Indonesia
FKUI - Indonesian Dean - 1987Pedoman Etik Penelitian Kedokteran Indonesia
Badan POM - 2000 Cara Uji Klinik yang Baik
Komnas Etik Penelitian Keseh. 2010Pedoman Etik Penelitian Kesehatan Indonesia
CODIFICATIONHospital ethics
Based on medical ethicsPioneered by the doctorAdopted by the government
PERATURAN MENTERI KESEHATANNo.24/Menkes/SK/XII/1988.
Developed by peer group - PERSI
KODERSI-2001
DEVELOPMENTRegulation and enforcement
Community morality
Profession Ethics
System bylaws
State laws
CLOSING REMARKBioethics - dynamics
Focal point: professional conducts
AltruismHolly tradition of medical profession
i. Believe in God.ii. Pure goaliii. Holly characteriv. Humblev. Seriousnessvi. Scientific and social integrityvii. Peer spirit