bioetik dlam prak kedok
TRANSCRIPT
-
7/28/2019 Bioetik Dlam Prak Kedok.
1/19
BIOETHICSINMEDICAL PRACTICE
SULIATI
-
7/28/2019 Bioetik Dlam Prak Kedok.
2/19
Essentially, bioethics is the process of
making moral decisions regarding health
care. The process of decision-making as well
as the transmission of those ethical decisionsis an important matter of study for the health
professional (Kreps & Thornton, 1984)
-
7/28/2019 Bioetik Dlam Prak Kedok.
3/19
In this paper we will discuss the topics in
which ethical issue are part of the practice
of medicine, as following :
1. Concept of informed consent
2. The doctor-patient relationship from
practitioners perspective
3. The patients autonomy vs paternalism
4. Managing ethical dilemmas in healthservice
-
7/28/2019 Bioetik Dlam Prak Kedok.
4/19
SULIATI P. AMIR
-
7/28/2019 Bioetik Dlam Prak Kedok.
5/19
-
7/28/2019 Bioetik Dlam Prak Kedok.
6/19
DOCTOR PATIENT RELATIONSHIPFROM PRACTITIONERS PERSPECTIVE
-
7/28/2019 Bioetik Dlam Prak Kedok.
7/19
The relationship between doctor and
patient is based on the concept of
partnership and collaborate effort, in whichthe doctor clinical expertise and the
Patients individual needs and preferences
are shared (BMA, 1993)
-
7/28/2019 Bioetik Dlam Prak Kedok.
8/19
Doctor are generally regarded as having a
positive duty to do good (beneficence). TheTraditional duty to do good has been
accompanied by the obligation to do no harm
primum non nocere (first do no harm)nonmaleficence (Stauch et al, 2006).
The members of the medical profession
undertake to place the interests of their patientsbefore their own in many circumstances.
(Stauch et al, 2006).
-
7/28/2019 Bioetik Dlam Prak Kedok.
9/19
The most common form of relationship is the
therapeutic relationship.
Doctors are expected to use their skills to thebest of their ability not only to treat the
condition
which is the subject of the consultation but also
to advise how best patient should conduct
themselves in order to maintain their heath.
(BMA, 1993).
As a prerequisite to choosing treatmentpatients
have the right to receive information from
doctors and to discuss the benefits and risks of
appropriate treatment.
-
7/28/2019 Bioetik Dlam Prak Kedok.
10/19
PATIENT AUTONOMY VS
PATERNALISTIC
1. The conflict between respect for autonomyand the desire to help the patient brings usthe problem of paternalistic ( Jonsen et al,
2010).2. In the context of heath care ethics
paternalistic involves acting without consentor even overriding a persons wishes oractions in order to benefit harm to patient(Garrett et al 1993, Stauch et al, 2005 )
-
7/28/2019 Bioetik Dlam Prak Kedok.
11/19
DEFINITION
1. Autonomy is the right of person to choose
and follow his or her own of life and action
(Bodenheimer & Grumbach, 2009)
2. Autonomy is the ability to make your own
decisions about what to do, rather than
being influence by someone else
(Collins EL Dict.1994)
-
7/28/2019 Bioetik Dlam Prak Kedok.
12/19
The health care formulation the principle of
autonomy can be expressed as follows :
You shall not treat a patient without informed
consent of the patient or his or her lawful
surrogate, except in narrowly defined
emergencies (Garret et al, 1993)
-
7/28/2019 Bioetik Dlam Prak Kedok.
13/19
PATERNALISTIC ( Stauch et al, 2006)
Term paternalistic many to act like father Thepaternalistic doctor knows best and regards himself asbeing the best judge as to what is for the patients owngood. It is interesting to consider the duty ofbeneficence in relation to the parent-child relationship.
Paternalistic ( Garrettet al,1993 )
1. In its dictionary meaning, its refers to ruling orcontrolling of others in a way what suggest a fathersrelationship with his children
2. In, the context of health care ethics, paternalism
involves acting without consent or over reading apersons wishes (consent) or actions in order tobenefit the patient or of least to preference harm tothe patient
-
7/28/2019 Bioetik Dlam Prak Kedok.
14/19
In clinical ethics, respect for patient
preferences take place within a therapeutic
relationship, that is, when some health
problem prompts a patient to seek help froma physician and a physician responds with
diagnosis, advice, and a proposed treatment.
In this relationship, physicians possess a defacto power : they have knowledge and skills
that the patient needs (Jonsen et al, 2010).
-
7/28/2019 Bioetik Dlam Prak Kedok.
15/19
The therapeutic relationship can be distortedby what has been called physicianspaternalism: a physicians assumes that his
or her medical judgment alone shoulddetermine the course of care. Modernmedical ethics refuse this sort ofpaternalism. Instead, both the physicians
and the patient must form an alliance inwhich medical recommendations and patientpreference together guide the course of care.(Jonsen et al, 2010)
-
7/28/2019 Bioetik Dlam Prak Kedok.
16/19
MANAGING ETHICAL DILEMMAS
IN HEALTH PRACTICE
-
7/28/2019 Bioetik Dlam Prak Kedok.
17/19
Bioethics identifies four ethical principles that
are particularly relevant to clinical medicine :
the principles of beneficence,
nonmaleficence, respect for autonomy, andjustice. (Bodenheimer and Grumbach, 2009;
Jonsen et al, 2010).
-
7/28/2019 Bioetik Dlam Prak Kedok.
18/19
THE FOUR PRINCIPLES OF MEDICAL ETHICS
(BODEN HUMER & GRUMBACH, 2009)
Nonmaleficenc
e
The duty care providers to do no
harm
Beneficence The obligation of health care
providers to help people in need
Autonomy The right of a person to choose and
follow his or her own plan life and
action
Justice The concept of treating everyone in
a fair manner
-
7/28/2019 Bioetik Dlam Prak Kedok.
19/19
THANK YOU