MEDICO LEGAL ASPECT IN

BRAIN DEATH
Dr. Ida Bagus Putu Alit. SpF,DFM
Bagian Forensik dan Mediko Legal FK UNUD

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Nama : Dr Ida Bagus Putu Alit,SpF,DFM
Tanggal lahir : Karangasem,14 Januari 1970
Pendidikan dan Pelatihan Formal :
1. Dokter Umum, Fakultas Kedokteran Universitas Udayana (1997)
2. Post Graduate Education on Forensic Medicine, Medical Ethics and Human Rights, Groningen State
University,the Netherland (2002)
3. Program Pendidikan Dokter Spesialis Forensik, Departemen Forensik dan Mediko legal FK Universitas
Indonesia (2005)
4. Primer DVI Course, Health Science Authority Singapore (2007)
Pekerjaan :
1. Staf Educative (Dosen) di FK UNUD,FKIK UNWAR, FK UNIZAR
2. Konsultan Forensik dan Etiko Mediko Legal beberapa RSUD di Bali
Jabatan :
1. Kepala Bagian/SMF Ilmu Kedokteran Forensik FK UNUD/RSUP Sanglah
2. Ketua Komite Etik dan Hukum RSUP Sanglah
3. Ketua Team Terpadu Penanganan Korban Tindak Kekerasan Perempuan dan anak (T2P KTK P-A) RSUP
Sanglah

CURRICULUM VITAE
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Kematian Otak :
Disfungsi Otak :
▪ Menyeluruh
▪ Irreversible
▪ Kerusakan struktur
▪ oksigenasi
Legal Reasoning : Brain Death is Death
▪ Finlandia (1971)
▪ US (Kansas)
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 Isu Medis
Bertahan hidup
Irreversible ?
Tranplantasi organ
Euthanasia ?

Kemajuan Critical thinking

teknologi Isu Etik

Kematian
Otak

ASPEK MEDIKO LEGAL 4

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ASPEK MEDIKO LEGAL

ETIK
UU No 36 Tahun 2009 tentang Kesehatan
Pasal 117

• Hubungan Dokter-Pasien
• Medical Futillity
• Personhood
• Do Not Resuscitated
Aspek • Advance Directive
Mediko • Surrogate Decision
Legal
Making

Hak atas Pelayanan Kesehatan Hak otonomi atas diri sendiri

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(The right to health care) (The right to selfdetermination)
 Interpersonal Paternalistic
▪ Era Hippokrates
▪ Konvensional
 Impersonal Horizontal Contractual
▪ Informed Consent
 Etika Medis:
▪ Hubungan Professional
▪ Hubungan Kemanusiaan
Profesi Dokter Dominan ( Father Knows Best)
HUBUNGAN HULPVERLENEN
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HUBUNGAN DOKTER- PASIEN 9/22/2017
 TEORI ETIKA
( AGENT, DEONTOLOGIS, TELEOLOGIS)

ANALISA FILOSOFIS MATI OTAK

Hati Nurani

KAIDAH DASAR MORAL

Beneficence, Non Maleficence, Autonomy dan justice PRIMUN NON NOCERE

(veracity, privacy and confidentiality, Fidelity)

PEMIKIRAN KRITIS
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 •Medical •Contextual
Indications Features

DIAGNOSIS
Kriteria
Surrogate
Harvard
Decission
Kriteria
Minessota

Advance
Directive

•Patient •Quality of
Preferences Life

CLINICAL ETHICS 8
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 Kuantitatif
Whenever the illness is too strong for the available remedies, the
physician surely must not expect that it can be overcome by medicine
to attempt futile treatment is to display an ignorance that allied to
Madness ( Hippocrates Corpus in Reiser Dyck and Curren, 1977)
 Kualitatif
For those who lives are always in a state of inner sickness Asclepius did
not attempt to prescribe a regime to make their life prolonged Misery
(Republic, Plato 1981)

MEDICAL FUTILLITY
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 Person Brain Death
Rasionalitas Apakah terafi Human being
Kesadaran Diri dilanjutkan ??

PERSONHOOD
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 UU No 36 Tahun 2009 tentang Kesehatan
pasal 117
Seseorang dinyatakan mati apabila fungsi sistem jantung sirkulasi
dan sistem pernafasan telah terhenti secara permanen, atau
apabila kematian Batang Otak telah dapat dibuktikan
 Brain stem Death is Death
 Medical reasoning ;
▪ Anatomi
▪ Fisiologis

ASPEK HUKUM T0RT BASE DUTY

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