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MEDIK
PUTU MELAYA
Mr. Chen, a 40 y.o. patient originally from China, had lumbar problems for
one year. The condition includes dull pain in his leg and the inability to sit
for long periods. X-ray examination reveals a prolapsed lumbar disc. He
has been treated with conventional pain medication with minimal effect.
His physician, Dr Robert O., recommends back surgery, but Mr Chen
reluctant to take this opinion. Instead, he asks the doctor to refer him to an
acupuncturist because his insurance coverage requires physicianss
approval for alternative therapy.
But Dr Olsen is skeptical about any kind of alternative therapy. He refuses
to order the acupuncture.
Did the physician act ethycally?
SAAT INI
AKUPUNKTUR MEDIK ??
SEJARAH
Penyebaran akupunktur
Dokter Belanda : - Ten Rhiyne (1683)
- E Kampfer (1712)
Perancis : L Berlioz (1816)
Belgia : Y Koyen (1849)
Swiss
: - Y Cramer (1857)
- Soulie de Morant (1929) : terjemahkan
Pelajaran akupunktur dan moksibusi
Elektro-akupunkto-kauterisator
Elektro-detektor
Penyebaran akupunktur
Amerika
: 1826
Meksiko : 1940
Argentina : 1950
Brasil
: 1950
Korea Utara : Prof Kim Bong Han meridian dan
titik akupunktur
1949
: penelitian klinis
1958
: akupunktur anestesia
1963
: Indonesia RSCM : tim riset
ilmu pengobatan timur UPF akupunktur
1996/97 : DitJen BinKesMas (akupressure dan
pengobatan tradisional)
akupunktur
Diintegrasikan ke dalam sistim pelayanan formal
DEFINISI
Bioethics
is the philosophical study of the ethical controversies
brought about by advances in biology and medicine.
Bioethicists are concerned with the ethical questions that
arise in the relationships among
life sciences, biotechnology, medicine, politics, law,
philosophy, and theology.
PRINCIPLES
The National Commission for the Protection of Human
Subjects of Biomedical and Behavioral Research
was initially established in 1974 to identify the basic ethical principles
that should underlie the conduct of biomedical and behavioral research
involving human subjects. However, the fundamental principles
announced in the Belmont Report (1979)--namely, autonomy,
beneficence
and justice--have influenced the thinking of bioethicists across a wide
range
of issues. Others have added non-maleficence, human dignity
and the sanctity of life to this list of cardinal values.
AKUPUNKTU
acupunkture
R
PASIEN
TINDAKAN
STERILITAS JARUM
INFORMED CONSENT
KASUS/ISSUES
SIAPA, DLL
BIOETHIC
Safety in Acupuncture
Amankah tindakan Akupunktur ?
Ditangan yang kompeten akupunktur
merupakan suatu tindakan yang relatif
aman
dengan beberapa kontra indikasi dan
komplikasi.
Perhatikan transmisi infeksi yang
merupakan
faktor resiko tindakan akupunktur
Resiko Tindakan
akupunktur :
- Transmisi infeksi (hepatitis,
HIV)
- Jarum patah, bengkok
- Reaksi yang tdk
diharapkan
- Nyeri dan rasa tidak
Pencegahan Infeksi :
Lingkungan kerja yang bersih
Tangan pengobat yang bersih
Persiapan bagian tubuh yang akan di
akupunktur
Jarum , alat dan kotak penyimpanan harus
steril
Tehnik aseptis
Penanganan yang cermat untuk jarum
bekas dan kapas bekas
Kontra Indikasi
Kehamilan
Kedaruratan medik
Kasus pembedahan
Tumor ganas
Gangguan pembekuan darah dan
sedang dalam pengobatan
antikuagulantia
CONTROVERSIES ISSUES
OF ACUPUNCTURE
YIN-YANG
23
Yin-yang
Malam
Barat/utara
Dingin
Air
Bulan
Perut
Permukaan dalam
Darah
Kronis
Merasa dingin
Depresi
Lemah
Sakit
Siang
Timur/selatan
Panas
Api
Matahari
Punggung
Permukaan luar
Energi/chi
Akut
Merasa panas
Senang
Kuat
Sehat
24
ACUPUNCTURE
YINYANG
HOMEOSTASIS
Meridian I (Paru-paru)
Meridian II (UB)
Meridian III (Lambung)
Merridian IV (Limpapankreas)
Meridian V (Jantung)
Meridian VI (UK)
Meridian VII (KK)
Meridan VIII (Ginjal)
Meridian IX(Sampul jantung)
Meridian X (Tri pemanas)
Meridian XI (K.Empedu)
Meridan XII (Hati)
Jam
Jam
Jam
Jam
Jam
Jam
Jam
Jam
Jam
Jam
Jam
Jam
3.00
5.00
7.00
9.00
11.00
13.00
15.00
17.00
19.00
21.00
23.00
1.00
5.00
7.00
9.00
11.00
13.00
15.00
17.00
19.00
21.00
23.00
1.00
3.00
27
Medical ethics
is the study of moral values
and judgments as they apply to medicine.
As a scholarly discipline,
medical ethics encompasses
its practical application in clinical settings
as well as work on its history, philosophy,
theology, and sociology.
Safety in Acupuncture
Amankah tindakan Akupunktur ?
Ditangan yang kompeten akupunktur
merupakan suatu tindakan yang relatif
aman
dengan beberapa kontra indikasi dan
komplikasi.
Perhatikan transmisi infeksi yang
merupakan
faktor resiko tindakan akupunktur
Medical ethics
tends to be understood narrowly as
an applied professional ethics,
whereas bioethics appears to have worked
more expansive concerns, touching upon
the philosophy of science and issues of biotechnology.
Still, the two fields often overlap
and the distinction is more a matter of style
than professional consensus.
Medical ethics shares many principles
with other branches of healthcare ethics,
such as nursing ethics.
Penelitian Akupunktur :
* Penelitian Akupunktur Dasar
- Titik Akupunktur
- Meridian
- Mekanisme kerja
* Penelitian Akupunktur klinis
terkait dengan setiap sistem
tubuh
For reprints and all correspondence: Christopher Zaslawski, College of Traditional Chinese Medicine,
Department of Medical and Molecular Biosciences, Faculty of Science, University of Technology, Sydney
2007, Australia. Tel: +61-2-9514-7856; Fax: +61-2-9514-7866; E-mail: chris.zaslawski@uts.edu.au
In this review, controlled clinical trials of acupuncture are placed into five categories on
the basis of the treatment with which acupuncture is compared. Methodological and
ethical issues relevant to each category are discussed. Wait list (or no treatment)
controls, which are ethically acceptable for stable, chronic conditions, assess the
efficacy of acupuncture relative to the natural history of the condition but do not control
for nonspecific treatment effects. Placebo controls, defined here as noninvasive
procedures such as inactive transcutaneous electrical nerve stimulation (TENS) or
mock needling, assess whether acupuncture has an effect beyond that of the
therapeutic milieu. Sham controls, defined as invasive but inappropriate procedures
such as shallow needling at nonacupoint sites, assess whether acupuncture efficacy
depends on the style and location of needling.
To cite this article:
Richard Hammerschlag. The Journal of Alternative and Complementary Medicine. Summer 1998, 4(2): 159-171.
doi:10.1089/acm.1998.4.159. Published in Volume: 4 Issue 2: September 10, 2007
RESULT
At 3 months, the number of days with headache decreased
from 8.4 7.2 (estimated mean s.e.) to 4.7 5.6 in the
acupuncture group and from 8.1 6.8 to 7.5 6.3 in the
control group (P < 0.001). Similarly, intensity of pain and
quality of life improvements were more pronounced in the
acupuncture vs. control group (P < 0.001). Treatment
success was maintained through 6 months.
PC1
SJ10 (?)
PC3
R
L
PC6
SJ5
SJ10
(?)(?)
SJ10
PC3
RR
L
L
SJ4
SJ5
PC1 (Tianchi)
PC6 (Neiguan)
PC8 (Laogong)
250 Ci/titik,
20 menit, WBS
PC1
Jantung
Lambung
Aliran
radiofarmaka
Meridian
PC6
PC8
MAU C
ANTIKK
..
TERIMAKASIH