KOMUNIKASI dan ETIKA

(pasien teman sejawat, antar

profesi)

Theresia L. Toruan

3 September 2015
Blok 10-11
FK Unsri Palembang
 Latar Belakang
Kesehatan adalah hak azazi manusia, karena itu
masyarakat berhak mendapatkan pelayanan
bermutu (UUD45)
Negara berkewajiban melindungi masyarakat
terhadap pelayanan Kesehatan yang tidak
profesional.
Kita harus melayani pasien dengan Standard Profesi,
Standard Prosedur Operasional serta kebutuhan
medik pasien.
Ko As adalah sarjana yang mempunyai pengetahuan
dan belajar untuk mendapat ketrampilan
 What is (medical) ethics?
A set of moral principles

The study of morality.

The philosophical study of moral values and rules.

Of or relating to moral action and conduct;

professionally right; conforming to professional
standards.
 ETHICS
Evidence based medicine is ethical related to
four ethical principles:
 HUBUNGAN DOKTER- PASIEN
Prinsip utama hubungan :
HUBUNGAN DOKTER PASIEN
 Etika kedokteran mencakup:

Kesanggupan memahami keluhan dan pribadi pasien

Kemampuan menumbuhkan empati

Kemampuan mempertahankan kerahasiaan hubungan

dokter-pasien

Kewajiban melakukan pendekatan ilmiah (analitik)

pada pasien dan masalahnya

Kewajiban memberitahu pasien tentang tindakan dan

rencana selanjutnya, serta melanjutkan asuhan pasien

Kemampuan menolong pasien mengambil keputusan

terbaik mengenai penyakit dan hidupnya
Samsuridjal Djauzi, MD, PhD
COMMUNICATION
 Think back for a minute on your own life
experiences
Recall from your own interaction with your
doctor or dentist
The quality of the communication that
involved
 Was it clear?
Was it empathetic?
Were you left with the impression that you
were told as much as you wanted to know?
Were you left with the impression that your
doctor was a good listener?
 COMMUNICATION
Is an important component of patient care
Must gain an understanding of the patients
perspective on his or her illness
Carefully, not to be judgemental or scolding,
.may rapidly close down communication
Communication skills
To begin
Hippocrates
Global Phenomenon
 Global Phenomenon
ILMU KEDOKTERAN dan NILAI NILAI
PERADABAN

BERKEMBANG DAN MAKIN KOMPLEKS

 COMPONENTS OF
CLINICAL COMPETENCE

Communication
skills

Knowledge Diagnostic
base skills, problem
solving
Physical
examination
skills

What happened?
 Common assumptions

Communication is a core clinical skill

and theres considerable science
behind it
 Common assumptions

Communication is
a series of learned skills
Not a personality trait
Anyone can learn who wants to
 Experience is an effective teacher of
communication skills

Ill get this later, on my own

All I need is a little more

practice......
 Common assumptions

Experience alone tends to be a poor

teacher of communication skills

It is a great reinforcer of habit just

doesnt discern well between good and
bad habits
 Goals of Communication

Forging a relationship is CENTRAL to the success

of every encounter, whatever the context,
however short or long the relationship
Paradigm Progression

Same paradigm progression

pertains to education
Kurtz SM, Silverman JD, Benson J and Draper J (2003) Marrying Content and Process in Clinical Method Teaching:
Enhancing the Calgary-Cambridge Guides
Academic Medicine 78(8):802-809
Initiating the Session
THE BASIC FRAMEWORK

Gathering information

Providing Building the

Structure relationship

Physical Examination

Explanation and planning

Closing the Session

The Calgary -Cambridge Approach

Initiating the Session

Gathering Information
Building the Relationship
Providing structure to the interview
Explanation and Planning
Closing the Session
 COMMUNICATION

Its a series of learned skill

Experience is a poor teacher: it needs

observation plus well intentioned,
constructive, detailed and descriptive
feedback plus rehearsel to effect change
 Harapan pasien kepada Dokter
Mampu mendengarkan, menghormati pendapat
pasien, berlaku santun dan penuh pertimbangan,
berkomunikasi dengan baik, memberikan nasihat
tanpa menggurui

Mampu menyimpan rahasia, sifat jujur dan punya

integritas, dan tetap memberikan asuhan
walaupun ilmu kedokteran tidak berhasil lagi.

Mampu mempertahankan hubungan luwes shg

pasien mendapat penjelasan lengkap dan
dilibatkan dalam keputusan tentang asuhan.
Samsuridjal Djauzi, MD, PhD
SPECIFIC ISSUES TO CORE communication
skills
A recommended protocol for giving
bad news

1. Prepare info, location, setting

2. Find out what they already know
3. Ask how much they want to know
4. Share the information
5. Respond to the patients emotion
6. Negotiate a concrete follow-up step
 Collaboration in Health Care-
Communication

Nurse-Physician Collaboration
Nurse Practitioner-Physician Collaboration
Social Worker-Physician Collaboration
Pharmacist-Physician Collaboration
Physician-Physician Collaboration
 FIVE STAR DOCTOR
Care provider
Decision maker
Communicator
Community Leader
Manager