BIOETHIC CASES

OLEH :
WAYAN BUDA PRADANA (17710130)
KELOMPOK PARE KEDIRI
cases 1
 Cases
 A man comes to the emergency room by the police because of a traffic accident, the
patient comes in an unconscious state, the patient has a lot of bleeding caused by a
collision, the doctor immediately gives action to stop the bleeding. After being treated
for a while when the patient's condition worsens from his TTV, doctors diagnose severe
brain injury, so the patient must be referred to a hospital that has more complete
facilities because the pare kediri hospital does not have a neurosurgery specialist.
 To make a referral must go through a predetermined procedure, the doctor is preparing
the referral requirements and contacting the hospital to be referred and chosen by the
family, but the hospital being contacted is not having a neurosurgery specialist, but the
family insists on being referred immediately for reasons had contacted the hospital, then
the doctor did not approve because the hospital had confirmed that it could not accept
the referral, then the patient's family asked to go home and agreed to the terms of forced
return
ETHIC DILLEMA

In this case, the doctor suggested referral should be taken to get the right action, but the
family did not approve and decided to go home and choose the hospital itself
 Autonomy vs Benefecience
 Prima facie : Autonomy
 No Kriteria Ada Tidak
ada
1 Prioritizing alturism X
B 2 Ensure basic values of human dignity X
E 3 Looking at the patien / family / something not only to the advantage X
of the doctor
N 4 Strive for more good / benefit compared to its ugliness X
E 5 Paternalism is responsible / compassionate X
F 6 Ensure a good minimum human life X
I 7 Goal-based restrictions X
8 Maximizing the satisfaction of happiness / patient preference X
C 9 Minimization of bad results X
I 10 Obligation to help emergency patients X
E 11 Respecting the rights of patients as a whole
12 Do not withdraw honoraria beyond appropriateness X
N 13 Maximizing the highest satisfaction overall X
C 14 Develop the profession continuously X
E 15 Providing nutritious yet inexpensive medicine X
16 Applying the Golden Rule Principle X
 No Kriteria Ada Tidak ada
N
O 1 Helping emergency patients X
2 The conditions for describing these criteria are:
N - Patients are very dangerous (emergency) / at risk of missing X
something important (critical) X
X
M - The doctor is able to prevent the danger or loss
A - The doctor's actions proved effective
- Benefits for patients> doctor's loss (only experiencing minimal risk) X
L
E 3 Treat injured patients X
4 Do not kill patients (do not do euthanasia) X
F 5 Do not insult / berate / use patients X
I 6 Do not view patients as objects X
7 Treating disproportionately X
C 8 Do not prevent patients from harm X
E 9 Avoid misrepresentation of patients X
N 10 Do not endanger the patient's life due to negligence X
11 Does not give life spirit X
C 12 Does not protect patients from attacks X
E 13 Do not conduct white collar crime in the health sector / hospital which is X
detrimental to the patient / family
 N Kriteria Ada Tidak ada
o
1 Respecting the right to self-determination, respecting the dignity of X
patients
2 Do not intervene in patients in making decisions (under elective X
conditions)
A 3 Be bright X
U 4 Appreciate privacy X
5 Keep patient secret X
T 6 Appreciate patient rationality X
O 7 Carry out informed consent X
N 8 Allowing adult patients and competent to make their own decisions X

O 9 Do not intervene or obstruct patient autonomy X

M 10 Prevent other parties from interfering with patients in making X
decisions, including the patient's own family
Y
11 Patiently waiting for the decision to be taken by the patient in a non- X
emergency case
12 Do not lie to the patient even for the benefit of the patient X

13 Maintain relationship (contract) X

 No Kriteria Ada Tidak ada
1 Enact everything universally X
2 Take the last portion of the dividing process he has done X
3 Giving equal opportunities to individuals in the same position X

4 Respecting patients' health rights (affordability, equality, accessibility, availability, X

quality)
J 5 Appreciate the legal rights of patients X
6 Respect the rights of others X
U 7 X
Maintain vulnerable groups (most disadvantaged)
S 8 Do not abuse X
T 9 Wise in macro allocations X
10 Provide a contribution that is relatively the same as the patient's needs X
I 11 Request patient participation according to patient needs X
C 12 The obligation to distribute profits and losses (costs, expenses, sanctions) fairly X

E 13 Return rights to the owner at the right time and competent X

14 Does not give heavy burden unevenly without valid reasons X

15 Respecting the rights of the population who are equally susceptible to X
diseases / health problems
16 Does not differentiate patient services on the basis of SARA, social status, etc. X
 4 BOX METHODE

Indikasi Medis Quality of Life

Mr. N is a patient who has severe brain injury The patient has been treated to stop bleeding
who must get the right action and get treatment to improve the condition

Client Preference Contextual Feature

The patient is unconscious and the family is the The patient is a member of the police and family
patient's younger sibling and is 40 years old as a member of the military, middle and upper
social economy
 Prinsip profesionalisme:

 Alturisme :Yes
 Duty : Yes, The doctor has taken action to prevent the situation getting worse by
performing treatment according to the procedure
 Respect for others : yes. The doctor has explained to the family about the prognosis of
the disease.
 Accountable :Ada.
 Humanity : Yes, The doctor provides appropriate care and will be referred
 Prima facie :Autonomy
ORDINARY AND EXTRAORDYNARY

 ORDINARY
Cases 2
Cases
 A newborn baby with a weight of 4000 grams. Because the weight
exceeds the average, the doctor checks the blood sugar, after the
examination turns out the baby's blood sugar is high, and suggests that
the baby is treated so that his blood sugar returns to normal. Initially the
family forced them to go home but after being given an explanation the
family agreed to be treated.
DILEMA ETIK

in this case the doctor advised to be treated to prevent bad conditions in

the future, at first the family refused to be treated but after being given
further explanation the family finally agreed to be treated.
 Autonomy vs Benefience
 Prima facie : Autonomy
 No Kriteria Ada Tidak
ada
1 Prioritizing alturism X
B 2 Ensure basic values of human dignity X
E 3 Looking at the patien / family / something not only to the advantage X
of the doctor
N 4 Strive for more good / benefit compared to its ugliness X
E 5 Paternalism is responsible / compassionate X
F 6 Ensure a good minimum human life X
I 7 Goal-based restrictions X
8 Maximizing the satisfaction of happiness / patient preference X
C 9 Minimization of bad results X
I 10 Obligation to help emergency patients X
E 11 Respecting the rights of patients as a whole X
12 Do not withdraw honoraria beyond appropriateness X
N 13 Maximizing the highest satisfaction overall X
C 14 Develop the profession continuously X
E 15 Providing nutritious yet inexpensive medicine X
16 Applying the Golden Rule Principle X
 No Kriteria Ada
Ada Tidak
Tidak ada
N ada
1 Menolong pasien emergensi X
O 1 Helping emergency patients X
2 Kondisi untuk menggambarkan kriteria ini adalah:
2 The conditions for describing these criteria are: X X
N  Pasien dalam keadaan amat berbahaya (darurat)/ beresiko hilangnya sesuatu yang
- Patients are very dangerous (emergency) / at risk of missing
penting (gawat)
X
 something
Dokter sanggupimportant (critical)
mencegah bahaya atau kehilangan tersebut
X
x
M - Tindakan
The doctordokter
is tersebut
able toterbukti
preventefektif
the danger or loss
- Manfaat bagi pasien > kerugian dokter (hanya mengalami resiko minimal) x
A The doctor's actions proved effective X
L - Benefits for patients> doctor's loss (only experiencing minimal risk)
3 Mengobati pasien yang luka X
E 34 Treat injured patients
Tidak membunuh pasien (tidak melakukan euthanasia) X
X
45 Do not
Tidak kill patients (domaki/memanfaatkan
menghina/mencaci not do euthanasia)pasien X
X
F 56 Do
Tidaknot insult /pasien
memandang berate / useobjek
sebagai patients X
X
I 67 Do not view
Mengobati secarapatients as objects
tidak proporsional X
X
78 Treating disproportionately
Tidak mencegah pasien dari bahaya X X
C 89 Menghindari
Do misrepresentasi
not prevent patientsdari pasien
from harm X
E 9
10 Tidak
Avoidmembahayakan kehidupanofpasien
misrepresentation karena kelalaian
patients x X
N 10
11 Do
Tidaknot endanger
memberikan the patient's
semangat hidup life due to negligence X x
11
12 Doesmelindungi
Tidak not give life spirit
pasien dari serangan X x
C 12
13 Tidak melakukan
Does not white collar
protect patients fromcrime dalam bidang kesehatan/kerumah sakitan yang
attacks X
E 13 merugikan pihak pasien/keluarganya
Do not conduct white collar crime in the health sector / hospital which is X
detrimental to the patient / family
 N Kriteria Ada Tidak ada
o
1 Respecting the right to self-determination, respecting the dignity of X
patients
2 Do not intervene in patients in making decisions (under elective X
conditions)
A 3 Be bright X
U 4 Appreciate privacy X
5 Keep patient secret X
T 6 Appreciate patient rationality X
O 7 Carry out informed consent X
N 8 Allowing adult patients and competent to make their own decisions X

O 9 Do not intervene or obstruct patient autonomy X

M 10 Prevent other parties from interfering with patients in making X
decisions, including the patient's own family
Y
11 Patiently waiting for the decision to be taken by the patient in a non- X
emergency case
12 Do not lie to the patient even for the benefit of the patient X

13 Maintain relationship (contract) X

 No Kriteria Ada Tidak ada
1 Enact everything universally X
2 Take the last portion of the dividing process he has done X
3 Giving equal opportunities to individuals in the same position X

4 Respecting patients' health rights (affordability, equality, accessibility, availability, X

quality)
J 5 Appreciate the legal rights of patients X
6 Respect the rights of others X
U 7 X
Maintain vulnerable groups (most disadvantaged)
S 8 Do not abuse X
T 9 Wise in macro allocations X
10 Provide a contribution that is relatively the same as the patient's needs X
I 11 Request patient participation according to patient needs X
C 12 The obligation to distribute profits and losses (costs, expenses, sanctions) fairly X

E 13 Return rights to the owner at the right time and competent X

14 Does not give heavy burden unevenly without valid reasons X

15 Respecting the rights of the population who are equally susceptible to X
diseases / health problems
16 Does not differentiate patient services on the basis of SARA, social status, etc. X
 4 BOX METHODE
Indikasi Medis
because the baby's weight is 4000 grams and
the baby's blood sugar is still high
Client Preference
after getting an explanation the parents
decided that the baby should be treated and
agreed to the doctor's actions
Quality of Life
further examination is carried out and
appropriate action is given
Contextual Feature
baby's parents come from middle-class
families down. The conflict between the doctor
and the patient is the doctor advising the baby to
be cared for but the parents want the baby to be
taken home
Prinsip profesionalisme:
 Alturisme : Ada
 Duty : Ada
 Respect for others : Ada
 Accountable : Ada
 Humanity : Ada
 Prima facie : Autonomy
ORDINARY AND EXTRAORDYNARY

 ORDINARY