INTRODUCTION OF BIOETHICS AND HUMANITIES IN MEDICAL EDUCATION

BY Prof. Dr. R. Muchtan Sujatno, dr., SpFK

Bioethics and Humanities consists of :

Introduction Philosophy of science Social and Cultural Science Health behavior Ethic in medical profession Other humanioras

LECTURES
1. Prof. Dr. Muchtan Sujatno, dr., SpFK INTRODUCTION OF BIOETHICS AND HUMANISM IN MEDICAL EDUCATION 2. Dr. Thaufik Siddiq Boesoirie, dr., SpTHT., MS PHILOSOPHY OF SCIENCE 3. a)Prof. Dr. Ridad Agoes, dr., MPH., DAPE, b)Ike MP Siregar, dr., MPH., SpKJ, c)Irvan Afriandi, dr., G.Dip.OEH., MPH, d)Kuswandewi Mutyara, dr., M.Sc SOCIAL AND CULTURAL SCIENCE 4. a)Tatang Muchtar S, dr., SpKJ, b)HR Zainie Hassan AR, dr., SpKJ, c)Tuti Wahmurti S Safiie, dr., SpKJ, d)Ike Mangasa P Siregar, dr., SpKJ., MPH, e)Teddy Hidayat, dr., SpKJ, f)RM Haryadi Karyono, dr, SpKJ, g)Nita Arisanti, dr, h)Kuswandewi Mutyara, dr., M.Sc-MAE HEALTH BEHAVIOR

CONTINUED
5. ETHIC IN MEDICAL PROFESSION 5.1 Prof. Soegana Tjakrasudjatma, dr., SpM
HISTORY OF MEDICINE

5.2

Pardjaman Tojo, dr., SpPA., SpPF

LEGAL ASPECTS IN MEDICINE

5.3

Empu Driyanto, dr. SpTHT

ETHICAL GUIDELINES IN MEDICAL PROFESSION

5.4

Prof. Dr. Djamhoer Martaadisoebrata, dr., SpOG., MSPH

ETHICAL GUIDELINES FOR BIOMEDICAL RESEARCH AND SCIENTIFIC MEDICAL WRITING

5.5

Prof. Sulaiman S. Sastrawinata, dr, SpOG

BIOETHIC

6.

# # #

Siti Suparti, dr

RELIGION
Armaya Ariyoga, Drs., Med., M.Kes

PANCASILA
Dr. Ambrosius Purba, dr., MS

CIVICS EDUCATIONS

 Ethics in medical profession

History of medicine Legal aspects in medicine Ethical guidelines in medical profession (service) Ethical guidelines in biomedical research Bioethics

Other humanioras
Religion Pancasila Civics Education

PBL

Definition
Bioethics : The study of the ethical problems arising from scientific advances, esp. in biology and medicine Biomedical revolution :
medical revolution biological revolution Balance by devotion to religion

Social revolution :
autonomy human rights

Side effect of medical revolution : empowerment of scientist

 Bioethics not just a particular field of human inquiry-the intersection of ethics and the life sciences-but also an academic discipline; a political force in medicine, biology, and environmental studies; and a cultural perspective of some consequence Understood narrowly, bioethics is simply one more new field that has emerged in the face of great scientific and technological changes. Understood more broadly :
it is a field that has spread into, and in many places has changed, other for older field. it has reached into law and public policy; into literary; cultural, historical study into the popular media, into the disciplines of philosophy, religion and literature and into the scientific field of medicine, biology, ecology and environment, demography and the social sciences.

 Varieties of Bioethics :
no single discipline can claim a commanding role. There are 4 central areas of inquiry can be distinguished. 1. Theoretical Bioethics 2. Clinical Ethics 3. Regulatory and Policy Bioethics 4. Cultural Bioethics

1. Theoretical Bioethics
Deals with the intellectual foundations of the field What are its moral roots and what ethical warrant can be found for the moral judgments Part of the debate: whether its foundation should be looked for within the practices and traditions of the life sciences.

2. Clinical Ethics
Clinical ethics: refer to the day - to day moral decision making of these caring for patients e.g: Should a respiratory to be turned off ?

3. Regulatory and policy Bioethics

The aim is to fashion legal or clinical rules and procedures designed to apply to types of cases or general practices.

 This area of ethics does not focus on individual cases. e.g. for regulation ethics 1970s effort to fashion a new legal definition
Of clinical death form a heart lung to a brain-death definition The development of guidelines for the use of human subjects in medical research Hospital rules for do-not-resuscitate orders.

Regulatory ethics ordinarily seeks laws, rules policies and regulations that will command a wide consensus and its aim is practical rather than theoretical

4. Cultural Bioethics
Countries with strong paternalistic traditions may not consider it necessary to consult with patients about some kinds of decisions. Refers to the effort systematically to relate bioethics to the historical, ideological, cultural and social context in which it is expressed.

 ABEL :
Bioetika adalah studi interdisiplin tentang masalah-masalah yang ditimbulkan oleh perkembangan biologi dan kedokteran, baik dalam skala mikro maupun makro, serta dampaknya pada masyarakat sistem nilai kini dan di masa yang akan datang.

McCullough :
Bioetika adalah disiplin yang berkaitan dengan moralitas pelayanan kesehatan, yang menyangkut dokter, pasien, institusi pemberi pelayanan kesehatan, dan kebijakan pelayanan kesehatan.

Jacobalis S :
Etika Klinis adalah praktis yang memberikan pendekatan terstruktur dalam membantu dokter mengambil keputusan dengan mengidentifikasikan, menganalisis dan memecahkan isu etik dalam kedokteran klinis.

Ethics
Ethics may judge human behavior based on determination of what is right and what is wrong through every value and principles that exist in certain moment of time life-life value (price) (health) individual-society parents-children justice-races anencephaly

HUMANITIES :
Languages and literatur, esp the classical Greek and Latin The branches of learning concerned with human thought and relations as distinguished from the sciences, esp literature, philosophy, history, etc

Humanity
Humanity and their nature is the basis of morality morality : everything that increases humanity morality values ethics behavior

Philosophy of Science
The philosophy of science is a knowledge which is showing where in the rationality lies, what is distinctive about its explanation and theoritical construction, what marks it off from guess-work and pseu-science and makes its predictions and technologies worthly of confidence, above all whether its theories can be taken to reveal the truth about a hidden objection reality At the end of the session the student should be able to understand Philosophy of science

Basic Socio and Cultural Science (Medical Anthropology)

This course form of part of the Bioethics and Humanities Unit in the first phase of preclinical period. The course aims to encourage the application of the perspective of social scientific understanding of health and illness to current relevant issues related to health services.

 The course is divided into two parts.

In the first part, it introduces basic concepts of culture and society as a framework to understand human health behavior in various social and cultural settings. In the second part, it provides some issues and themes of medical anthropology in relation to current situation of multiculturality and constant social cultural changes.

At the end of the session the student should be able to understand Basic Socio and Cultural Science (Medical Anthropology)

Health Behavior
Recognize appropriate health behavior which should results in primary prevention Prepare intentional activity that is design to achieve health or illness related learning At the end of the session the student should be able to understand what is Health behaviour

Ethics in Medical Education

Consists of :
1 History of medicine 2 Legal aspects in medicine 3 Ethical guideline in medical profession 4 Ethical guideline in biomedical research 5 Bioethics

At the end of the session the student should be able to understand Ethics in Medical Education

History of medicine
Medical History of Earlier Time
The reason for studying medical history is the desire to understand medicine itself and to grasp its techniques, its organization, and its underlying ideas. The medical system of earlier time differed from what it is now, it most be remembered that they functioned, and fulfilled their task. Studying the history of medicine from this point of view has an illuminating and

 Medical History in Indonesia

The medical system since the XVIIIth century. The purpose of medical services was to maintain healthy labor in the plantation. The first medical school in 1870

at the end of the course the student should know of history of medicine, especially the features of medical

Legal aspects in medicine

The Norm of Medical Practice The Civil Law System and The Common Law System The Penal Code and The Private Code The international and national (Indonesian) medical ethics The licencing law The health law of Indonesia (UU No. 23 tahun 1992)

 Medical malpractise Liability for treatment in the emergency Informed consent Protection of consumer law (UU Perlindungan Konsumen) Medical malpractice liability insurence The physician and criminal law The physician in the court and the Indonesian medical association at the end of the course, the student

 Ethical guidelines in medical profession (service) define ethics related to profession. nowadays medical profession is being critizied medical code of ethics give example of the ethical guideline in application At the end of the course, the student should have a better knowledge and understanding

Ethical guideline in medical profession service

 Understand the evolution of the medical ethic and the development of guidelines for biomedical research declaration of Helsinki, CIOMS and GCP Ethical guidelines for biomedical research
At the end of the lecture, the students should have a better knowledge and understanding in all regulation and guidelines related to ethical aspects in biomedical research and have a proper attitude toward it.

Ethical guidelines in biomedical research

Scientific Medical Writing (SMW)

At the end of the lecture, the students should

 Introduction : the rapid development in biomedical technology and human rights and their effect on ethical conduct Genetics Reproductive Technology Population Control Health care Death and dying Environmental ethics Bioethics
at the end to sensitize students to the range of ethical issues that the life sciences, health and health care present To aid students in developing skills in ethical analysis

Bioethics

ETHICS
INTRODUCTION TERMINOLOGY: The term that closely resembles to ethics is moral. The word ethic originated from Greek: ETHOS referring to some following meanings common: residence, prairie, stall, habit, custom/tradition, moral, character, perception, attitude, the way of thinking. The plural form ta etha meaning tradition provides background for the term ethic that had been adopted by Aristoteles ( 384 322 BC) to reflect moral philosophy.

Definition
Ethics the science of what accustomed to conduct or the science of tradition. Etimologically, this term is not appropriate meaning, such as word ethics, profession ethic. The Indonesian dictionary Kamus Umum Bahasa Indonesia (Poerwadarminta, 1953) said that ethics refers to the science of moral principles. The Indonesian Dictionary Kamus Umum Bahasa Indonesia ( P & K, 1988) suggest that ethics is: 1. The science about what is good and bad and about right and moral obligation (characters). 2. Set of principles or values concerning characters 3. Values of the good and the bad in which believed by a subgroup or a society.

Other Humaniora Subjects

Consist of :
Religion Pancasila Civics Education

At the end of the session the student should be able to understand

Religion Pancasila Civics Education

Conclusion
This is a series of lecture given continuously throughout the year of medical education At the end of his/her medical education the new insurable physician should have a full comprehension of ethical and moral aspects in medical profession. And that he should put this noble attitude into daily practice as a health provider, researcher and scientific writer the must also be sensitive to ethical issues related to biotechnology development.