Setelah melakukan serangkaian pemeriksaan Dokter A

menyimpulkan bahwa Tn Lmenderita TBC Paru aktif.

Setelah menyampaikan hasil pemeriksaan tersebut makaTn L
meminta kesediaan Dokter A untuk tidak menyampaikan hasil
pemeriksaan tersebut kepada tunangannya Nn R.
Permintaan yang sama juga disampaikan olehibu Tn L yang juga
mendampingi Tn L di tempat praktik Dokter A.

Bagaimana seharusnya Dokter A bersikap ?

Jika Dokter A menolak permintaan Tn L mk azas profesionalisme

apakah yang mendasari sikap Dokter A ?

Bagaimana pula jika Dokter A memenuhi permintaan itu ?

 A profession is any group sharing a special
body of knowledge, standards of education
and practice, professional associations, and
an ethical framework based in a social
contract that permits a high degree of self-
regulation.

On that view, ethics is an important

descriptor for a profession, but ethics is not
its essential and indispensable defining
feature.
 The contract
Kontrak antarabetween professions
kelompok and
profesi dengan
society is relatively
masyarakat umum. simple.
The professions
Profesi are granted
diberi monopoli a monopoly
dalam menggunakan
keahliannya dalam pelayanan kpd masyarakat,
over the use of a body of knowledge, as
dengan menimbang otonominya, prestige dan
well as considerable
imbalan finansialnya autonomy, prestige,
and financial rewards on the
Dan sebaliknya profesi harus menjamin
understanding
kompetensi that memberikan
mereka, they will guarantee
layanan yang
competence,
altruistik, provideyang
berperilaku altruistic service,
bermoral dan and
conduct their affairs with morality and
berintegritas
integrity
Cruess SR et al: MJA 2002 177 (4): 208-211
 Professionalism is the basis of medicine's
contract with society.
It demands placing the interests of patients
above those of the physician, setting and
maintaining standards of competence and
integrity, and providing expert advice to
society on matters of health.
Essential to this contract is public trust in
physicians, which depends on the integrity of
both individual physicians and the whole
profession
 Altruism is the essence of professionalism.
The best interest of the patients, not self-
interest, is the rule.
Accountability is required at many levels - to
individual patients, society and the
profession
Excellence entails a conscientious effort to
exceed normal expectations and make a
commitment to life-long learning
 Duty is the free acceptance of a
commitment to service.
Honour and integrity are the consistent
regard for the highest standards of
behaviour and refusal to violate ones
personal and professional codes.
Respect for others (patients and their
families, other physicians and professional
colleagues such as nurses, medical
students, residents, subspecialty fellows,
and self) is the essence of humanism"
 True professionalism means the pursuit of
excellence, not just competence
Professionalism is predominantly an
attitude, not a set of competencies
A real professional is a technician who cares
Professional is not a label you give yourself.
Its a description you hope others will apply
to you

Maister DH: True Professionalism, The Free Press, 1997

 Cognitive knowledge, the scientific
knowledge and technical dexterity doctors
possess that enables them to diagnose and
treat patients.

Moral component of professionalism, which

requires that the needs of patients come
before the needs of the doctor.

Collegial responsibility for doctors to

monitor one another and to ensure
competence in the profession (peer-review)
 COMPETENCE CONDUCT /
KNOWLEDGE AND ATTITUDE
SKILLS EMPATHY
PHYSICAL AND DUTY OF CARE
MENTAL FITNESS COLLEGIAL
RESPONSIBILITY
 At present, the medical profession is
confronted by an explosion of technology,
changing market forces, problems in health
care delivery, bioterrorism, and globalization.
Physicians are experiencing frustration as
changes in the health care delivery systems in
virtually all industrialized countries threaten
the very nature and values of medical
professionalism.
 Sistem Pendidikan Kedokteran yg mahal
Sistem Pembiayaan yg fee for service
Sistem Pelayanan Kedokteran yg for profit:
komoditi ekonomi
Sistem liberalisasi pengadaan obat/alkes
Masyarakat yang semakin materialistik
Peraturan yang tidak lengkap
 public perception
Ketidakpercayaan that medicine
masyarakat terjadifailed to
apabila self-
regulate in
masyarakat a waybahwa
menilai that can guarantee
profesi kedokteran
competence,
gagal melakukanand that it putyang
swa-regulasi its own interest
menjamin
above thatdan
kompetensi, of patients andkepentingannya
meletakkan the public di
medicine
atas has protected
kepentingan pasien incompetent or
unethical colleagues in the name of
collegiality
Atau bila kedokteran melindungi anggotanya yg
tidak kompeten dan tidak etis atas nama
kolegialitas

Cruess SR et al: MJA 2002 177 (4): 208-211

 Meetings among the European Federation of
Internal Medicine, the American College of
PhysiciansAmerican Society of Internal
Medicine (ACPASIM), and the American Board
of Internal Medicine (ABIM) have confirmed
that physician views on professionalism are
similar in quite diverse systems of health care
delivery
Fundamental Principles:
Principle of primacy of patient welfare
Principle of patient autonomy
Principle of social justice

Annals of Internal Medicine, Vol 136 Issue 3, 5 Feb 2002

http://www.annals.org/cgi/content/full/136/3/243
 Commitment to professional competence
Commitment to honestly with patient
Commitment to patient confidentiality
Commitment to maintaining appropriate
relations with patients
Commitment to improving quality of care
 Commitment to improving access to care
Commitment to a just distribution of finite
resources
Commitment to scientific knowledge
Commitment to maintaining trust by managing
conflict of interest
Commitment to professional responsibilities

Please visit : www.professionalism.org

 Altruism

Respect for
Accountability
others

Honor and
Excellence
Integrity

Duty
 ETIKA PERILAKU
DISIPLIN PROFESI
HUKUM PUBLIK
Eh disini tertulis bahwa
kejadian kesalahan medis di
rumah sakit ini sangat tinggi Oh, pantesan,
katanya gue di-
histerektomi

Paul Barach, MD, MPH, Univ of Miami Medical School

 Pasal 55 ayat (1) UU No 23 tahun 1992
tentang Kesehatan : setiap orang berhak
atas ganti rugi akibat kesalahan atau
kelalaian yang dilakukan tenaga kesehatan.

Pasal 50 UU No 29 tahun 2004 tentang

Praktik Kedokteran : dokter dan dokter gigi
berhak memperoleh perlindungan hukum
sepanjang melaksanakan tugas sesuai
dengan standar profesi dan standar
prosedur operasional.
DOKTER JANGAN MELAKUKAN:
KESALAHAN
KELALAIAN
TAK SESUAI STANDAR PROFESI
TAK SESUAI S.O.P.

ITULAH YG DISEBUT BOTTOM LINE ETHICS

BELUM CUKUP UNTUK SEORANG PROFESIONAL,
HARUS DITAMBAH DENGAN KEPEDULIAN
KEPADA PASIEN DAN PROFESI
 Praktik yang baik adalah praktik yang sesuai
dengan peraturan perundang-undangan:
Kompeten dan berwenang
Sikap profesional:
Sesuai etika dan standar
Patuh pada disiplin profesi

Kepatuhan kepada Profesionalisme akan

mencegah malpraktik