Etika Hukum Kedokteran

1. Tantangan Etika
& Hukum
dalam Kedokteran Digital

2. is the natural evolution of healthcare
TELEMEDICINE

3. OUTLINE
ASPEK HUKUM
ASPEK ETIKA
PENGERTIAN
TAKE HOME MESSAGE
PERLINDUNGAN HUKUM

4. Digital Medicine describes as field, concerned with the use of
technologies as tools for measurement , and intervention in
the service of human health.
Digital Medicine products are driven by high-quality hard ware
and software that support the practice of medicine broadly,
including treatment, recovery, disease prevention, and health
promotion for individuals and across population.
(Digital Medicine Society - DiMe)
PENGERTIAN
DIGITAL
MEDICINE
Kedokteran digital dideskrpsikan sebagai bidang
yang menaruh perhatian terhadap penggunaan
teknologi sebagai alat untuk melakukan penilaian
dan intervensi dalam pelayanan kesehatan manusia.
Produk dari kedokteran digital di “drive” oleh
teknologi berkualitas tinggi baik hardware maupun
software untuk mendukung praktik kedokteran
secara luas termasuk pengobatan, pemulihan,
pencegahan penyakit, dan promosi kesehatan untuk
individu maupun masyarakat luas

5. The field of knowledge and practice associated with the
development and use of digital technologies to improve
health. Digital health expands the concept of e-Health digital
consumers, with a wider range of smart devices and
connected equipment. It also encompasses other use of digital
technologies for health such as the Internet of Things (ioT),
Artificial Intelligence (AI), Big Data and Robotic.
(WHO : Global Strategy on Digital Health 2020-2025)
PENGERTIAN
DIGITAL
MEDICINE
Kesehatan digital adalah bidang ilmu pengetahuan
yang berhubungan dengan perkembangan dan
penggunaan teknologi digital untuk meningkatkan
kesehatan. Kesehatan digital memperluas konsep
tentang e-health bagi pengguna teknologi digital
dengan cakupan yang luas dari perangkat pintar dan
peralatan yang terkoneksi. Hal ini meliputi
penggunaan teknologi digital untuk Kesehatan
seperti Internet of Things (IoT), Artificial Intelligent
(AI), Big Data dan teknologi robotic.

6. Telemedicine is the delivery of care services, where
distance is a critical factor, by all health care
professionals using information and communication
technologies for the exchange of valid information for
diagnosis, treatment and prevention of disease and
injury, research and evaluation, and for the continuing
education of health care providers, all in the interest of
advancing the health of individuals and communities
(WHO: Telemedicine, Opportunities and Developments
in Member States, Report by the second Global
Observatory for e-Health Series, 2010)
PENGERTIAN TELEMEDICINE
Telemedicine adalah pemberian pelayanan
kesehatan jarak jauh oleh profesi kesehatan dg
menggunakan teknologi informasi dan komunikasi
meliputi pertukaran informasi diagnosis, pengobatan,
pencegahan penyakit dan cedera, penelitian dan
evaluasi, dan pendidikan berkelanjutan (bagi)
penyedia layanan kesehatan untuk kepentingan
peningkatan kesehatan individu dan masyarakat
(PMK NO. 20 th 2019)

7. Telemedicine is the practice of medicine over a
distance, in which interventions, diagnostic and
treatment decisions and recommendations are based
on data, documents and other information
transmitted through telecommunications system
(WMA Statement on the Ethic of Telemedicine,
69th WMA GA Reykjavik, Iceland, October 2018)
PENGERTIAN
TELEMEDICINE
Telemedicine adalah pelayanan kedokteran jarak jauh
dimana keputusan dan rekomendasi utk intervensi,
diagnosis dan pengobatannya berdasarkan data,
dokumen dan informasi lainnya yang ditransmisikan
melalui sistem komunikasi

8. Telehealth is the delivery of health care services, where
patients and providers are separated by distance.
Telehealth uses ICT for the exchange of information for
the diagnosis and treatment of disease and injury,
research and evaluation, and for the continuing
education of health professionals.
(WHO: Telehealth, Analysis of the third global survey on
e-Health based on the reported data by countries, 2016)
PENGERTIAN TELEHEALTH
Telehealth is the use of information and
communication technology to deliver health and
healthcare services and information over large and
small distances
(WMA Statement on Guiding Principles for the Use
of Telehealth for the Provision of Healthcare, WMA
GA India, October 2009)

9. e-Health is defined as the use of information and
communication technology in support of health and
health-related fields.
Mobile health (mHealth) is a subset of e-Health and
is defined as the use ofmobile wireless technology
for public health
PENGERTIAN
E-HEALTH
e-Health didefinisikan sebagai penggunaan teknologi
informasi dan komunikasi untuk mendukung upaya
kesehatan dan bidang yang berhubungan dengan
kesehatan
Mobile health (mHealth) adalah bagian dari
e-Health, yang didefinisikan sebagai penggunaan
teknologi mobile nir kabel untuk kepentingan
kesehatan masyarakat
WHO GUIDELINE:
Recommendation on Digital Interventions For Health
System Strengthening. WHO 2019

10. ASPEK ETIK
THE MORAL PRINCIPLE
PRIMUM NON NOCERE
FIRST, DO NOT HARM
Belmon Report 1979
Principles of Biomedical Ethics

11. BELMONT REPORT 1979
RESPECT FOR PERSONS (AUTONOMY)
Dalam bentuk Informed Consent
Menghormati kebebasan pasien dlm bertindak & mengambil
keputusan serta tanggungjawab atas keputusannya
BENEFICIENCE
Mempertimbangkan potensi kerugian dengan kemungkinan
manfaat yang akan diperoleh dalam setiap tindakan
JUSTICE
Mempertimbangkan secara adil manfaat dan beban dari
pemberi jasa pelayanan dan penerima jasa pelayanan

12. AUTONOMY (OTONOMI)
Menghormati kebebasan pasien dlm bertindak & mengambil
keputusan serta tanggungjawab atas keputusannya
NON-MALEFICENCE (TIDAK MERUGIKAN)
Primum non nocere, first do no harm
Yang utama jangan menyakiti - Kewajiban untuk tidak mencelakakan
BENEFICENCE (BERBUAT BAIK)
Kewajiban utk berbuat baik dan membantu orang lain
Mempertimbangkan risiko dan manfaat
JUSTICE (KEADILAN)
Memperlakukan pasien sesuai dengan kebutuhan dan kemampuan
IN CLINICAL PRACTICE
MORAL PRINCIPLE
Tom L. Beauchamp and James F. Childress:
PRINCIPLES OF BIOMEDICAL ETHICS 7th Ed, 2013

13. VERACITY (KEJUJURAN)
Akurat, tepat, objektif dan komprehensif
PRIVACY (PRIVASI)
Menjaga hal-hal yg bersifat pribadi
CONFIDENTIALITY (KERAHASIAAN)
Adalah bagian dari informasi pribadi
Wajib merahasiakan hal-hal yg bersifat rahasia
Hanya boleh dilepas sesuai perundangan
FIDELITY (LOYALITAS)
Menaruh perhatianbesarkepadapasien
IN CLINICAL PRACTICE
PROFESSIONAL-PATIENT RELS. PRINCIPLES
Tom L. Beauchamp and James F. Childress: PRINCIPLES OF BIOMEDICAL ETHICS 7th Ed, 2013

14. “In sum, while ethics and law are different in certain
ways, ethics remains a foundation of law, and often
provides a justificatory basis for legal norms” .
( WHO Global Health Ethics Key Issues, 2015 )
ETHICS AND LAWS
“When law in conflict with medical ethics, physician
should work to change the law. In circumstances of
such conflict, ethical responsibilities supersede legal
obligation”
(WMA Declaration on the Relation of Law and Ethics,
October 2019 )

15. ETIK, DISIPLIN, HUKUM

16. TELEMEDICINE “ In addition to the positive consequences of
telemedicine, there are many ethical and legal issues
arising from these new practices. Notably, by
eliminating a common site and face-to-face
consultation, telemedicine disrupts some of
the traditional principles which govern the physician-
patient relationship. Therefore, there are certain
ethical guidelines and principles that must be
followed by physician involved in telemedicine“.
( The World Medical Association)

18. PERNYATAAN IDI TENTANG REKAM MEDIS
BUTIR 4:
Perintah dokter melalui telpon untuk suatu tindakan
medis, harus diterima oleh perawat senior. Perawat
senior ybs hrs membaca ulang catatannya tentang
perintah tsb dan dokter ybs mendengarkan
pembacaan ulang itu dg seksama serta mengkoreksi
bila ada kesalahan. Dalam waktu paling lambat 24
jam, dokter yg memberi perintah hrs
menandatangani catatan tsb
Lampiran SK PB IDI No.
315/PB/A.4/88
AWAL TELEMEDICINE DI INDONESIA?

20. HAK & KEWAJIBAN
DOKTER

21. 21 KEWAJIBAN
DOKTER
KODEKI 2012

22. ASPEK HUKUM
“ e-Health is an interesting tools, as the digital-
based health serviceapplication will benefitted the society. However, Indonesia needs to speed
up the issuance of e-Health Regulation ”
(Dr. Nyoman Adhiarna e-Business Director, Ministry of Communication and Information:
21st Century Health Care Challenges, A Connected Health Approach, Megatrends in Health Care, 2019
REGULASI TELEMEDICINE

23. HIRARKI HUKUM
HUKUM
UU NO. 12 TH 2011 ps.7

29. REGULASI
TERKAIT
KEWENANGAN
DOKTER

30. REGULASI
TERKAIT
REKAM MEDIS
PMK NO 269 TH 2008
PUTUSAN MA NO. 21 TH
2011 ATAS
JR PMK NO. 269 TH 2008

31. REGULASI
TERKAIT
UU NO 14 TH 2008
TENTANG KIP

32. REGULASI
TERKAIT
UU NO 19 TH 2016
TENTANG ITE

33. REGULASI
TERKAIT
UU NO 19 TH 2016
TENTANG ITE

34. REGULASI
TERKAIT
Sanksi Pidana

35. REGULASI
TERKAIT
Perlindungan Hukum

36. REGULASI
TERKAIT
Perlindungan Hukum
AMANAH UU

37. REGULASI
TERKAIT
Perlindungan Hukum
DARI PERUNDANGAN

38. REGULASI
TERKAIT
Perlindungan Hukum
DARI PERUNDANGAN

39. REGULASI
TERKAIT
STANDAR PROFESI

40. REGULASI
TERKAIT
STANDAR PELAYANAN

41. TAKE HOME MESSAGES

43. TERIMAKASIH