LEARNING ONJECTIVES

Aimed competency:
Conducting ethical justification in every professional activities as a medical doctor.

Subjects: Medical dispute

Lecture objectives: 1. Undertanding the meaning, dynamics, prevention and management of medical dispute. 2. Undertanding the meaning, dynamics, prevention and management of eticolegal conflict

Community Medical problems

Trust Appreciation Specific privilege Social contract

Q U A L I T Y
C A R E

Doctor Medical competentcy

MEDICAL CARE Therapeutic contract

Doctor Patient Mutual agreement

Therapeutic contract
A social contract specific characteristics

THERAPEUTIC CONTRACT Specific characteristics Formality: implicit, convention Object: medical problems Aims: providers: effort to cure, not cure patients: cure Responsibility: providers: quality care patients: abiding and support the process Condition: mutual believe and respect

Therapeutict contract (between provider, a/o doctor and patient) Right and Responsibility

Dissatisfaction

medical dispute

MEDICAL DISPUTE

Demand Contract Outcome Dissatisfied Complaint Allegation Auction

MEDICAL ALLEGATION
Dissatisfaction to the outcome 1. Condition of the diseases 2. Adverse effects

3. Missed conduct Negligence Intentional

malpractice

PROVED MEDICAL AUCTION

Malpractice
Therapeutic contract Damage to the patient

Missed conduct
Damage is due to missed conduct

Missed conduct ?
System bylaws Efficient Science Standard The best Quality care Moral Ethics Honorable

DISCIPLINED CARE
Administrative discipline Clinical discipline Ethical discipline = MEDICAL DISCIPLINE Missed conduct = undisciplined care

UUPK -MEDICAL COUNCIL

Practice based on standard Standard = reference to disciplined care

MANAGEMENT OF MEDICAL ALLEGATION

Provider

Institution Ethical Committee Professional Court - MKDKI

Common Court

MANAGEMENT OF MEDICAL ALLEGATION Provider = Doctor Review the process Discuss the complaint
* severity * MAE (Medicine Adverse Effect) * miss conduct ^ negligence ^ intentional - mal behave

incongruency of perception? substantial wrong doing mutual agreement Accepting the situation Further auction

MANAGEMENT OF MEDICAL ALLEGATION Institution Ethical Committee Review the process Discuss the complaint Idem Providers + * severity Intermediation * MAE + Compensation * miss conduct Disciplinary action negligence malbehave Hospital incongruence perception? Dinkes IDI mutual agreement MKEK Accepting the situation Further auction

MANAGEMENT OF MEDICAL ALLEGATION MKDKI - Professional Court Allegation Assesment Decision: do breaking the disciplines ? Sanction: Deregistration Reschooling Specific attention Refered to MKEK

Do not eliminate the right of the patient to undertake the auction to the civil and criminal court

MANAGEMENT OF MEDICAL ALLEGATION Common Court

Civil Court: Miss Conduct Compensation Criminal court: Breaking specific laws/ regulation

Medical Dispute - Prevention

Discipline care Honorable care Understanding the dynamics of the dispute ongoing preventive action. Building up conducive doctor patient relationship: attentive empathic care through better communication skill. Honest and responsible. Admitting the wrong doing.

HONORABLE CARE
Respecting mankind
Sifat Ketuhanan power of the almighty Kemurnian niat pure intention Keluhuran budi - wisdom Kerendahan hati - humbleness Kesungguhan kerja hard working Integritas ilmiah dan sosial Scientific and social integrity Kesejawatan peer spirit

ALTRUISM

Therapeutict contract (provider and the patient) Provider is a team within a system Conflict among member of the team or Staff of the system eticolegal conflict

ETICOLEGAL CONFLICT
Sophistication of medical technology Teamwork approach through a system different health / medical professionals in rendering medical care conflict Source of conflict: Autonomy Authority Professional pride Other interest Character: Personal and professional behavior

ETICOLEGAL CONFLICT Management

Provider

Institution Ethical Committee MKEK Other health prof. Organization Resolution of the conflict Formative action

ETICOLEGAL CONFLICT Prevention

Acknowledge and respect different professionals within the system.
Undertaken the role and behave according to their position within the system. Consistently work according to the standard. Enhancing peer spirit

END REMARK Medical practice: a social contract. Operationally implemented as a therapeutic contract. Contract lead to dissatisfaction, medical dispute legal auction. Should be prevented and managed properly in maintaining public trust and appreciation. Medical care could lead to conflict among providers. Should be perevented and managed properly, in maintaining the spirit and the honor of medical profession.