Kisi2 Pemilihan Prima Facie

Kaidah Dasar Moral

Agus Purwadianto.
Jakarta, 2004
Kasus Konkrit 1
Keputusan Pilar Keputusan Klinis sehari2
Medis

-
Keputusan
etis
 Indikasi
Biomedik medik
Keputusan Pilar Keputusan Klinis sehari2
Medis

Info-
etis
-
Keputusan
medik

pilihan pasien
kualitas hidup
fitur kontekstual

Mindset non medis

Struktur Psiko-
Sosio-budaya
Tkt keseriusan Kep. Klinis
 Struktur masyarakat Indonesia 
plural
 Dokter << sensitif sosio-antropologi
budaya.
 Stereotip mahasiswa FK terlalu
bangga diri (positivisme,
teknologisme, simplistisme)
Isu Etik
 Isu etik bukan isu medik.
 KALAU BINGUNG : SETIAP KDM
MASUKKAN SEPERTI TEST PEN  SATU
PERSATU
 DR FOKUS MEMANDANG 1 PASIENNYA 
3 KDM KECUALI JUSTICE
 ”PRIMA FACIE” = titik titer ”BERUBAH
MENJADI” KDM yg paling relevan saat itu
Isu Etik
 dari KDM  acuan tertinggi
moralitas manusia
 acuan generalisasi etik yang
menuntun suatu tindakan
kemanusiaan.
 Bahasa moral & lingkup kerja
analisis etik RUTIN ditengah
pluralitas HIDUP manusia
 Principles-based
approach  Prima Facie
T.Beauchamp & Childress (1994) & Veatch (1989)

Beneficence
Autonomy

Non Maleficence Justice

Contextual features Clinical Decision

Quality of life Making
Insight Core Problem
Keywords

Basic Beneficence
Nonmaleficence
Moral Autonomy
Justice
Principle
Prima Facie Context vs Text
Choose 1-2 out
of 4 most
Principle relevan
(problem
solving)

Ethics Virtue

Theory Duty - deontologist

Utilitarian -
teleologist
Happiness
 Ethical Culture
Custom
Relativism

Ethical Science &

technology
determinant
Dilemma Societal &
capital
determinant
Ceteris Choose 1 most
influential
Paribus principle

Ethical
Consistency

Problem Coherent
Correspondency

Solving Pragmatic
Legal Administrative
Penal

Option Civil
 Implementation of the 1st year students

2nd EPC Module

Batch 2003 & 2004

Our own Group

Select 24 of 67 cases Presentation
(Dr. Tenar’s) cases
= 24 tutors Plennary Sessio

Individual/Group : Take home exam

 Medical
Indication
Deductive logic
Beneficen Autonomy Justice
Non Maleficence
ce

Method =
Logic Thinking  critical analysis

Combination of
It’s characteristics = Patient’s Context
 Check list (Observation Sheets)
Beneficence Criterion Yes No

Promoting altruism
Guaranteeing human dignity
Viewing patient/family not as profit
objects
Maximize agregat net benefit
Compassionate paternalism
Guaranteeing minimal life of patient
Restricting “goal based approach”
Maximize patient satisfaction
Group No. Tutor’s name
 Check list (Observation Sheets)
Beneficence Criterion (2) Yes No

Maximize overall highest happiness
Continuing professional
development
Giving effective-low priced medicine
Applying Golden rule principle
Promoting patient’s best interest
etc

Group No. Tutor’s name

 Check list (Observation Sheets)
Justice Criterion Yes No

Applying everything universally
Taking last portion of dividing
something
Giving P-same position’s similar
opportunity
Respect P’s rights : affordability,
equality, accessibility, availability,
quality)
Respect P’s legal rights
etc Group No. Tutor’s name
 Check list (Observation Sheets)
Autonomy Criterion Yes No

Respecting self-determination
rights, supporting of P’s dignity
Not intervening decision making
process of the P (elective condition)
Truthfullness
Respect privacy
Confidentiality etc
Supporting P’s rationality
Compassionate informed consent
Group No. Tutor’s name