LEARNING ONJECTIVES

Aimed competency:
Conducting ethical justification in every professional activities as a
medical doctor.
Topic : The Relevancy and the Dynamics of Development of
Medical Professional Ethics.
Lecture objectives:
1. Understanding the relevancy of the existency of medical
professional ethics. C3, A1, P1
2. Understanding the concept of biomedical ethics in relation to
medical professional ethics. C3, A1, P1
3. Understanding the determinant of bioethics development:
empirical experiences, philosophic and sosciologic studies, and
religions norms. C3, A1, P1
4. Understanding the role and the position of professional organization in medical professional ethics codification. C3, A1, P1

relevancy

COMPETENCY

Specific privilege

Earned the life

relevancy

Competency
dedicated his/her life
public trust
appreciation
specific privilege
authority
autonomy
recognized profession

Medical Profession

relevancy

Medical Profession
Specific privilege
reciprocal commitment by the profession
a social contract
quality care
updated competency
honorable care
medical profession ethics
ethical codes and guidelines

medical ethics

COMPETENCY

Specific privilege

Earned the life

Professional Ethics

RELEVANCY
Medical Ethics
A moral commitment by the medical
profession, that they will honor the
specific privilege trusted by the
community by rendering honorable
quality medical care.
Medical ethics code: the moral references
in rendering honorable medical care.

Mankind Activities

Ethics

Knowledge
right-wrong

sci
ent
if ic

Moral
good-bad

s
c
i
et
h
est

Arts
Nice-bad

Meaning
Moral dimension of the activities
value system: good or bad
morality
Morality for a specific ectivitiies/
community
ethics
morality for medical professional
Medical professional ethics
= Medical Ethics

Other MEANING

A Study
Philosophical study
Moral philosophy
Ethics philosophy
What should be adopted

Theoretical Ethics - Normative Ethics

Prescriptive Ethics

Other MEANINGS

A study
Sociologic study

Empirical practices
Community morality

Applied Ethics Descriptive ethics

DEVELOPMENT

Biomedical Sciences
Medical Technologies
Rapid development
ample choice
more sophisticated
team approach
complicated system
Widening the scope of ethical problems

DEVELOPMENT
Widen Scope different ethics references
Different health professionals:
Nursing ethics
Pharmacist ethics
etc
Health care dilivery system:
Hospital ethics
Decision maker ethics
etc
Biomedical study:
Health research ethics ethics
etc

DEVELOPMENT

Biomedical Sciences
Medical Technologies
Rapid development
Object subject: human - mankind
The study outcome of the study influence
human dignity
More expensive
Team approach - System
development of the dimensions/ intensity
of ethical problems

DEVELOPMENT
Dimensions and intensity
before: focus mainly on patient safety and
interest
More complicated moral issue on:
Social justice
Human dignity
Respect of life

BIOMEDICAL ETHICS CONCEPT

Integration all dimensions
BIOMEDICAL ETHICS BIOETHICS

Compilation all aspects of biomedical ethics

development
But still in the context of health
study on ethical, social, laws on other issues
related to medical cares and biomedical sciences

A scientific discipline
Medical ethics is a part of bioethics.
Medical professional should comply to bioethics

DEVELOPMENT OF BIOMEDICAL ETHICS

Four media:
1.Empirical experiences
2. Sociologic studies
3. Philosophy studies
4. Religion norms

EMPIRICAL EXPERIENCES

Medical practice:
Rapidly develop
Moral conduct of doctors
Accepted morality
Compilation
New ethical guideline

SOCIOLOGIC STUDIES

Medical practice:
Varied practiced morality
Practiced
Sociologic studies
Generalization
Suggested ethical norms

PHILOSOPHIC STUDIES

Moral philosophy
Moral theory
Bioethics principle
Recommended norms

Theoritical ethics

Science
philosophy

Moral
Philosophy

Sciences

Moral
norms

right
wrong
nature

good
bad
endeavor

THEORY
Utilitarian
Good - bad ~ Consequences
Multiple consequences studies
Rule Utilitarian
Act Utilitarian

THEORY
Deontology - Kantianism
Good - Bad ~ Ratio - thinking
Maxim = moral responsibility
Positive duties
Negative duties
multiple dimension

THEORY
Individualism
Good - Bad ~ Individual right
freedom to decide - liberalism
Positive/ negative right
Individual person vs Community
Individual responsibility

THEORY
Communitarian
Good - Bad ~ Communal morality
community responsibility X liberalism

THEORY
Ethics of care - Feminism
Good - Bad ~ Emotional binding
Moral commitment
Caring Loving Inner binding
Inter relationship
Reciprocal needs

RELIGION
Religion norms

Interpretation

Ethical codes

Practical
aspects

Varied medium
Dynamics of thinking and
practices
Varied norms
Universalisme vs Relativisme
Basic principle: universal
Praxis: relative

CODIFICATION
Medical ethics - World
World Medical Association
International Code of Medical Ethics
(London 1948 revision)

+ Declaration

CODIFICATION
Medical ethics - Indonesia
Peer Group
Professional Organization
MKEK IDI

Compilation Codification
KODEKI
Fatwa - Pendapat

CODIFICATION
Biomedical study - World
Nurenberg Code 1947
Autonomy Risk Scientific foundation
Helsinki Declaration 1967 cccc
Written protocol risk managable
WHO-CIOMS 1982-1983-1991
Ethical Review Committee
USPH Belmont Report 1978-cccc
Animal study

CODIFICATION
Biomedical study - Indonesia
FKUI - Indonesian Dean - 1987
Pedoman Etik Penelitian
Kedokteran Indonesia
Badan POM - 2000
Cara Uji Klinik yang Baik
Komnas Etik Penelitian Keseh. 2004
Pedoman Etik Penelitian Kesehatan
Indonesia

CODIFICATION
Hospital ethics
Based on medical ethics
Pioneered by the doctor
Adopted by the government
PERATURAN MENTERI KESEHATAN
No.24/Menkes/SK/XII/1988.
Developed by peer group - PERSI
KODERSI-2001

DEVELOPMENT
Regulation and enforcement
Community
Profession
System
State

morality
Ethics
bylaws
laws

CLOSING REMARK
Bioethics - dynamics
Focal point: professional conducts
Altruism
Holly tradition of medical profession
i.
Believe in God.
ii. Pure goal
iii. Holly character
iv. Humble
v.
Seriousness
vi. Scientific and social integrity
vii. Peer spirit