BIOETIKA DIDALAM ILMU KEDOKTERAN

Devisi BHMPMEU – FKUSUBlok Generic Skill2012

Pra Kuliah :

Tingkat EkonomiBudayaAgama

Gaya HidupKehidupan Keluarga

LingkunganDll……..

STUDENTS( BAHAN )

FK USU(PROSES)

DOKTER( PRODUK )

DOKTER( PRODUK )

ATTITUDE

SKILLKNOWLEDGE

Pra FK

PendidikanFormal

Non Formal Keluarga

FKMembentuk

MenggemblengMembina

PRODUK SIAP PAKAIDapur

Bahan

5 STARSDOCTOR

Skill

Knowledge

attitudeBioetika

&Humaniora

Care providerDecision MakerCommunicatorCommunity LeaderManager

FK

TUJUAN PENDIDIKAN DOKTER

KIPDI I

KIPDI II

KIPDI IIISeven Competency Area’s

Etika Medik / KedokteranHukum kedokteranSosial BudayaAgama

Bioetika & Humaniora

Etik terapan / studi tentang

masalah etik yang timbul atau diantisipasi akan

timbul pada suatu kegiatan Ilmu dgn tujuan bukan

untuk penyampaian informasi atau

keterampilan tetapi “pengertian” atau

“budaya budi”.FM Suseno

• To be a professional or competent medical doctor, physician or health professionals; Competence Based Curriculum (CBC).

1. Knowledge (Cognitive) competence2. Skills (Psychomotor) competence3. Behavior (Attitude, Affective) competence

*

Quality development

Basic standard

Under standard

C P A

Ethics, Biomedical Ethics, BioethicsBioethics (HELP):

(Medical) Humanities(Medical) Ethics(Medical) Law(Medical) Professional Behavior

Bioethics Education1. Bioethics in Medical/ Health Services2. Bioethics in Medical/ Health Research3. Bioethics in Medical Health Education

Bioethics Education (Teaching and Learning)Across the continuum of medical education.

1. Undergraduate2. Graduate

Clerkship/ clinical rotation Internship

3. Postgraduate: Master and doctorate programmes Specialty and subspecialty trainings.

Fig. 1. Teaching and Learning Bioethics Across the continuum in Medical Education

Vertically and horizontally integrated throughout medical education and training.

I VII XIII XIX

II VIII XIV XX

III IX XV XXI

IV X XVI

V XI XVII

VI XII XVIII

1 6432 5

7 AREAS OF COMPETENCY

1. Effective communication2. Clinical skills3. Scientific basis of medical knowledge4. Management of health problems5. Management of information6. Self awareness and self development7. Ethics, morals, medico-legal aspects and profesionalism,

and patient safety

7. Area of ethics, morals, medico-legal aspects and professionalism, and patient safety

22. Have a professional attitude

23. Behave professionally in cooperating with others

24. Play a role as a member of a professional health service team

25. Conduct medical practice appropriately in the multicultural society of Indonesia

26. Comply with the medico-legal aspects of medical practice

27. Prioritise patient safety in medical practice

Teaching Bioethics in Medicine

1. Undergraduate students2. Clerkship (Clinical Rotation), Graduate3. Residency Training, Postgraduate4. Medical Practitioners (CME/ CPD)

Bioethics in Medical Education Curriculum

2003 International standards in Medical Education (WFME) 3. (Basic, Postgraduate, CPD)Knowledge, skills, and behavior competencies

Before Indonesian National Core Curriculum In Medical 2006 Education (CHS) social - behavior, humanities, philosophy, ethics and law.

2006 National Core Curriculum in Medical Education (IMC). Ethics, moral, medico - legal, professionalism, patient safety.

WHAT IS BIOETHICS/ ETHICS?1) Ethics can be described as sub-branch of applied

philosophy that seeks “what are the right and the wrong”, “The good and the bad” set of behavior in a given circumstance.

2) Medical ethics is defined as interdisciplinary teaching and research discipline which critically, historically and analytically identifies and examines moral and ethical aspects of (decision concerning) health care and medical research.

3) Bioethics is defined as the branch of ethics that investigates problems specifically arising from medical and biological practice. These include problems of the nature and distribution of treatment, the spare of authority of the patient, the physician, and others, the limitation of acceptable intervention and experimentation (see abortion, euthanasia), and the priority of genetic research and its application.

WHY BIOETHICS MUST/ SHOULD BE TAUGHT/ TRAINED

- To enhance the ability to care for patients and families.

- Applying relevant knowledge, analyzing the problems, and deciding or resolving ethical quandaries.

- Bioethicists, moral philosophers, chaplains should not displace the clinical teachers.

WHAT SHOULD BE THOUGHT ?

Clinician regularly deal with the common set of ethical issues, e.g.: truth telling, consent, confidentiality, conflict of interest, end-of-life issues, resource allocation, research ethics, etc.

This modules (issues)- for introductory teaching of bioethics. What not to teach – to teach theory unrelated to cases.

Clinicians want to learn the right thing to do and how to do it. Teaching bioethics materials

1) WHO – SEARO (2005); 2) UNESCO Study materials (2008); 3) Bioethics for family medicine (2005); 4) Bioethics for clinicians (series, 2000); 5) Clinical ethics for medical House Officer (1999), etc.

HOW SHOULD BIOETHICS BE THOUGHT AND ASSESSED ?

Special courses on bioethics or integrated into traditional course. Hidden curriculum? Elective programme?

Closely linked to patient care.1) At the bedside or in the clinic (out patient) 2) Case-based conference – practical and theoretical

aspects of bioethics.

Medical factors Diagnosis Treatment Prognosis

Preferences Patient Family Team

Quality of life Before During After

Context Support system Cost, availability,

special circumstances

An approach used for case – based teaching and ethical decision-making.

EVALUATION AND ASSESSMENT

1) In-training evaluation reports 2) Clinical performance3) Objective structured clinical examinations (OSCE)4) Multiple choice written examinations5) Short answer or essay questions, commonly

REFERENCES:1. Soenarto S, Padmawati RS, Mahardinata NA, and

Sasongko TH, 2002. Proceeding Bioethics 2000: An International Exchange. First Ed., Yogyakarta.

2. Anoname, 2007. Seminar and Workshop on Teaching Bioethics for Medical Students (undergraduate), Yogyakarta, December 10-12.

3. WFME, 2003. WFME Global Standards for Quality Improvement: Postgraduate Medical Education-WFME Office: University of Copenhagen – Denmark.

4. KKI (Konsil Kedokteran Indonesia), 2006. Standar Pendidikan Profesi Dokter, Jakarta.

5. KKI (Konsil Kedokteran Indonesia), 2006. Standar Kompetensi Dokter, Jakarta.

6. Mc Kneally and Singer PA, 2001. Bioethics for Clinicians (series): Teaching Bioethics in the Clinical Setting. CMAJ: Apr. 17, 2001. www.cma.ca/cmaj/series/bioethics.htm

7. Aksoy, 2002. The Four Principle of Bioethics As Found in 13th Century Muslim Scholar Maulana’s Teachings. BMC Medical Ethics No. 3.

8. Helland DE, 2002. What is Bioethics? Report from a Seminar, November 2001, on Teaching Bioethics, Organized by The Nordic Committee on Bioethics. Denmark.

9. WHO, 2005. Health Ethics in South – East Asia. Vol. 4. Teaching Health Ethics. Resource Materials from WHO SEARO. New Delhi.

10. UNESCO, 2008. Bioethics Core Curriculum. Section 1: Syllabus Ethics Education Programme. UNESCO Version 1.0.

11. Bereza, M, ____Clinical Ethics Curriculum in Family Medicine Sample Teaching Module Problem Solving: Analytical Methodology in Clinical Ethics. Mc Gill University, Canada.

12. Singer PA and Todhill AM, 200. Bioethics for Clinicians, Continuing the Series. www.cma.ca/cmaj/series/bioethics/htm

13. Forrow L, Zand M, and Baden L, 1999. Clinical Ethics for the Medical House Officer: General Principles and Cases, Third Printing, January. Boston, MA.

14. Certified Courses on Bioethics (Humanity-Ethical-Legal-Professional Aspects), 2011. “The 1st – 5th Series”