Transcript Bioetika Didalam Ilmu Kedokteran

BIOETIKA DIDALAM
ILMU KEDOKTERAN
Devisi BHMP
MEU – FKUSU
Blok Generic Skill
2012
Pra Kuliah :
Tingkat Ekonomi
Budaya
Agama
STUDENTS
Gaya Hidup
( BAHAN )
Kehidupan Keluarga
Lingkungan
Dll……..
DOKTER
( PRODUK )
FK USU
(PROSES)
ATTITUDE
DOKTER
( PRODUK )
KNOWLEDGE
SKILL
Formal
Pendidikan
Non Formal
Pra FK
Keluarga
Bahan
FK
Membentuk
Menggembleng
Membina
5 STARS
DOCTOR
Care provider
Decision Maker
Communicator
Community Leader
Manager
PRODUK SIAP PAKAI
Dapur
attitude
Skill
Knowledge
Bioetika
&
Humaniora
TUJUAN
PENDIDIKAN DOKTER
Etika Medik / Kedokteran
Hukum kedokteran
Sosial Budaya
Agama
KIPDI I
KIPDI II
Seven
KIPDI III Competency
Area’s
FK
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) competence
2. Skills (Psychomotor) competence
3. Behavior (Attitude, Affective) competence
C
P
A
Quality development
*
Basic standard
Under standard
 Ethics,
Biomedical Ethics, Bioethics
Bioethics (HELP):
(Medical) Humanities
(Medical) Ethics
(Medical) Law
(Medical) Professional Behavior
 Bioethics
1.
2.
3.
Education
Bioethics in Medical/ Health Services
Bioethics in Medical/ Health Research
Bioethics in Medical Health Education

Bioethics Education (Teaching and Learning)
Across the continuum of medical education.
1.
2.
Undergraduate
Graduate


3.
Clerkship/ clinical rotation
Internship
Postgraduate:


Master and doctorate programmes
Specialty and subspecialty trainings.
1
2
I
VII
XIII
XIX
II
VIII
XIV
XX
III
IX
XV
XXI
IV
X
XVI
V
XI
XVII
VI
XII
XVIII
3
4
5
Fig. 1. Teaching and Learning Bioethics Across the continuum in Medical Education
Vertically and horizontally integrated throughout medical education and training.
6
7 AREAS OF COMPETENCY
1.
2.
3.
4.
5.
6.
7.
Effective communication
Clinical skills
Scientific basis of medical knowledge
Management of health problems
Management of information
Self awareness and self development
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
students
2. Clerkship (Clinical Rotation), Graduate
3. Residency Training, Postgraduate
4. 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
2006
Indonesian National Core Curriculum In Medical
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)
2)
At the bedside or in the clinic (out patient)
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 decisionmaking.
EVALUATION AND ASSESSMENT
1)
2)
3)
4)
5)
In-training evaluation reports
Clinical performance
Objective structured clinical examinations (OSCE)
Multiple choice written examinations
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”