Kaidah dasar bioetika dalam pengambilan keputusan klinis yang etis

Abstract

AbstrakKaidah dasar bioetika adalah suatu karakteristik yang unik dari prinsip yang dapat digunakan untuk menganalisis lebih tajam suatu standar, untuk membenarkan peraturan dan dapat menjadi pedoman dalam pengambilan keputusan klinis yang etis dalam praktik sehari-hari. Tinjauan pustaka ini bertujuan untuk memberi suatu metode dalam proses pengambilan keputusan klinis yang etis bagi dokter. Untuk manfaat kemajuan sains, tinjauan ini telah mengembangkan pemanfaatan kaidah dasar bioetika di bidang medis, terutama hubungan dokter-pasien, profesionalisme serta bioetika medis. Beberapa metode pengambilan keputusan klinis yang etis dibahas dan didiskusikan. Dengan meningkatkan pemahaman dan pelatihan penggunaan kaidah dasar bioetika dalam kehidupan seharihari diharapkan akan mampu menjaga hubungan dokter-pasien secara lebih baik. Kata kunci: kaidah dasar bioetika; keputusan klinis; etika; hubungan dokter-pasien Abstract

Ethical and Medicolegal Considerations in the Termination of Pregnancy Due to Lethal Congenital Anomalies in Banda Aceh, Indonesia

“…and 3what should be done to this patient? [11] The first question concerns diagnostic and classification problems. In this case, the doctor will use all of his medical abilities to be able to minimize the diagnostic error that can be made [6], [7].…”

“…Doctors provide the best for patients. In this case, the termination of pregnancy must be performed based on the condition that the fetus has lethal congenital anomalies and the doctor must determine the safest method for terminating the pregnancy [11], [12], [13]. In this case, the doctor has educated the patient's mother and family along with alternative choices that can be made (informed choice) and after getting an explanation from the doctor, the patient and her family agreed to sign an informed consent form.…”

“…What if in the steps, these questions pose a dilemma for doctors to make decisions? [11], [12], [13] There are four approaches that can be used to solve the ethical dilemma, namely [8] (1) single-principle theories, the principle here is to choose one principle by defeating other principles after careful consideration, (2) ranking (lexically ordering) principles, the principle here is to make a ranking (lexical) of the principles that exist and the decision is taken on the principle that the order is located at the top, (3) balancing, the principle is the decision is taken by balancing the existing principles, and (4) combining ranking and balancing, the principle here is to try to rank and as far as possible make these principles in one group. But in practice, it is very difficult because the many values with each other beat each other and cannot be balanced [11].…”

Contraceptive Choices for Women with Intellectual Disability

“…Therefore, sterilization decided unilaterally is a violation of medical ethics. If the medical team or family worried about patient menstrual hygiene, the foremost action to take fi rst is less invasive contraceptive methods such as combination oral contraceptive, medroxyprogesterone injection, intrauterine device, and endometrial ablation 3,6,8,9 The medical team responsible for the patient wellbeing have differents opinion in managing this case. Obstetricians-gynecologist (obgyn) suggested doing sterilization as a form of precaution to prevent this incident reoccurs.…”

“…If the women with intellectual disability do not have any capacity in choosing an appropriate contraceptive, so the medical team need to do a holistic approach which is appropriate for the patient. 3,[8][9][10]…”