Scenario C ( just fiction) In the local newspaper, there is a letter from a reader which I quoted as follows.

Is it appropiate to become a doctor? wee! a"o, at midni"ht, I went to our pediatrician and !noc!ed at the door.#$ %% months dau"hter, &i&i, suddenl$ "ot hi"h fe&er and continual con&ulsion. fter !noc!in" at the door about %' minutes, finall$ the doctor wo!e up. I told him m$ problem, and as!ed to come to m$ house and help m$ dou"hter. (ut, what is response i "ot? )he doctor standin" a!imbo, said that i had to understand the norm because it was midni"ht. *o!ter is also human that needs a rest. I apolo"i+ed, but because the docor had wo!en up, I e,pected himto help m$ dou"hter. (ut the doctor became more an"r$. -e said that he also had children who must be cared, and also had pepare a lecture. )he doctor su""ested to ta!e m$ dau"hter to the hospital. If he help me now, it will be accustomed. fter I as!ed for his help and apolo"i+ed repeatedl$, the doctor consistentl$ !elp his attitude. t last, I "i&ed up. nd then I too! .i&i hurriendl$ to the hospital.

I.

)erm Clarification Con&ulsion/ caused b$ the release of abnormal electric transmission in the brain. 0ediatrician/ a doctor who speciali+ed in children health -i"h 1e&er/ the fe&er which o&er the normal temperature 2orm/ considered b$ "ood practice and there is no punishment if we brea! it. !imbo/ hips ttitude/ the beha&ioral

II.

0roblem Identification %. .i&i, suddenl$ "ot hi"h fe&er, and continual con&ulsion. 3. )he doctor refuse to come her house, because it was mid ni"ht. 4. )he doctor "et an"r$ 5. )he docor consistenl$ !ept his attitude. '. )his problem is alread$ published in news paper.

III.

0roblem nal$sis %. a) 6hat is the s$mptomps hi"h fe&er, and continual con&ulsion? b) -ow to o&ercome hi"h fe&er and continual con&ulsion? c) 6hat is the impact of hi"h fe&er, and continual con&ulsion if it7s not o&er come immediatel$? 3. a) 6h$ the doctor refuse? b) 6hat should the doctor to face this case? c) In what circumtances, can a doctor refuse a patient?e,plain8 4. a) Is it appropriate that a doctor "et an"r$?e,plain8 b) -ow should the doctor react?

5.

a) 6hat are the ethics of a doctor? b) 6h$ does the doctor !ept his attitude?

'.

a) Is it ri"ht if a patient published the problem to the news paper?e,plain8 b) -ow is the best response from the patient?

%.

a) S$mptomps 1e&er (especiall$ hi"h fe&er) )onic clonic con&ulsion or "rand mal 9nconscious durin" 4: seconds ; ' minutes )onic postur Clonic mo&ement )on"ue or chee! bitten In!ontinensia (ta!e out !emih water or tinja) <bstacle breath phneu ( stop breath ) (lue s!in

b) t bab$ 3 months ; ' $ears "i&e paracetamol or !ompres,"i&e enou"h food little but recure c) step 3. a) (ecause,accordin" to doctor.relationship doctor and patient article %= that doctor must ta!e care their heath,so the$ can wor! well,but accordin" from patient a doctor didn7t ha&e empath$ to come to her house to anamnesis her bab$,and "i&e first help e,ample/ "i&e spoon between tooth up and tooth down to a&oid tooth was bitten b$ bab$. b) If doctor want to help her, *octor come to her house,anamnesis her bab$ and "i&e first help e,ample/ "i&e spoon between tooth up and tooth down to a&oid tooth was bitten b$ bab$.In article %4 that e&er$ doctor must do help emer"enc$ e,cept other person who can help. If doctor didn7t want to help her.*octor refuse li!e ethics of communication c) ccordin" patient 2o,because in relation doctor and patient article %4 that e&er$ doctor must do help emer"enc$ e,cept other person who can help. nd in scenario, patient often ha&e treatment in that doctor. ccordin" doctor,doctor ha&e obli"ation to their self too li!e relation doctor and patient article %= that doctor must ta!e care their health. 4.a) 2o, because as a doctor profesional,we must ha&e "ood attitude nd we must !now that all people didn7t the same norm.for e,ample/ doctor standin" a!imbo. ccordin" doctor that standin" a!imbo is natural,but not the same with patient who ha&e different tradition b) *octor shouldn7t an"r$ with patient, and doctor must aware that ma$be patient didn7t ha&e same norm.So, doctor must ha&e well attitude. 5.a) benefience, non malifience, confidenlit$, justice (pun", dijelasin aja la"i)
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b)(ecause,doctor is public fi"ure in comunit$, and he thou"h that his attitude was ri"ht '.a)$es,because in this news paper,patient didn7t metion who is doctor. So, no problem. b)0atient should inform this case with #>?> who ha&e obli"ation to !now about this case,and process this case. nd then if #>?> jud"e that the doctor is wron",#>?> will "i&e this case at I*I.I*I will call doctor.and finished in the court. )hen,published in news paper if doctor pro&en wron".
IV. Hypothesis Doctor refuse to come to her house, because doctor didnt have empathy,didnt have a good medical communication,didnt apply relation doctor and patient ,and K D!KI. "o, resulting to medical dispute.

V.

#earning issue &hat I 'no( Definition !ssential element of medical communicatio n Definition &hat I dont 'no( )he impact of poor communicatio n *pply empathy &hat I have to prove *pply communicatio n in our life Ho( I (ill learn "lide )e+t boo' ,ournal Internet "lide )e+t boo' ,ournal Internet "lide )e+t boo' ,ournal Internet "lide )e+t boo' ,ournal Internet "lide )e+t boo' ,ournal Internet "lide )e+t boo' ,ournal Internet "lide )e+t boo' ,ournal Internet

$asic %aterial %edical communicatio n

!mpathy

%edical professionalis m

-elation doctor and patient

Definition %ost fulfill criteria as doctor professionalis m Definition

*pply medical professinalis m

)he effect (ith our attitude if (e dont apply in our life !ffect if dont apply in our life

-ight and obligation doctor and patient Kind of virtue ethic

Virtue ethic

Definition

Ho( a(are bet(een doctor and patient that they respect to other *pply in our life

$asic principle of bioethic %edical dispute

Kind of basic principle of bioethic Definition

*pply in our life

!ffect if (e apply

.actors (hich cause

Ho( step by step to inform about medical dispute

VI.

/oncept %apping

Vivi got sic'

/ontinued convulsion %om came to doctor

.ever

*ccept

-efuse

didnt have a good communication

didnt have empathy

didnt apply basic principle of bioethic

.eel dissatisfy, and (rite in ne(spaper

medical dispute

contravene 223K

VII.

"ynthesis

#edical communication Commnunication is an important component of patient care with holistic and collaborati&e approach. Essential element of Medical Communication %. (uild relationships #nemonic 0 ? 3. @AS/

0..partnership, ac!nowled"es that the ph$sician and the patient are in this to"ether ?..empath$, e,presses understandin" to the patient ..apolo"$, ac!nowled"es that the ph$cisian is sorr$ the patient had to wait, that a laborator$ test had to be repeated, etc @..respect, ac!nowled"es the patient7s sufferin", difficulties, etc A..le"itimi+ation, ac!nowled"es that man$ patient are an"r$, frustrated, depressed, etc S..support, ac!nowled"es that the ph$sician will not abandon the patient.

<pen the discussion 0h$sician7s first "reetin". 0h$sician show personal concern b$ offerin" a handsha!e and warm smile. 0ut the patient at ease in what could otherwise to be unfamiliar, if not fri"htenin" en&ironment.
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4. Bather Information Shiftin" from a ph$sicianCcentered to patientCcentered inter&iew st$le 0h$sician interrupt patients an a&era"e of %D seconds after the patient be"ins to spea!. 0atient rarel$ continued to e,press all their true concern once the$ were interrupt 2o more than %': seconds was needed to e,press all their concern at the be"innin" or the inter&iew )wo words EE. What else?

5.

9nderstand the 0atient7s 0erspecti&e Explore contextual factors (e.g., family, culture, gender, age, socioeconomic status, spiritually)

'. Share Information Use language the patient can understand Check for understanding Encourage questions

=. @each "reement on 0roblems and 0lan F. 0ro&ide Closure s! whether the patient has other issues or concern Summari+e and affirm a"reement with the plan of action *iscuss follow up

The Impact of Poor Communication 0oor communication/ G decreases confidence and trust in medical careH G deters the patient from re&ealin" important informationH G causes si"nificant patient distressH G leads to the patient not see!in" further careH G leads to misunderstandin"sH G leads to the misinterpretation of medical ad&iceH G underlies most patient complaintsH and G predicts ne"li"ence claims.

Doctor-related Obstacles G inadequatel$ trained in communication s!illsH G lac!in" in sensiti&it$ or empath$H

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G unwillin" to reco"nise patient autonom$H G unaware of problems arisin" from differences in lan"ua"e and cultureH G affected b$ time pressuresH or distracted b$ e,ternal or personal factors. Patient-related obstacles )he patient ma$ be/ G affected b$ the condition, illness or medicationH G an,ious, embarrassed or in denial about the medical conditionH G ine,perienced in identif$in" and describin" s$mptomsH G intimidated b$ health care settin"sH G o&erawed b$ the doctor7s percei&ed statusH G disad&anta"ed b$ differences in lan"ua"e and cultureH G confused b$ the use of medical jar"onH G reluctant to as! questionsH or G concerned about time pressures In this scenario, the doctor didn7t appl$ medical communication in our life.#edical communication ha&e doctor obstacle.)he doctor didn7t ha&e empath$,and if $ou didn7t ha&e empath$,$ou couldn7t appl$ medical communication.

Empathy which literall$ translates as Iin feelin"I, is the capabilit$ to share and understand anotherIs emotions and feelin"s. It is often characteri+ed as the abilit$ to Jput oneself into anotherIs shoesJ.

#edical 0rofessional #edicine is the art and science of healin". It encompasses a ran"e of health care practices e&ol&ed to maintain and restore health b$ the pre&ention and treatment of illness. professional is a member of a &ocation founded upon specialised educational trainin". )he word professional traditionall$ means a person who has obtained a de"ree in a professional field. )he term professional is used more "enerall$ to denote a white collar wor!in" person, or a person who performs commerciall$ in a field t$picall$ reser&ed for hobb$ists or amateurs. So, medical professinal is a member of a &ocation upon specialised art and science of healin" trainin". s a medical professional #ust fullfil 4 criteria/ %. >nowled"e 3. S!ills 4. ttitude

*octor7s professional attitude %. 6arm

3. ?mpath$ 4. Benuine In this scenario,doctor didn7t ha&e professional as a doctor.*octor professional want help person especiall$ patient emer"enc$

@elation doctor and patient )he doctorCpatient relationship is central to the practice of medicine and is essential for the deli&er$ of hi"hCqualit$ health care in the dia"nosis and treatment of disease. )here is ri"ht and obli"ation as a patient @i"ht *eclaration of Aisbon on the ri"ht of the patient (6# C%KK%)/ C C C C @i"ht to choose the doctor @i"ht to healthcare @i"ht to recei&e L reject treatment after information @i"ht to confidencialit$

0atient7s <bli"ation %. Bi&e a full and honest information about hisLher health problem 3. <be$ the doctor7s ad&ice, warnin", and "uidance. 4. <be$ the rules in health ser&ices. 5. 0a$ the medical professional for the ser&ices.

*octor7s ri"ht %. *octor ha&e a ri"ht to "et law protection as lon" as heLshe do the job based on professional standard and operational procedures standard. 3. @i"ht to "et full and honest information from the patientLfamil$. 4. @i"ht to recei&e pa$ment

*octor7s <bli"ation %. Bi&e medical ser&ices based on professional standard, operational procedure standar, and patients7 medical need. 3. @efer patient if doctor do not able to do some e,amination or treatment. 4. )o !eep patients secret as a secret, e&en when the$ alread$ passed awa$ *octor, and patient didn7t aware about ri"ht and obli"ation.So,result medical dispute.

Basic principle of bioethic #oral basic norms %. beha&in" well (beneficence)

6

Beneral beneficence/ Secure and maintain other ri"hts 0re&ent the loss happenin" to others ?liminate the conditions causin" loss to others

Specific beneficence/ -elpin" the disabled person Securin" people from dan"erous situation

0atient7s interests first CAoo!in" at patientL patient7s famil$L thin"s not onl$ to ma!e benefit for the doctorL hospitalL other part$ C #a,imi+in" the "ood impact (includin" the number of it is "reater that the bad impact) C )o "uarantee the main &alue / what e&er e,ists, it ur"es us to beha&e well to them (moreo&er there7s a li&in")

3. 2ot ma!in" disad&anta"e (non maleficenceL primum non nocere) Complementar$ side of beneficence from patient7s point of &iew, such as/ #ust not beha&e e&il or do harm to patient #inimi+in" the bad impact

*octor must appl$ beneficence and non malificence in communit$.Ai!e article D that e&er$ doctor must ta!e care their patient

irtue theory is an approach to ethics which emphasi+es the character of the moral a"ent, rather than rules or consequences, as the !e$ element of ethical thin!in" 1i&e focus who formulate b$ (euchamp/ a. Compassion b. *iscerment

c. )ruthwortiness d. Inte"rit$ e. Conscientousness

)he doctor didn7t appl$ &irtue ethic,and didn7t moti&ation to help patient.

Medical Dispute 1actors medical dispute *issatisfaction to the outcome %. Condition of the diseases 3. d&erse effects ;
7

.ariation of biolo"ic process 4. #issed conduct 5. Intentional

#ana"ement of medical alle"ation Common Court Ci&il Court/ #iss Conduct Compensation Criminal court/ (rea!in" specific 990> re"ulation #iss conduct brea!in" >9-0 Intentuional criminal action

0atient should inform this case with #>?> who ha&e obli"ation to !now about this case,and process this case. nd then if #>?> jud"e that the doctor is wron",#>?> will "i&e this case at I*I.I*I will call doctor.and finished in the court. )hen,published in news paper if doctor pro&en wron". 0re&entition of medical dispute *iscipline care -onorable care 9nderstandin" the d$namics of the dispute on"oin" pre&enti&e action. (uildin" up conduci&e deoctor patient relationship/ attenti&e empathic care throu"h better communication s!ill. -onest and responsible. dmittin" the wron" doin".

)he patient should followed this procedures for "i&e inform

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