ETHICAL GUIDELINES

IN MEDICAL PROFESSION
BY
EMPU DRIYANTO, MD, ENT SPECIALIST

INTRODUCTION

Ethics = ethikos (Greek)

Moral duty
What is good and bad
Moral duty and obligation
To protect the rights of human
being

DEFINITION
The study of general nature of
morals and the specific moral
choices to be made by the
individuals in the relationship with
others.
Referring to a profession
The rules, standards or code of
governing the conduct of the
members of the profession.

CRITICISMS
The ethics of professional conduct
is being questioned.
Many medical doctors are criticized

FACTORS INFLUENCING
CRITICIMS
Education
Increased awareness:
The right to health care
Greater participation in planning care

Different perception

VIOLATION TO PROFESSIONAL
ETHICS
May arise in all types of health
services organization
May subject to disciplinary action
Doctors should have a better
knowledge and understanding in
all regulations and guidelines

INTERNATIONAL MEDICAL CODE OF ETHICS

(IMCE)

Used as main reference

Formulated in the 3rd Congress of World
Medical Association (WMA) in 1949 in
London
Revised several times
The last revision in 1968 in the 22nd
Congress of WMA in Sydney.

SOME DECLARATIONS RELATED WITH MEDICAL ETHICS

ISSUED BY WMA:

Helsinki Declaration of 1964

Medical Research involving human subject.
Sydney Declaration of 1968 and Venice Declaration of 1983
Criteria of death and terminal illness which is associated with organ
transplantation
Oslo Declaration of 1970
Pregnancy abortion
Munich Declaration of 1973
Application of administration technology
Tokyo Declaration of 1975
The use of restricted drug
Brussel Declaration of 1985
Assisted reproduction
Madrid Declaration of 1987
Eutanasia and genetic engineering

INDONESIAN MEDICAL CODE OF ETHICS

First time set in 1969 in a medical congress in Jakarta

Formulated based on the 1968 revised-IMCE

Underwent revisions several times

The last revision in 1983

Consists of 20 articles:
a.5 articles, regarding general obligations of medical
doctors.
b.9 articles, regarding medical doctors obligation to the
patients
c.2 articles, regarding medical doctors obligation to
themselves
d.1 article, regarding the closing

GUIDELINES OF ETHICS IN
MEDICAL PROFESSION

GUIDELINE I

The main purpose of medical profession

Giving humanity service
Highest respect for the human dignity
MD should hold high the trust of the patient
put on them
Examples:
The patients must be treated in a human manner
All patients must be treated alike.
Patients complaint must be observed

GUIDELINE II:
MD should:
Makes every effort to improve knowledge
and skills
Makes the best use of their professional
capability for the patients and their
colleagues.
The knowledge and skill required:
General knowledge and skill in controlling
various diseases.
Knowledge and skill of emergency
medicine
They should follow continuing medical
education

GUIDELINE III:
MD:
Should practice scientifically proved-method of medication
Is prohibited to cooperate with other parties which are not
based on these principles.
When giving medication, the followings should be observed:
Medicine administration must be based on indication
The potentiation and antagonistic effect of drugs must be
taken into account when administered in combination
Drugs given to the pregnant women must be carefully
taken into consideration
Treatment which is not in line with the medical science is
prohibited

GUIDELINE IV:
MD:
Should protect the community and its own profession from
inappropriate moral conduct and professional capability.
Should not only respect and obey the prevailing laws and
regulations but also hold the medical profession in high
esteem.
Should possess the courage without hesitation to disclose
the illegal or unethical actions of their colleagues.

Examples:
The examination of patient with the
opposite sex
Refraining from doing immoral conduct:
a. Committing adultery
b. Terminating pregnancy
c. Giving narcotics without medical
indication
d. Serving alcoholic beverage and the
like in the private office

GUIDELINE V:
MD:
May choose or determine the patients
In emergency situation, should be able to
provide the best services.
When accepts a patient, he/she should treat
the patient as best he/she can until hospital
discharge.

MD must not attract patients by any means.

MD:
Is prohibited to advertise their practice
May use name board (bill board) in private office with
certain size.
Is prohibited:
a. To use decoration and illumination like in advertisement.
b. To give additional information like:
General practice, also for children and pregnant
women
General practice, for children and adult
General practice and ciscumcision

GUIDELINE VI:
MD:
Must not practice medicine in a situation:
a. which may interfere with their freedom to
perform medical assessment and to
choose medical treatment
b. which may decrease the quality of their
medical services.

Example:
MD is prohibited to always write a certain
prescription on the request of drug manufacturer
without considering the indication and price of the
drug.

GUIDELINE VII:
MD:
Must limit their professional earnings to the
services they have already provided.
Must receive only fee in line with:
a. The services provided
b. The Financial capability of the patients
Is prohibited to receive any fee or tips from
patients referral.
Give drugs, supplies and the like for the patients
benefit

GUIDELINE VIII:
When facing a difficult case or considering that the
quality of services may be improved through
consultation, MD should hold a consultation.

GUIDELINE IX:
MD are prohibited:
to reveal the patients confidentiality
to disclose the patients limitation

GUIDELINE X:
MD:
Should account for their services:
a. to individual patients
b. to the community

Should take part actively in the

activities that are intended to
improve the health and welfare of
individual and community

CONCLUSION
Ethics are important in health delivery
system
Ethical issues may arise in all types of
health service organization
In medical profession, ethics provide
professional standard for medical
activities.
The standards protect both the medical
doctor and the patient