Professional Documents
Culture Documents
Patient
Decision
Mr.
A., 65 years old, wants to have a
healthy limb amputated
“I
am not happy with my present body, but
long for a peg-leg.”
Two Questions
Two questions:
Would
it be wrong for a surgeon to perform
the amputation?
Informed consent is a
process, not just a
signed document.
The Idea of Informed Consent
Informed
consent adalah suatu proses yang
menunjukkan komunikasi yang efektif antara
dokter dengan pasien, dan bertemunya
pemikiran tentang apa yang akan dan apa
yang tidak akan dilakukan terhadap pasien.
Suatu
izin (consent) atau pernyataan setuju
dari pasien yang diberikan dengan bebas
dan rasional,sesudah mendapat informasi
dari dokter dan yang sudah dimengertinya
Syarat PTM
THRESHOLD ELEMENT
1. Competence
INFORMATION ELEMENTS
1. Disclosure of information
2. Understanding of information
CONSENT ELEMENTS
1. Voluntariness
2. Authorization
Syarat PTM
Competence:
Kapasitas membuat keputusan
Lebih ke arah syarat dapat memberikan
consent daripada sekedar elemen
Pasal 13 permenkes no 290/menkes/per/III/
2008
Dewasa, >21 tahun
Sadar
AGE OF CONSENT
Diatas 18 tahun
full competence atau sudah menikah
12-17 tahun
proxy consent dan assent dari pasien
Dibawah 12 tahun
non competence
Syarat PTM
Disclosure:
Adekuat atau tidaknya ditentukan:
Tradisi praktek profesional
Kebutuhan informasi pada individu pasien
tersebut
Kebutuhan informasi bagi reasonable
person
Understanding.
The patient needs to recall
conversations about treatment, to make the
link between causal relationships, and to
process probabilities for outcomes. Problems
with memory, attention span, and intelligence
can affect one’s understanding.
Capacity components
Appreciation. The patient should be able to identify the
illness, treatment options, and likely outcomes as things that
will affect him or her directly. A lack of appreciation usually
stems from a denial based on intelligence (lack of a
capability to understand) or emotion, or a delusion that the
patient is not affected by this situation the same way and
will have a different outcome.
Moral
Legal
Moral Reason #1: The
Importance of Consent
Capable patients are, by definition, able
to give informed consent to treatment
The
importance of informed consent is
supported both by