Doctor's testimony needed to explain Sukarno's death<\/p>\n
By R. Diah Imaningrum<\/p>\n
MALANG, East Java (JP): The cause of Sukarno's death has
\nsuddenly become an issue of heated public debate and suspicion
\nafter one of his widows, Ratnasari Dewi, alleged that the
\ncountry's first president was murdered.<\/p>\n
Mahar Mardjono of the University of Indonesia -- a member of
\nthe medical team which treated Sukarno during his final illness
\nin the late 1960s -- subsequently denied the accusation. He
\naverred from describing Sukarno's ailment in detail due to his
\nrespect of doctor-patient confidentiality in the Indonesian
\nMedical Code of Ethics.<\/p>\n
This is not enough to satisfy the people's wish to know the
\ntruth about Indonesian history, especially concerning the
\nproclaimer of national independence.<\/p>\n
If the case goes to court, the most important testimony will
\nbe from a witness who is still alive: Sukarno's physician.<\/p>\n
Intrinsically, this presents a dilemma because the nature of
\nthe relationship between a doctor and his patient is
\nconfidential, a principle which the doctor is ethically bound to
\nuphold.<\/p>\n
Article 11 of the Indonesian Medical Code of Ethics states: \"A
\ndoctor shall preserve the secrecy of all he knows about his
\npatient even after the patient has died, due to the confidence
\nentrusted to him.\"<\/p>\n
It is described further in Government Regulation No. 10\/1966
\non obligations to keep medical confidentiality. \"Healthcare
\nservice providers, including students at a school of medicine,
\nhave an obligation to keep all of what they know about their
\npatients secret, as long as they work in the medical field,
\nexcept in instances where there is another law of the same or
\nhigher degree that determines otherwise.\"<\/p>\n
Up to now, there is no law superseding Government Regulation
\nNo. 10\/1966. Even Article 322 of the Criminal Code states that
\npeople obliged to keep issues secret due to their profession can
\nbe condemned if they make sensitive disclosures. Article 53 of
\nChapter 2 of Law No. 23\/1992 on health also ensures the patient's
\nright to medical confidentiality.<\/p>\n
Thus, the obligation is binding both ethically and legally for
\ndoctors in their treatment of patients.<\/p>\n
The problem is whether the obligation can be eschewed for the
\nsake of a greater interest, such as a judicial process.<\/p>\n
Ethical systems in the professional world can be either duty-
\noriented or consequence-oriented. The duty-oriented ethical
\nsystem -- or deontological, derived from the Greek deon (duty)
\nand logos (discourse) -- requires professionals to focus their
\nreasons for actions on duty.<\/p>\n
The consequence-oriented ethical system -- or teleological --
\nrequires professionals to consider the outcomes or consequences
\nof their actions. If the consequences of an obligation, for
\nexample, will harm another person, then the obligation can be
\ndisregarded.<\/p>\n
A landmark example of ethical systems on medical secrecy was
\nthe case of Prosenjiit Poddar.<\/p>\n
In August 1969, Poddar, a young voluntary outpatient being
\ntreated at the University of California in Berkeley, informed his
\npsychologist that he was going to kill a young woman. From
\nworking with the young man, the psychologist knew the woman's
\nidentity.<\/p>\n
After consulting with his superior and a psychiatrist, the
\npsychologist asked the campus police to detain Poddar at a mental
\nhospital for observation. The police put Poddar into custody but
\nsoon released him when he appeared normal. The psychologist's
\nsuperior then withdrew and destroyed all written letters and
\nnotes, and ordered no further action on Poddar. No one warned the
\nwoman, although she was expected to return to Berkeley soon.<\/p>\n
Shortly afterward, Poddar persuaded the woman's brother to
\nshare an apartment with him, near where she lived with his
\nparents. Poddar subsequently visited the woman and killed her.<\/p>\n
When the woman's parents learned that the psychologist, two
\nconsultants and the police had known of Poddar's threat, they
\nsued them. They charged that all three parties were criminally
\nnegligent in permitting the release of Poddar from custody
\nwithout notifying them or their daughter of the danger she was
\nin.<\/p>\n
The case presents a conflict of interest between an obligation
\nto keep patient confidentiality and the responsibility to prevent
\npotential harm to someone. In other words, there is a conflict
\nbetween duty-oriented and consequence-oriented ethical systems.
\nThe majority of judges would have a tendency to choose the second
\nas more important.<\/p>\n
Which system is followed by Indonesian laws? Government
\nRegulation No. 10\/1966, Article 322 of the Criminal Code and Law
\nNo. 23\/1992 indicate that Indonesian law tends to adhere to the
\nduty-oriented ethical system.<\/p>\n
If the cause of Sukarno's death were tried in a court of law,
\nit would be the first legal case concerning medical
\nconfidentiality in the country.<\/p>\n
Producing evidence is always difficult if a case involves
\nprofessional secrecy. Can the secrecy be sacrificed for the
\ngreater interest? What reasons must be considered to determine
\nthe greater interest?<\/p>\n
In a court of law, the judge, according to Law No. 14\/1970,
\nwill have the authority to determine the values of life existing
\nin the society. If there is no law or rule that regulates a case
\nor if the law is incomplete, the judge cannot summarily reject
\nthe case, but will be tested to find a pertinent legal precedent.<\/p>\n
Conversely, the House of Representatives, as a lawmaking
\ninstitution, has to analyze and consider the legal precedent used
\nby the judge in order to institute a relevant legal product.<\/p>\n
There will be dialectics between the law-finding process and
\nlaw-making. As long as judges only focus on legislation as a
\nfoundation to handle a case, then the process to determine a
\nrelevant legal precedent will be less progressive.<\/p>\n
The writer is a lecturer in the School of Law at Widya Karya
\nCatholic University in Malang, East Java.<\/p>",
"url": "https:\/\/jawawa.id\/newsitem\/doctors-testimony-needed-to-explain-sukarnos-death-1447893297",
"image": ""
},
"sponsor": "Okusi Associates",
"sponsor_url": "https:\/\/okusiassociates.com"
}