Health bills differ, and the patient dies?<\/p>\n
Leony Aurora, The Jakarta Post, Jakarta<\/p>\n
Agus Subiantoro was happy that the operation to empty his bladder
\nwent smoothly and painlessly. A few days later, he was surprised
\nto find out there was a tiny tube in his kidney.<\/p>\n
His surgeon told him the tube was needed to dissipate kidney
\nstones and that it would later need to be removed. Agus insisted
\nthat he had never been informed about a second operation, and
\nthat he could not afford it.<\/p>\n
The case, which took place in 2001, ended with a settlement
\nand a free operation for Agus.<\/p>\n
It is usually quite difficult to bring an alleged malpractice
\ncase to court and win. Plaintiffs say that doctors as witnesses
\ntend to protect colleagues while doctors can often overwhelm
\njudges, who have little or no medical background, with the
\ncomplexity of medicine.<\/p>\n
A malpractice trial can drag on for several years before a
\nverdict.<\/p>\n
In a bid to protect and ensure legal certainty for both the
\nprovider and recipient of health services, the House of
\nRepresentatives has proposed a bill on medical services.<\/p>\n
The bill calls for the establishment of a Medical Practitioner
\nDiscipline Court, which would have health and law experts as
\nmembers\/judges, to hear malpractice cases.<\/p>\n
However, other policymakers have a different view regarding
\nlegal settlements of malpractice cases.<\/p>\n
\"Such a court would take a long time to establish,\" Azrul
\nAzwar, Director General of Public Health at the Ministry of
\nHealth, told The Jakarta Post recently.<\/p>\n
Therefore the Cabinet has proposed its own draft that promotes
\na Discipline Committee, which comprises doctors and health law
\nexperts.<\/p>\n
\"This committee will promote mediation, but if the plaintiffs
\nare not satisfied with the ruling, they can proceed to the
\ncourt,\" said Azwar.<\/p>\n
Medical practitioners and observers, however, are pushing for
\na standard for medical services, which specifies required tests
\nor actions for specific diseases. Neither of the drafts stipulate
\nsuch a standard.<\/p>\n
Marius Widjajarta of the Indonesian Health Consumer
\nEmpowerment Foundation (YPKKI) said medical service standards
\nshould be made legally binding through a government regulation in
\nthe implementation of Law No. 23\/1992 on health.<\/p>\n
He said such standards could also protect doctors facing
\nlawsuits, because it would be easier to prove they had done their
\njob properly.<\/p>\n
Azwar denied there was a lack of standards in the profession.<\/p>\n
\"Just use the curriculum under which a doctor is trained,\" he
\nsaid. \"One school may differ slightly from another, but there is
\nno contradiction.<\/p>\n
\"We may have no national standard yet, but I don't see the
\nrush for one,\" he said.<\/p>\n
Taufik Basari, a lawyer from the Jakarta Legal Aid Institute,
\nwho is currently handling a malpractice suit filed by a man who
\nlost his wife to an apparently treatable condition, said the
\nstandards should be formalized by a law.<\/p>\n
\"The society has to have access to it,\" he said.<\/p>\n
He said a disciplinary committee, which would have closed
\ntrials, would keep people from direct involvement.<\/p>\n
Taufik also slammed the lenient punishment and the short
\nperiod available, 30 days, for people to file a lawsuit over
\nmalpractice.<\/p>\n
Sanctions through the disciplinary committee are limited to
\nreprimands and suspension of licenses for a year, while according
\nto the government draft, malpractice would also carry a Rp 25
\nmillion (US$2,906) fine for damages to be paid to a winning
\nplaintiff.<\/p>\n
\"Such sanctions do not protect the integrity of the medical
\nprofession itself,\" Taufik said.<\/p>\n
In his client's case, more than Rp 47 million was spent on his
\nwife's medical bills, but she still died.<\/p>\n
Info-box<\/p>\n
Comparison between drafts of medical law<\/p>\n
House of Representatives draft<\/p>\n
Article 52: The Medical Practitioner Discipline Court falls under
\nthe district court for people seeking justice for malpractice.<\/p>\n
Article 62: Judges include law experts and medical experts.<\/p>\n
Article 136: Sanctions include one-year suspension of practice
\nlicense\/letter of assignment. Material damages can be paid up to
\nRp 25 million.<\/p>\n
Article 93: Complaints are only admissible within two years after
\nmedical treatment has taken place.<\/p>\n
Government draft<\/p>\n
Article 31: A disciplinary commission is an independent
\ninstitution to uphold justice in a case of malpractice.<\/p>\n
Article 39: All trials heard in the disciplinary commission are
\nheld behind closed doors, unless specified otherwise.<\/p>\n
Article 43: Sanctions can be a written reprimand, revocation of
\nlicenses or an obligation to take a special training course.<\/p>\n
Article 32: Lawsuit can only be submitted within 30 days after an
\nalleged malpractice occurs.<\/p>",
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