JP\/4\/yearend<\/p>\n
The Jakarta Post
\nJakarta<\/p>\n
The joy of having a second child proved to be short-lived for
\nHasan Kesuma, 33, a self-employed resident of Bogor, West Java.<\/p>\n
Just days after giving birth to their second child, his wife
\nAgian Isna Naili, 33, slipped into a persistent vegetative state
\nin July and has been on life support equipment for the past five
\nmonths at the Cipto Mangunkusumo Hospital in Central Jakarta.<\/p>\n
Agian delivered her second baby at the Islamic Hospital in
\nBogor without incident and later moved to the Yuliana Maternity
\nHospital for the convenience. Soon after she was admitted, she
\ndeveloped symptoms of hypertension, prompting family members to
\ntake her back to the Islamic Hospital.<\/p>\n
The next thing family members knew, was that Dr. Gunawan
\nMuhammad, a doctor who assisted during Agian's delivery, had to
\nperform an operation on her.<\/p>\n
What happened during that operation, only Gunawan and his
\nassistants know.<\/p>\n
On the operating table, Agian fell into a deep comma and has
\nnot regained consciousness since.<\/p>\n
Hoping against all odds, Hasan brought Agian to the Cipto
\nMangunkusumo Hospital, but doctors there told him his wife stood
\nlittle chance of surviving the coma.<\/p>\n
Claiming that he could no longer bear the suffering his wife
\nwas going through, Hasan filed a motion with the Central Jakarta
\nDistrict Court in October seeking to euthanize Agian. The court
\nrejected the petition for administrative reasons.<\/p>\n
Meanwhile, Gunawan has consistently maintained a silence over
\nwhat happened in the theater.<\/p>\n
Agian's case has renewed the debate about how claims of
\nmalpractice by doctors should be dealt with in the country, an
\nissue that has grown in prominence during recent years as
\npatients and their families demand higher standards from medical
\nprofessionals.<\/p>\n
Indonesian Health Consumers Empowerment Foundation chairman
\nMarius Widjajarta says the foundation has received about 30
\nreports of alleged malpractice from January to August this year.<\/p>\n
"In 2003, there were only some 20 reports for the whole year.
\nMost of the reports pointed their fingers at doctors," he told
\nThe Jakarta Post.<\/p>\n
The Legal Aid for Health institute, meanwhile, says it has
\nreceived 182 reports of malpractice allegations since 2002, or an
\naverage of about 60 cases a year.<\/p>\n
Chairman Iskandar Sitorus says the actual extent of
\nmalpractice by doctors in this the country is likely to be much
\nhigher than reported as most Indonesians either have little
\nknowledge about malpractice, choose not to contest cases or
\ndecide to settle them out of court.<\/p>\n
Malpractice, according to Marius, mostly takes place because
\nof negligence, carelessness and the incompetence of doctors. In
\nsome cases, though, doctors deliberately violate standard
\noperating procedures.<\/p>\n
Malpractice was also caused by a lack of laws regulating the
\nperformance of doctors in hospitals, he said.<\/p>\n
"Doctors can do almost anything they like, as there are no
\nstandards about what is wrong and what is right," Marius told the
\nPost.<\/p>\n
He stressed Indonesia still had no clear legal definitions of
\nmalpractice. "Patients may claim that they have experienced
\nmalpractice, while doctors can easily claim what they did was not
\nmalpractice at all."<\/p>\n
The long-awaited law on the medical sector that was endorsed
\nby the House of Representatives in September, has no specific
\nprovisions about the punishments for perpetrators of malpractice.<\/p>\n
However, patients disappointed with or disadvantaged by the
\nservice provided by doctors or other medical professionals can
\nnow file lawsuits against them through the courts.<\/p>\n
Doctors and dentists can lose their jobs or face stiff fines
\nand even prison terms if they are found to have violated their
\nprofession's code of ethics.<\/p>\n
The law also says doctors or dentists who provide medical
\nservices without valid licenses, or fake licenses, face prison
\nterm of up to five years and fines of up to Rp 100 million
\n(US$10,869). The same penalties could be handed down to foreign
\ndoctors or dentists who provide medical services without
\nregistering themselves with Indonesian authorities.<\/p>\n
Anyone who poses as a doctor or dentist and provides medical
\nservices faces a maximum prison term of up to five years and a
\nfine of up to Rp 150 million.<\/p>\n
However, Marius said the penalties did not protect patients
\nfrom malpractice as the law only spells out administrative
\nsanctions.<\/p>\n
"The law is useless as it does not mention anything about
\nmalpractice and its legal consequences. It will protect doctors
\nmore than the public," he said.<\/p>\n
"Patients here should be more pro-active. They have to learn
\nto educate themselves and be more critical," Marius said.<\/p>\n
Pulmonologist Tjandra Yoga Aditama told the Post the education
\nof doctors here would impact on how they treated their patients
\nlater.<\/p>\n
"Hospitals and nurses here are used to serving doctors, not
\npatients. Doctors become gods who control other people's lives,"
\nsaid the practitioner who is also a member to the Indonesian
\nHospitals Union (Persi).<\/p>\n
"The curriculum must be changed soon -- the students should
\nbecome interns in hospitals much earlier to make them more
\nfamiliar with the real world. They should do this in their third
\nyear," said Tjandra. In the current system, students do not enter
\nhospital as interns until their fourth year.<\/p>\n
He said, a module teaching doctors about how to empathise with
\ntheir patients had also been introduced in several important
\nmedical faculties recently, including at the University of
\nIndonesia (UI).<\/p>\n
"Doctors here need to listen more to their patients. They are
\nnot robots and patients are human beings as well," said Tjandra,
\nwho is a lecturer at UI.<\/p>",
"url": "https:\/\/jawawa.id\/newsitem\/jp4yearend-1447899208",
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"sponsor": "Okusi Associates",
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