Wed, 22 Jan 2003

Bill gives more protection to doctors than patients

The Jakarta Post, Jakarta

In the case of malpractice, many people opt not to file a lawsuit, fearing that law enforcers would demand that an autopsy be performed on the bodies of their loved ones.

They instead chose to remain quiet or seek a peaceful settlement.

Some cases have, however, made it to court, but nearly all of them ended with disappointment for the plaintiffs as the majority of verdicts were in favor of the doctors.

Most of the verdicts claimed that the cases were accidents or that the doctors did the right thing.

Nothing is likely to change as the House of Representatives is working on a bill on the medical practice that apparently favors doctors.

The bill was drafted by the Indonesian Doctors Association (IDI), which handed it over to House Commission VII for health and people's welfare.

The commission processed the bill to become the House's initiative bill and submitted it to the House in late 2001 for deliberation together with the government.

The bill pays scant attention to the issues of malpractice and instead devotes most of its 182 articles to the establishment of a special court to settle disputes between physicians or health organizations and their clients.

A total of 119 articles -- out of 182 articles -- discuss the establishment of a medical profession disciplinary court, who may become the judges and how to file a lawsuit with the court.

In contrast, only two of the bill's articles are related to crime: articles 172 and 173. Even so, the two articles fail to mention malpractice but are related to doctors' licenses and certification.

Marius Widjajanto, chairman of the Indonesian Health Consumers Organization, said that the new bill only confirmed the strong position of doctors against people who sought justice over possible malpractice.

"The objective of drafting the law was aimed at strengthening the position of those involved in medical services, while patients positions are weakened," Marius told The Jakarta Post on Tuesday.

The deputy chairman of House Commission VII for people's welfare, Ahmad Sanoesi Tambunan, dispelled the concerns, saying that the main objective of the bill was to give a legal basis for the establishment of the medical council and the special court.

"Both institutions, which will be established after the bill is passed into law, will address all complaints about health services and resolve disputes between doctors and their patients," he said.

Another member of IDI, Sanoesi, said it was important that people did not misconstrue the bill, but support the deliberation of the bill to give stronger legal grounds for the public to get better health services.

"We submitted the bill in late 2001. And we have contacted a number of officials to discuss the issue, but so far we have got no positive response," complained Sanoesi.

A senior IDI official, Merdias Almatsier, also called for the immediate deliberation of the bill.

"We need a medical profession disciplinary court as an umbrella to resolve problems such as malpractice," he said.

Marius, however, disagreed and said the country would be better off not having a medical law rather than having the one submitted to the House.

He suggested the government utilize prevailing Law No. 23/1992 on health to protect the people from possible losses from medical practices.

The government, Marius said, should draw up a number of government regulations (PPs) to address various issues of medical practices, including malpractice and the establishment of a medical council.

According to Marius, the law requires some 30 PPs to make it applicable. However, the government has thus far made only six.

In the absence of clear regulations, the police, prosecutors and judges would find it difficult to send irresponsible doctors to jail due to the strong bond among doctors.

Thus far, he said, the police, prosecutors and judges used articles in the Criminal Code as their reference to try doctors accused of malpractice.

"It is not surprising, therefore, if judges cannot make fair decisions on malpractice cases as there is no clear legal basis that can be used as a reference for their decision on alleged malpractice," said Marius.

Therefore, Marius said that it would be better for the government to drop the deliberation of the bill and concentrate on making more PPs to protect the public from bad medical practices.

Article 172: Anyone intentionally committing medical practice: (a) without a medical registration certificate and license to practice; (b) without a medical nameboard outside their office or practice; (c) not following professional medical standards; (d) promising success for certain medical treatments; (e) not keeping medical records; can be jailed for a maximum of five years and/or fined Rp 150 million.

Article 173: Anyone who (a) employs medical workers without a license to practice or a registration certificate; (b) implements medical science causing heavy ethical impact without the consent of the Medical Council; can be jailed for a maximum of 10 years and/or fined Rp 300 million.