If doctors hurt but not help: It's malpractice

Emmy Fitri, The Jakarta Post, Jakarta

For "Maya", going to the doctor to seek help only leads to more pain.

It started when a surgeon left a catheter near her kidney. She spent the next two and a half years in misery.

Maya fought for her rights and demanded the surgeon fix what was wrong. It was a struggle for her as the management of the hospitable, a reputable one in Jakarta, washed its hands of the matter and said it was all the doctor's responsibility.

Maya is not alone in having to suffer from a professional blunder.

Yet it is not always a case of doctor knows best, and when they do make mistakes, it's still not easy to put matters right for the patient here.

In Maya's case, she received monetary compensation for the harm, which also included the cost of removing the catheter.

But, unlike other parts of the world, awareness of patients' rights remains low in this country. Other people who have suffered from medical malpractice, including relatives of patients killed, decide not to pursue with the case due to the emotional pain involved, or because of the fear of confronting authority.

"We prefer not to bring up our case again because we have suffered enough. It would take time for our complaint to be processed and, if we succeed, any compensation will not bring back the lives of my loved ones," said "Winfrid", a retired Army brigadier general.

Winfrid lost his daughter and grandson when doctors at a luxury hospital in South Jakarta misdiagnosed their condition and prescribed them the wrong medicine.

Still stressed and angered by the loss, his choice of action has been to avoid the hospital. But he is unwilling to take a stand to ensure that others do not suffer from the terrible consequences of professional incompetence.

The chairman of the Indonesian Health Consumer Empowerment Foundation (YPKKI), Marius Widjajarta, said it was better to report or lodge complaints to "competent institutions".

"Now it's you, but later it can happen to others. Why not prevent the same error if we can?," Marius said.

The foundation has handled 147 cases since its founding four years ago. Most of the cases were settled through negotiation with doctors or hospitals where the malpractice took place.

"We only give advocacy, and if the victims want to proceed to court, we will transfer their cases to the University of Indonesia's Legal Aid Foundation (LBH-UI)," he said, adding there was no charge to patients for YPKKI's mediation.

Secretary of the ethical and honorary council of the Indonesian Doctors Association (IDI) Agus Purwadianto said that the council received up to 40 complaints a year.

He said about 20 percent of those were accidents caused by the doctor's negligence, while the majority resulted from miscommunication between doctors and patients.

"We process the complaints and summon the doctors, even those who are not IDI members," he added.

He said that the council could revoke a doctor's license in the most serious violations. However, he said that only one doctor, former Bandung-based physician Simon Gunawan, had lost his license, after using a nonconventional method for treating the liver disease of the late Adam Malik, a former vice president. And that was in 1985.

Marius said the country's poor regulation of the health sector was among the contributing factors to widespread malpractice.

He pointed out that the government had yet to issue regulations for the elaboration of Health Law No. 23/1992.

He said that several items of legislation were in fact urgently needed to protect the rights of health consumers, such as laws on standardized professions of doctors and paramedics, the rights of patients, occupational health, certain medical treatments for pregnant women and requirements and procedures of plastic surgery and reconstruction.

Due to the absence of health legislation, if there were malpractice cases brought to court, the judges would class them under the Criminal Code, Marius said.

"The verdict will be very light as the cases will be regarded as general crimes," he said.

He also alleged that IDI focused merely on protecting the profession and not upholding patients' rights.

Agus denied the allegation, saying the council stood above the association itself and worked as independently as possible to respond to any public complaints.

Usually after meeting with the council and having their grievances heard, irate patients or their relatives are relieved, Agus said.

He said the public must take a critical perspective and always ask doctors questions if they did not understand their treatment. "It is their right to put questions to the doctors because it is their body and their health that are put at stake."

As a precautionary measure, the public can check the reputation of a hospital before deciding to use its services.

The Indonesian Consumers' Foundation (YLKI, Tel. 7971378, 7981858/59) has collected the public's complaints about hospitals in Jakarta and put them on a rating list.

"The public as consumers can check with us as we can't publicize the data. We welcome any questions if the consumers are seeking our advice for their choices," YLKI's executive Muhammad Ikhsan said.