Authors:

Liauw Djai Yen, Vionita Simanjuntak, Danadipa Yoga Mahardika, Felicia Cynthiadewi Yantoro, Kezia Adelize Aurelia Junus, Richard Wijaya, Kezia Nathania Limbong Allo, Patricia Michelle Lukito, Anna Sakurai Dananjaya, Yurike Wijaya, James Sugiarto, Danadipa Yoga Mahardika, Alicia Gani

Abstract:

“Background: Balance between autonomy and paternalism in the context of decision making of individuals with schizophrenia is a complicated and ethical problem. Collaboration between healthcare workers, family members, and individuals with schizophrenia is crucial to ensure decision made is for the individual’s best interest whilst upholding their dignity and rights. Methods: This is a literature review study. References used are literature from journal articles, law texts, and other textbooks in Indonesian and English. Results and Discussion: In clinical practice, doctors and patients both have autonomy to make the best decision. In patients with schizophrenia, autonomy conflicts with paternalism due to errors in cognitive function and decision making. Some studies have shown that schizophrenia patients can increase their understanding through information repetition, or by using improved information delivery procedures. Loss of capacity of decision making in patients with schizophrenia is temporary and can recover with time. Conclusion: It is important to find balance between autonomy and paternalism in medical practice. Doctors need to give clear information to patients, discussing benefits, downfalls, and risks from a certain procedure, respecting patient preference. However, doctors also have the responsibility to use their clinical judgement to give the best medical outcomes for patients.”

Keywords

Keyword Not Available

Downloads:

Download data is not yet available.

References

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing.
  • Beauchamp, T. L., & Childress, J. F. (2009). Principles of Biomedical Ethics (7th ed.). Oxford University Press.
  • Dudley, R., Campbell, J., & Perry, J. (2016). Decision-making capacity and undue influence: Curricular priorities for psychiatry. The Canadian Journal of Psychiatry, 61(10), 605-610.
  • Buchanan, A. E., & Brock, D. W. (1990). Deciding for Others: The Ethics of Surrogate Decision Making. Cambridge University Press.
  • Jonsen, A.R., Siegler, M., & Winslade, W.J. (2015). Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine. McGraw-Hill Education. (Buku ini membahas berbagai isu etika dalam kedokteran, termasuk prinsip otonomi)
  • Lynøe N, Engström I, Juth N. How to reveal disguised paternalism: version 2.0. BMC Med Ethics. 2021;22:170.
  • Craciun, Petronela, Vicol, Mihaela Catalina, Turliuc, Serban, Astarastoae, Vasile. Autonomy Versus Paternalism in Non-Voluntary Admissions.  Revista Romana de Bioetica. Isai Vol. 10, Iss. 4, 2012. Available from: https://www.proquest.com/openview/0df94b1d3b28bd3a144ed454439bfeb2/1?pq-origsite=gscholar&cbl=1536336. Accessed 16 June 2023.
  • Perhimpunan Dokter Spesialis Kedokteran Jiwa. (2012). Pedoman Nasional Pelayanan Kedokteran (PNPK) Jiwa/Psikiatri.
  • Perhimpunan Dokter Spesialis Kedokteran Jiwa. (2011). Konsensus Penatalaksanaan Gangguan Skizofrenia.
  • Kementerian Kesehatan RI. (2018). Hasil Utama RISKESDAS 2018.
  • Hany M, Rehman B, Azhar Y, et al. Schizophrenia. [Updated 2023 Mar 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539864/
  • Pemerintah Pusat RI. UU No. 29 Tahun 2004 tentang Praktik Kedokteran [JDIH BPK RI] [Internet]. [cited 2023 Jun 18]. Available from: https://peraturan.bpk.go.id/Home/Details/40752/uu-no-29-tahun-2004
  • Kementerian Kesehatan Republik Indonesia. Permenkes RI Nomor 290/Menkes/PER/III/2008 tentang Persetujuan Tindakan Kedokteran [Internet]. Available from: https://rskgm.ui.ac.id/wp-content/uploads/2021/03/219.-pmk2902008.pdf
  • Agud HN, Padala PR. The effect of psychotic symptoms on decision-making capacity and its assessment in a patient with schizoaffective disorder. The Primary Care Companion For CNS Disorders. 2023;25(1). doi:10.4088/pcc.22cr03319
  • Pons EV, Salvador‐Carulla L, Calcedo‐Barba A, Paz S, Messer T, Pacciardi B, et al. The capacity of schizophrenia and bipolar disorder individuals to make autonomous decisions about pharmacological treatments for their illness in real life: A scoping review. Health Science Reports. 2020;3(3). doi:10.1002/hsr2.179
  • Hostiuc S, Rusu MC, Negoi I, Drima E. Testing decision-making competency of schizophrenia participants in clinical trials. A meta-analysis and meta-regression. BMC Psychiatry [Internet]. 2018 Jan 5 [cited 2023 Jun 15];18:2. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756338/
  • Sugawara N, Yasui-Furukori N, Sumiyoshi T. Competence to Consent and Its Relationship With Cognitive Function in Patients With Schizophrenia. Front Psychiatry [Internet]. 2019 Apr 12 [cited 2023 Jun 15];10:195. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6474312/
  • Calcedo-Barba A, Fructuoso A, Martinez-Raga J, Paz S, Sánchez de Carmona M, Vicens E. A meta-review of literature reviews assessing the capacity of patients with severe mental disorders to make decisions about their healthcare. BMC Psychiatry. 2020;20(1). doi:10.1186/s12888-020-02756-0

PDF:

https://jurnal.harianregional.com/ijlfs/full-103243

Published

2024-01-05

How To Cite

YEN, Liauw Djai et al. Otonomi VS Paternalisme: Pengambilan Keputusan Medis pada Pasien dengan Skizofrenia.Indonesian Journal of Legal and Forensic Sciences (IJLFS), [S.l.], v. 13, n. 2, p. 78 - 87, jan. 2024. ISSN 2657-0815. Available at: https://jurnal.harianregional.com/ijlfs/id-103243. Date accessed: 08 Jul. 2024. doi:https://doi.org/10.24843/IJLFS.2023.v13.i02.p02.

Citation Format

ABNT, APA, BibTeX, CBE, EndNote - EndNote format (Macintosh & Windows), MLA, ProCite - RIS format (Macintosh & Windows), RefWorks, Reference Manager - RIS format (Windows only), Turabian

Issue

Vol 13 No 2 (2023): Indonesian Journal of Legal and Forensic Sciences

Section

Articles

Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License