Legal aspect VS Cultural aspect

      Why legal aspect? Talking about legal aspect, it always reminds me of laws or rules, codes, acts and so on. Almost every block system that we had went through, we were taught about some relevant hukum or undang-undang. It seems that doctor has to be responsible not only for the God, the patients, himself but also law. To practice medicine so called the noblest science by Hypocrates , it is a human beings’ life that doctor deals with. A doctor’s job can be life-saving but a doctor’s mistake can make people becoming handicapped or worse, losing their life. Thus, there is a must a set of laws or regulations to be implemented in medicine.

      In Indonesia, regulations of medical practice refer to the Acts of Medical Practice (Acts Number 9/2004 of National Acts). Dr hendro had pointed out that the aims of these regulations are to give law protection the patients against malpractice, to increase the quality of medical services and to assure people and medical practitioners to have law certainty. Besides, there are two independent institutions have been established to ensure the practice of the Acts of Medical Practice. They are Indonesian Medical Council (KKI) and Indonesian Medicine Discipline Honorary Assembly (MKDKI). These two institutions have almost the same objectives with the aims I had mentioned previously.

      So now, law and regulations have been made to protect the patients. It is common sense that a doctor who maintains his or her competence will be far less likely to cause harm. Those who truly cares for and maintain a good rapport with their patient is unlikely to be sued.  However, sometimes, a malpractice lawsuit is filed because we have an angry patient. What had went wrong?  “Believing doctor’s skill and seriousness, patients and their relatives will receive with pleasure whatever results of the medical treatment already made.” How to achieve this? This is where cultural aspect might play a role in medicine.

      A doctor should not just focus on biological aspect but also psycho-socio-cultural aspects to carry out  a holistic approach. The meeting between doctor and patient can be very different in views of reality. There are three important aspects where we can relate socio-cultural approach to medicine. First, the cultural communication is pivotal. The communication process after “bad things” happened can be not lege artis which is not accurate, not clear, or not comprehensive. If the doctor is capable of communicate in a way that is culturally accepted, patients or their relatives can understand and feel better.



" Bio - Psycho - Socio- Cultural Approach"

        Second, what cultural meaning of health and illness the community or lay people perceive. Knowing the people’s belief, knowledge, morals, and how they organize their life, doctor can encourage prevention and health promotion to the community. Third, doctors not only play the role as data users but also data producer. The patients’ narrative, patients’ perception on vulnerability, severity, seriousness, outcome of illness are examples of data not to be missed. The patients’ perception of disease may be varied in relation with socio-cultural issues among the individuals.

      The essence of medical practice is relationship between doctor and patient. If a doctor carries out their duty ethically, with professional responsibility, and up to the medical standard, no one shall be blamed or harmed in this doctor- patient relationship. Besides, nowadays, the patients’ awareness of being legal protection against malpractice has been increasing. Therefore, doctors should understand the legal aspect of medical practice and bear in mind that always do no harm.

References :
Lecture notes by
1) Dr. Hendro Widagdo, Sp. F            : Legal Aspect in Medicine
2) Dra. Retno Siwi Padmawati, MA    : Cultural aspect in Medicine