"Strengthening Legal Frameworks and Patient Safety: A Narrative Review of Medical and Dental Malpractice in Indonesia" by Ghulam Mustafa and Ede Surya Darmawan
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Abstract

Many cases of medical and dental malpractice in Indonesia are still related to patient safety and healthcare quality. This narrative review aims to identify solutions that can be implemented. The main focus is to compare the incidence of malpractice in clinical medical and dental practice, emphasizing legal implications, coverage, and internal organizational issues. A systematic literature search was conducted through databases such as Pubmed, ScienceDirect, Google Scholar, Springer, Garuda, and other online databases. Articles published no later than 2024. Eleven studies were selected that discussed the problem of malpractice in Indonesia. Independent screening and critical appraisal were carried out to minimize bias, and data were retrieved and assessed through narrative synthesis. The results showed limited or lack of informed consent, non-compliance, administrative negligence, poor communication, and laws on medical malpractice. Causal factors, such as negligence in the operating room, misdiagnosis, and lack of consent forms, were common and most often resulted in patient injury or death. This review also explains a lack of studies related to this due to the poorly organized data collection system on complaints of medical malpractice in the country and the lack of adequate legal governance regarding dental malpractice. Regulations related to legal practices in Indonesia are still poorly organized, and even in similar cases, consistent enforcement is not guaranteed. These factors indicate the need for an evaluation of the healthcare system in Indonesia. Suggestions that can be given are to involve the community in the informed consent process, improve medical training, and improve the legal system so that these incidents can be reduced in number and patients feel protected.

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Bahasa Abstract

Banyak kasus malpraktik di bidang medis dan kedokteran gigi di Indonesia yang berhubungan dengan keselamatan pasien dan kualitas perawatan kesehatan. Tinjauan naratif ini bertujuan untuk mengidentifikasi solusi yang dapat diterapkan. Fokus utamanya adalah membandingkan kejadian malpraktik dalam praktik medis dan kedokteran gigi klinis dengan penekanan pada implikasi hukum, cakupan, dan masalah internal organisasi. Pencarian literatur dilakukan secara sistematis melalui berbagai basis data, seperti Pubmed, ScienceDirect, Google Scholar, Springer, Garuda, dan database online lainnya. Artikel yang diterbitkan tidak lebih dari tahun 2024. Sebelas studi dipilih dengan membahas masalah malpraktik di Indonesia. Untuk meminimalkan bias, penyaringan independen dan penilaian kritis dilakukan serta data diambil dan dinilai melalui sintesis naratif. Hasilnya terdapat keterbatasan atau kurangnya persetujuan yang diinformasikan, ketidakpatuhan, kelalaian administratif, komunikasi yang buruk, dan undang-undang tentang malpraktik dalam kedokteran. Faktor penyebab, seperti kelalaian di ruang operasi, diagnosis yang salah, dan kurangnya formulir persetujuan, sering terjadi dan paling sering mengakibatkan cedera bahkan kematian pasien. Tinjauan ini juga menjelaskan bahwa terdapat kekurangan studi terkait ini disebabkan oleh sistem pengumpulan data mengenai keluhan terhadap malpraktik medis yang buruk terorganisir di negara ini serta tidak ada tata kelola hukum yang memadai mengenai malpraktik kedokteran gigi. Peraturan terkait praktik hukum di Indonesia masih terorganisir dengan buruk dan bahkan pada kasus serupa belum tentu dijamin penegakan hukumnya secara konsisten. Faktor-faktor tersebut menunjukkan perlunya evaluasi terhadap sistem layanan kesehatan di Indonesia. Saran yang dapat diberikan, yaitu masyarakat dilibatkan dalam proses persetujuan yang diinformasikan, meningkatkan pelatihan medis, serta memperbaiki sistem hukum agar insiden ini dapat berkurang angka kejadiannya dan pasien merasa dilindungi.

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