Criterion 1.2.5 ethical dilemma

Criterion 1.2.5

The provision of UKM and UKP services is carried out with ethical considerations in making service decisions.

1) Main Thoughts:

a) Community Health Centers face many challenges in providing safe and quality health services. Advances in the field of medical technology, limited resources, and ever-increasing patient expectations in line with increasing public education as well as ethical dilemmas and frequent controversies have become things that Community Health Centers can face.

b) Likewise, if decisions regarding services raise questions, conflicts, or dilemmas for the Puskesmas and patients, families or decision makers, and others. This dilemma can arise from issues of access, ethics, patient treatment or discharge, and so on.

c) The leadership of the Community Health Center determines management methods and finds solutions to the dilemma. The health center identifies who needs to be involved in the process and how patients and their families participate in resolving ethical dilemmas.

d) Ethics is a norm or value regarding the inner attitudes and behavior of humans. Therefore, it is still abstract, not yet written. If it is written, it is called a code of ethics.

e) An ethical dilemma is a situation faced by someone that requires a decision to be made regarding appropriate behavior. For example, someone is not willing to be immunized for reasons of belief, someone is not willing to give birth in a health service facility (fasyankes) for reasons of belief, consideration of whether or not to charge for treatment costs to patients who cannot afford it, the bill for treatment costs is considered greater by the patient, not carry out pregnancy/postpartum examinations for reasons of local beliefs/culture.

f) If necessary, the head of the Community Health Center can form and determine an ethics team with membership consisting of representatives of UKM services, UKP services, quality and management administration.

g) Support from the head and/or staff of the Community Health Center in resolving the ethical dilemma that occurs can take the form of advocacy to community/religious leaders, coaching, coordinating with district/city regional health services and other related parties as well as other forms of support.

2) Assessment Elements:

a) The Community Health Center has reporting and resolution procedures if an ethical dilemma occurs in UKP services and UKM (R) services.

b) Reporting is carried out if an ethical dilemma occurs in UKP services and UKM services (D,W).

c) There is evidence that the leadership and/or staff of the Community Health Center supports the resolution of ethical dilemmas in UKP services and UKM services and has been implemented in accordance with regulations (D,W).