Pertimbangan Etika Klinik dan Medikolegal untuk Pengelolaan Anestesi pada Kasus Cedera Otak Traumatik

Taufik Suryadi Ismail, Kulsum Kulsum

Abstract


Cedera Otak Traumatik (COT) merupakan penyebab utama kematian dan kesakitan pada anak-anak dan dewasa muda di seluruh dunia. Dilaporkan sebuah kasus COT pada seorang pasien anak laki-laki berusia 5 tahun yang jatuh dari lantai 2. Pasien didiagnosis dengan cedera kepala berat dengan perdarahan epidural dan subdural dengan level ASA 3–4. Dilema etis yang dihadapi ahli anestesi adalah tindakan anestesi berisiko tinggi tetapi kemungkinan penyelamatan nyawa tidak berhasil, sehingga apakah masih tetap dilakukan operasi atau hanya diberikan terapi suportif?. Laporan ini membahas tentang pemecahan dilema etik dan medikolegal berdasarkan teori etika klinik. Hasil pertimbangan etika dan medikolegal pada kasus ini dilakukan secara komprehensif dengan menghasilkan keputusan bersama antara tim dokter dengan keluarga pasien. Dengan pemberian informasi yang adekuat mengenai indikasi medik dengan tetap memperhatikan sudut pandang permintaan (keinginan) pasien, kualitas hidup maupun fitur kontekstual maka meskipun pada akhirnya pasien ini tidak berhasil diselamatkan, paling tidak keluarga pasien puas atas pelayanan yang telah diberikan.

 

Clinical Ethics and Medicolegal Considerations for Anesthesia Management in Cases of Traumatic Brain Injury

Abstract

Traumatic Brain Injury (COT) is a leading cause of death and illness in children and young adults throughout the world. A case of COT was reported in a 5-year-old boy who fell from the 2nd floor. The patient was diagnosed with a severe head injury with epidural and subdural bleeding with ASA levels 3-4. The ethical dilemma faced by the anesthesiologist is the high-risk anesthetic procedure but the possibility of life saving is unsuccessful, so whether the surgery is still being performed or only given supportive therapy?. This report discusses solving ethics and medicolegal dilemmas based on clinical ethics theory. The results of ethical and medicolegal considerations in this case were carried out comprehensively by producing a joint decision between the team of doctors and the patient's family. By providing adequate information regarding medical indications while still giving attention to the patients' preferences, quality of life and contextual features, even though these patients were ultimately unsuccessful, at least the patient's family was satisfied with the services provided.


Keywords


anestesia; cedera otak traumatik; etika klinik; medikolegal; anesthesia; clinical ethics; medicolegal; traumatic brain injury

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DOI: https://doi.org/10.24244/jni.v9i2.250

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DOI:  https://doi.org/10.24244/jni 

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