Dissecting justice: The legal significance of medical records and informed consent in malpractice cases

Muhammad Darwis

doi:10.55942/pssj.v6i3.1092

Authors

Muhammad Darwis Faculty of Law Andi Sapada Institute of Social Sciences and Business, Parepare-Indonesia

DOI:

https://doi.org/10.55942/pssj.v6i3.1092

Keywords:

Medical Records, Informed Consent, Medical Malpractice, Legal Evidence, Protection of Medical Personnel

Abstract

This study examines the legal position and strength of medical records and informed consent as evidence in medical malpractice cases in Indonesia. Using normative legal research methods, this study applies a statutory approach and an analytical approach to understand the aspects of health law and related evidentiary law. The study results indicate that medical records have a strong position as written evidence in civil procedural law and as written evidence in criminal procedural law. Meanwhile, informed consent plays an important role in proving the fulfilment of the doctor's obligation to provide information to patients. However, the existence of informed consent does not necessarily eliminate the doctor's responsibility if proven to have committed negligence. This study also reveals that the use of medical records and informed consent as evidence must consider aspects of patient confidentiality and the development of electronic medical record technology. In conclusion, although medical records and informed consent have significant evidentiary power, their use must be carried out carefully by considering the case context, medical professional standards, and applicable health law principles to ensure justice in resolving medical malpractice cases in Indonesia.

Author Biography

Muhammad Darwis, Faculty of Law Andi Sapada Institute of Social Sciences and Business, Parepare-Indonesia

Muhammad Darwis is Vice Dean II of the Faculty of Law, Social Sciences, and Business Andi Sapada, made significant contributions through the delivery of input, conceptual ideas, and the development of research methodologies. His active role was reflected in the formulation of the research framework, discussed with the Institute for Research and Community Service, actively discussing the selection of relevant methods, and strengthening the theoretical foundation so that the research meets academic and institutional standards. In addition, his contributions focused on strengthening practical legal arguments, mapping actual issues relevant to community needs, and integrating consultation results into the structure of analytical studies.

References

Abduh, R. (2021). Kajian hukum rekam medis sebagai alat bukti malapraktik medis. De Lega Lata: Jurnal Ilmu Hukum, 6(1), 221–233. https://doi.org/10.30596/dll.v6i1.4661

Angela, L., Widjaja, M., & Juliansen, A. (2023). Analisis yuridis dasar hukum perlindungan hukum terhadap dokter dan dokter gigi dalam menjalankan pelayanan kesehatan. Innovative: Journal of Social Science Research, 3(2), 1933–1944. http://j-innovative.org/index.php/Innovative/article/view/521

Andayani, A., Siska, & Purwani, S. P. (2024). Confidentiality in digital health records: Aligning privacy and care advancement in hospitals. Journal of Law, Politic and Humanities, 5(1). https://doi.org/10.38035/jlph.v5i1.787

Astuti, D. W. (2009). Kedudukan hukum rekam medis dan informed consent sebagai alat bukti dalam kasus malpraktek (Undergraduate thesis). Universitas Islam Indonesia.

Chazawi, A. (2022). Malapraktik kedokteran. Sinar Grafika.

Darwis, M. (2024). Analisis hukum terhadap kedudukan rekam medis dan informed consent sebagai alat bukti dalam kasus malpraktek (Undergraduate thesis). Institut Ilmu Sosial dan Bisnis Andi Sapada.

Daud, K. R., Sagala, P., Sutarno, S., & Sutrisno, S. (2024). Analisis yuridis kekuatan hukum rekam medis elektronik sebagai alat bukti dalam suatu sengketa medis. Jurnal Cahaya Mandalika, 2648–2661. https://doi.org/10.36312/jcm

Denianto, L. (2010). Rekam medik elektronik ditinjau dari kedokteran dan Islam (Diploma thesis). Universitas YARSI. https://digilib.yarsi.ac.id/2385/

Ginting, J. P. (2019). Rekam medis sebagai alat bukti dalam penyelesaian sengketa layanan medis. Al’Adl: Jurnal Hukum, 12(2), 259–276. https://www.academia.edu/114873273/Rekam_Medis_Konvensional_Dan_Elektronik_Sebagai_Alat_Bukti_Dalam_Perkara_Pidana

Hapsari, C. M. (2014). Kajian yuridis pemakaian rekam medis elektronik di rumah sakit.

Juliardi, B., Runtunuwu, Y. B., Musthofa, M. H., TL, A. D., Asriyani, A., Hazmi, R. M., Syahril, M. A. F., Saputra, T. E., Arman, Z., & Rauf, M. A. (2023). Metode penelitian hukum. CV. Gita Lentera.

Kesuma, S. I. (2023). Rekam medis elektronik pada pelayanan rumah sakit di Indonesia: Aspek hukum dan implementasi. Aladalah: Jurnal Politik, Sosial, Hukum dan Humaniora, 1(1), 195–205. https://doi.org/10.59246/aladalah.v1i1.188

Laelatussofah, S. (2024). Rekonstruksi regulasi perlindungan hukum sumber daya manusia kesehatan pada penanganan pasien di rumah sakit berbasis keadilan (Doctoral dissertation). Universitas Islam Sultan Agung.

Mannas, Y. A., & Elvandari, S. (2023). Aspek hukum telemedicine di Indonesia. PT RajaGrafindo Persada.

Matippanna, A. (2019). Pentingnya memahami informed consent dan rahasia medis dalam praktek kedokteran. Uwais Inspirasi Indonesia.

Nawi, S. (2017). Penelitian hukum normatif versus penelitian hukum empiris (5th ed.). PT Umitoha Ukhuwah Grafika.

Pebrina, A. R., Najwan, J., & Alissa, E. (2022). Fungsi penerapan informed consent sebagai persetujuan pada perjanjian terapeutik. Zaaken: Journal of Civil and Business Law, 3(3), 468–486. https://doi.org/10.22437/zaaken.v3i3.18966

Purwoto, A. (2024). Pertanggungjawaban pidana: Sebuah tinjauan yuridis. Duta Sains Indonesia.

Qamar, N., & Rezah, F. S. (2020). Metode penelitian hukum: Doktrinal dan non-doktrinal. CV. Social Politic Genius (SIGn).

Rizka, S. A., & Budiono, A. (2022). Hukum kesehatan. Muhammadiyah University Press.

Sarake, H. M. (2014). Buku ajar rekam medis. STIKES Husada Borneo.

Sitepu, F. (2025). Inform consent sebagai perlindungan hukum dalam pelaksanaan tindakan dokter dan paramedis (Studi di Rumah Sakit Umum Bandung) (Master’s thesis, Universitas Medan Area). https://repositori.uma.ac.id/jspui/bitstream/123456789/27443/2/231803021%20-%20Fadel%20Sitepu%20-%20Fulltext.pdf

Sudiyanto, H. (2019). Etika hukum keperawatan. STIKes Majapahit.

Sulistyaningrum, H. P., Afrilia, D., & Murty, T. (2021). Medical records: Preventive efforts in medical services for COVID-19 patients. SOEPRA Jurnal Hukum Kesehatan, 7(2), 327–345. https://doi.org/10.24167/shk.v7i2.3684

Sulolipu, A. B., & Handoyo, S. (2019). Perlindungan hukum terhadap profesi dokter dalam penyelesaian sengketa medis berdasarkan prinsip keadilan. Jurnal Projudice, 1(1), 60–82. https://jurnal.pascasarjana.uniba-bpn.ac.id/index.php/JurnalProjudice/article/view/29

Syarif, M., Ramadhani, R., Graha, M. A. W., Yanuaria, T., Muhtar, M. H., Asmah, N., Syahril, M. A. F., Utami, R. D., Rustan, A., & Nasution, H. S. (2024). Metode penelitian hukum. Get Press.

Sylvia Anjani, S., & Abiyasa, M. T. (2023). Disrupsi digital dan masa depan rekam medis (Kajian Peraturan Menteri Kesehatan Nomor 24 Tahun 2022 tentang rekam medis elektronik). Selat Media.

Arthanti, W. B., Rusdi, M. S., Yuliwulandari, R., & others. (2024). Etika kedokteran dengan hukum kesehatan. Thalibul Ilmi Publishing & Education.

YH, U. K. R., & Susanto, D. (2024). Amicus curiae di Indonesia: Suatu penerapan dan tantangan. Tohar Media.

Yunanto, A., & Helmi, S. H. (2024). Hukum pidana malpraktik medik: Tinjauan dan perspektif medikolegal. Penerbit Andi.

Dissecting justice: The legal significance of medical records and informed consent in malpractice cases

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Author Biography

Muhammad Darwis, Faculty of Law Andi Sapada Institute of Social Sciences and Business, Parepare-Indonesia

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