BEYOND LEGAL COMPLIANCE: RECONSTRUCTING PATIENT PROTECTION THROUGH THE MORAL CONSTITUTION OF MEDICAL PRACTICE IN INDONESIA

Abstract

The gap between legal norms (das sollen) and the actual implementation of healthcare services (das sein) remains a persistent challenge in medical practice in Indonesia. Although the legal framework, including Law No. 17 of 2023 on Health, Law No. 29 of 2004 on Medical Practice, and Law No. 44 of 2009 on Hospitals, provides a normative basis for patient protection, its implementation continues to face disparities in service quality between BPJS and non-BPJS patients, weak informed consent practices, prescribing practices that are not always fully patient-oriented, and ineffective legal accountability mechanisms for medical malpractice. This study aims to examine the axiological foundations of medical practice law and develop a legal reconstruction for substantive patient protection in Indonesia. Employing a normative-empirical approach, the study integrates statutory, conceptual, case, philosophical, and empirical approaches. Data were obtained through literature and legal document analysis, judicial decisions, and interviews with relevant informants, and analyzed qualitatively through data reduction, presentation, and inductive conclusion drawing. The findings reveal persistent disharmony between positive law and professional ethics, administrative and procedural dominance, healthcare inequalities, weak informed consent implementation, and ineffective accountability mechanisms. The study proposes reconstructing medical practice law through stronger integration of legal norms, professional ethics, human rights, and accountability mechanisms to advance substantive justice, utility, and legal certainty in patient protection.