Chaos of Medical Liability
Legal systems must move past the outdated binary between individual and institutional liability. Today, healthcare is a complicated interconnected ecosystem.
Ruang Menulis untuk Indonesia
Kopi TIMES adalah ruang kolaboratif bagi siapa saja yang ingin menyuarakan ide, pengalaman, dan pemikiran kepada publik luas. Di sini, tulisan lahir dari beragam latar belakang: akademisi, mahasiswa, guru, santri, profesional, pelaku UMKM, pegiat komunitas, aktivis, birokrat, politisi, seniman, hingga warga biasa yang peduli pada isu di sekitarnya.
SURABAYA – In the healthcare system of today, a seductive illusion of accuracy, professionalism and accountability is sold. Beneath the shiny wrapper of hospital accreditation and clinical protocols, lurks a profoundly unsettled legal situation when things go wrong, no one appears to be accountable. It harms patients, but accountability evaporates in the mists of liability where the attending physician (DPJP) and the hospital are concerned. This is more than a small coding error.
This is a systemic design defect. At the heart of the crisis is unresolved tension between professional autonomy and institutional control. You are trained to provide your own medical judgment as a physician but you work in systems that dictate the resources at your disposal, who is staffing the facility, what devices will be available as assessment aids or even treatment pathways. When something goes wrong, hospitals fall back on the principle that doctors are independent contractors. On the other hand, Physicians out to pass off the blame on systemic failures congested hospitals, nonexistent tools or administrative coercion.
This leads to a stalemate in the law. But there has continued to be a perilous vagueness in the doctrinal distinctions between vicarious liability, corporate negligence, and individual malpractice across many jurisdictions, and even some nascent legal systems. Hospitals argue, however, that they are providers of services not responsible for clinical results. But doctors counter that they should not be blamed alone for decisions driven by the limitations of their institutions. This shared avoidance creates a vacuum of responsibility.
And it is patients who fall into it. Credentialing systems, which should be a robust assurance of competence and accountability, often act as bureaucratic foils rather than meaningful safeguards. Hospitals welcome privileges, but avoid accountability. They validate doctors as authority figures, but deny any responsibility for their actions. This contradiction is not accidental, rather a structural convenience.
If more troubling, however, is not having adequate legal standards delineating the boundaries of DPJP power from that of institutional liability. It begs the question, if policy at a medical institution drives a clinical decision, who is liable? When the treatment option is changed due to pressures of economical efficiency? When systemic blindness wears the cloak of individual mistake?
In the absence of a clear legal line, justice is improvised by courts on a case by case basis with arbitrary and often unjust results. Such unpredictability breeds distrust in the public and threatens the legitimacy of healthcare law itself.
What emerges is not just legal uncertainty, but institutional impunity. Legal systems must move past the outdated binary between individual and institutional liability. Today, healthcare is a complicated interconnected ecosystem. Responsibility should be composite, graduated and assigned. Just as physicians must remain accountable for our financial decisions, hospitals too should be held legally accountable for the environments they create.
Anything else is a willful abdication of justice. That is until the law naturally adapts to reflect the practice of modern medicine the anarchy that exists within our system of medical liability will continue to exist, not as a consequence but rather an accepted injustice working in furtherance of and with impunity upon each and every patient.
***
*) By: Fransiscus Nanga Roka, Faculty of Law University 17 August 1945 Surabaya, Managing Partner of Law Firm Victorious Indonesia and Member of Indonesian Medical Association.
*) This opinion piece is entirely the responsibility of the author and is not the responsibility of the timesindonesia.co.id editorial team.
*) Kopi TIMES, or the opinion section in TIMES Indonesia, is for the general public. The maximum length of the article is 4,000 characters or approximately 600 words.
*) Include the author's name, profession, photo, and contact number.
*) Manuscripts should be sent to https://kopi.times.co.id/
*) The editorial team reserves the right not to publish submitted opinion pieces.
Simak breaking news dan berita pilihan TIMES Indonesia langsung dari WhatsApp-mu!
Klik 👉 Channel TIMES Indonesia
Pastikan WhatsApp kamu sudah terpasang.
