Medical malpractice and professional accountability in Indonesia: An overview of civil, criminal, and ethical liability of health care providers

Abstract

Introduction: Medical malpractice and professional accountability remain contentious issues in Indonesia due to increasing complaints and persistent uncertainty in applying civil, criminal, and disciplinary liability. Although multiple health laws regulate medical practice, fragmentation and the absence of a unified malpractice doctrine continue to complicate accountability.

Methods: This narrative review analysed academic literature, statutes, judicial decisions, and policy documents published between 2021 and 2025. The review focused on the operation and interaction of civil liability, criminal responsibility, and professional disciplinary mechanisms, particularly following the enactment of Law No. 17 of 2023.

Results: The findings demonstrate a substantial gap between normative legal frameworks and their practical enforcement. Civil liability is formally positioned as the primary compensatory mechanism, but is undermined by high evidentiary burdens, procedural complexity, and limited patient access, reducing its effectiveness. Criminal liability has been inconsistently applied through general negligence provisions, contributing to the over-criminalization of medical judgment, although recent reforms introduce professional assessment as a gatekeeping safeguard. Professional and ethical disciplinary mechanisms function as essential filters for assessing compliance with standards. Yet, their decisions remain weakly integrated with civil and criminal processes, producing parallel and sometimes conflicting outcomes. Overall, accountability remains forum-dependent, fragmented, and insufficiently coordinated.

Conclusion: Indonesia’s medical malpractice regime is legally extensive but operationally fragile. Addressing these deficiencies requires more precise differentiation between medical error and negligence, strengthening civil remedies as the primary avenue for patient redress, consistent use of criminal law as ultimum remedium, and improved coordination between disciplinary and judicial mechanisms to ensure proportional accountability and legal certainty.