Jurnal Dharmaputra Hukum Kesehatan (JDHK) is the first academic journal in Indonesia dedicated specifically to the field of medical law. Established to bridge the gap between legal scholarship and medical practice, JDHK provides a critical forum for interdisciplinary dialogue on legal, ethical, and regulatory issues in healthcare. The journal publishes peer-reviewed articles that explore topics such as medical malpractice, patient rights, health law legislation, bioethics, professional liability, and the legal implications of public health policy—both in the Indonesian context and from a global perspective. As a pioneering platform in this emerging field, Jurnal Dharmaputra Hukum Kesehatan is committed to advancing academic excellence and contributing to the development of a just and accountable healthcare system through scholarly analysis and legal discourse. The journal is published biannually and accepts manuscripts in both English and Indonesian.
Informed Consent for High-Risk Procedures in Indonesia: Legal Formalism, Shared Decision-Making, and the Problem of Therapeutic Misunderstanding
Introduction: Informed consent constitutes a fundamental ethical and legal requirement in modern healthcare, particularly for high-risk procedures that involve substantial risks of morbidity, disability, or mortality. Despite legal reforms that strengthen patient rights in Indonesia, informed consent is frequently implemented as a documentation-centered process, raising concerns regarding the quality of patient understanding and participation in clinical decision-making. Methods: This study employed a normative-juridical narrative review by analyzing Indonesian health legislation, bioethical principles, medico-legal literature, and international publications related to informed consent, shared decision-making, patient autonomy, and therapeutic misunderstanding. Relevant legal and scientific sources were synthesized thematically. Results: Indonesian regulations establish a comprehensive legal foundation for informed consent and require disclosure of information regarding diagnosis, proposed interventions, potential benefits, risks, alternatives, and prognosis. However, implementation often remains focused on obtaining signed consent forms rather than ensuring substantive patient comprehension. Contemporary evidence supports shared decision-making as a patient-centered approach that promotes meaningful involvement in healthcare decisions. Nevertheless, limited health literacy, cultural paternalism, communication barriers, emotional distress, and the complexity of medical information continue to contribute to therapeutic misunderstanding, particularly in high-risk clinical settings. These factors may undermine the validity of consent despite apparent legal compliance. Conclusion: The validity of informed consent should extend beyond documentary authorization and encompass effective communication, patient understanding, voluntariness, and collaborative decision-making. Integrating shared decision-making principles into high-risk consent processes may reduce therapeutic misunderstanding, strengthen patient autonomy, and enhance medico-legal protection for both patients and healthcare professionals in Indonesia.
Copyright (c) 2026 Jurnal Dharmaputra Hukum Kesehatan
Criminalization of Medical Error in Indonesia: A Critical Review of Professional Autonomy, Patient Protection, and the Limits of Penal Law
Introduction: The criminalization of medical errors in Indonesia represents an ongoing systemic conflict between safeguarding professional autonomy, protecting patient rights, and defining the legitimate limits of penal law. Historically, the direct application of general negligence provisions under the Indonesian Penal Code (KUHP) exposed medical practitioners to disproportionate criminal liability, driving defensive medicine practices. This article critically examines the shifting legal landscape following the enactment of Law Number 17 of 2023 concerning Health. Methods: This study employs a normative juridical research method using statutory, conceptual, and case approaches. It evaluates positive legal norms governing medical malpractice, the structural transition of disciplinary bodies, the application of the ultimum remedium principle, and the effectiveness of alternative dispute resolution mechanisms. Results: The findings indicate that Law Number 17 of 2023 establishes a tiered liability framework prioritizing restorative justice and mandatory mediation. The Professional Disciplinary Council serves as an initial administrative "gatekeeper" to assess professional discipline before judicial intervention, reinforcing the lex specialis doctrine. However, the centralization of disciplinary authority under the Ministry of Health and procedural friction with police investigative powers generate significant legal uncertainty. Conclusion: While the 2023 Health Law represents a progressive shift toward a safety and system-improvement culture, further legislative harmonization is required to resolve procedural friction and preserve the independent professional judgment of healthcare workers.
Telemedicine Liability in Indonesia After the Digital Health Turn: Rethinking Doctor-Patient Relationships, Cross-Border Practice, and Standard of Care
Introduction: The rapid expansion of telemedicine in Indonesia following the COVID-19 pandemic has transformed healthcare delivery and improved access to medical services across the archipelago. However, this digital transition has also generated complex legal challenges concerning medical liability, professional accountability, cross-border practice, and the applicability of conventional standards of care in virtual clinical settings. This review aims to analyze telemedicine liability in Indonesia by examining the evolving doctor–patient relationship, jurisdictional challenges in cross-border telemedicine, and the need for a telemedicine-specific standard of care. Methods: A narrative legal review was conducted using statutory, conceptual, and comparative approaches. Primary sources included Indonesian laws and regulations governing health services, telemedicine, electronic transactions, personal data protection, and medical records. Secondary sources consisted of peer-reviewed journal articles, professional guidelines, policy reports, and comparative regulatory frameworks from other jurisdictions. Results: The digital health transformation has shifted the traditional bilateral doctor–patient relationship into a trilateral interaction involving patients, healthcare professionals, and digital platform providers. Existing regulations establish civil, criminal, administrative, and professional disciplinary liability frameworks. However, significant ambiguities remain regarding the allocation of responsibility between clinicians and electronic system operators. Cross-border telemedicine continues to operate within a regulatory gap characterized by licensing, jurisdictional, and enforcement challenges. Moreover, Indonesia has yet to develop a clearly defined telemedicine-specific standard of care that adequately addresses limitations of remote assessment, technological constraints, and AI-assisted clinical decision-making. Conclusion: Telemedicine liability in Indonesia requires adaptive regulatory reform, clearer allocation of platform and clinician responsibility, formalized digital standards of care, and dedicated frameworks for cross-border practice. Strengthening these areas is essential to ensure legal certainty, professional accountability, and patient safety in the digital health era.
Electronic medical records as legal evidence in Indonesian healthcare disputes: A review of authentication, confidentiality, and evidentiary challenges
Introduction: The nationwide implementation of electronic medical records in Indonesia has transformed clinical documentation into a digital legal artifact. Although electronic medical records improve continuity of care and administrative efficiency, their use as legal evidence in healthcare disputes raises complex questions regarding authenticity, confidentiality, integrity, and evidentiary reliability. This review aims to analyze the legal position of electronic medical records as evidence in Indonesian healthcare disputes, with particular attention to authentication, confidentiality, audit trails, chain of custody, and practical evidentiary barriers. Methods: A normative-juridical narrative review was conducted by synthesizing Indonesian health law, electronic information law, personal data protection law, procedural law, and scholarly literature on electronic health records, digital evidence, cybersecurity, and health data governance. Results: Electronic medical records have a legal basis as electronic documents and may support civil, criminal, administrative, ethical, disciplinary, and insurance-related proceedings. Their probative value depends on reliable electronic systems, user-specific authentication, certified electronic signatures, immutable audit trails, accurate timestamps, metadata preservation, confidentiality safeguards, and controlled extraction procedures. Current Indonesian regulation provides a strong normative basis, but operational gaps remain in system certification, shared-account prevention, forensic readiness, interoperability, and medico-legal disclosure protocols. Conclusion: Electronic medical records can function as important legal evidence in Indonesian healthcare disputes. Their evidentiary strength requires integrated governance that combines legal compliance, clinical documentation discipline, technical security, and ethical protection of patient confidentiality.
Beyond “malpractice” reconstructing medical negligence in Indonesia through the lens of patient safety, defensive medicine, and health system error
Introduction: Medical negligence in Indonesia is often compressed into the single public label of “malpractice,” although contemporary legal and patient-safety scholarship distinguishes unavoidable medical risk, human error, professional negligence, reckless conduct, and organizational failure. This review aims to reconstruct medical negligence in Indonesia through the integrated lenses of patient safety, defensive medicine, and health system error. Methods: This narrative legal-policy review synthesized peer-reviewed scientific journal articles published between 2022 and 2026, with legal analysis limited to Indonesian statutes and regulations. Sources were selected when they addressed medical negligence, hospital liability, professional accountability, patient safety culture, incident reporting, defensive medicine, or hospital risk management. Results: Indonesian medical negligence should not be assessed only as individual fault, but as a layered phenomenon involving clinical judgment, team communication, institutional governance, safety culture, reporting systems, and regulatory design. Law No. 17 of 2023 on Health strengthens the legal basis for patient rights, professional accountability, hospital responsibility, and dispute processing, while Minister of Health Regulation No. 11 of 2017 provides a patient-safety framework for incident prevention and learning. However, fear of litigation and criminalization may encourage defensive medicine, while blame-oriented cultures suppress incident reporting and weaken organizational learning. Conclusion: Reconstructing medical negligence beyond “malpractice” requires a shift from retrospective blame toward proportionate accountability, just culture, system learning, and legally coherent risk management. Indonesian health law should be implemented in a way that distinguishes medical risk from negligent conduct, protects patients’ rights, supports fair professional evaluation, and makes hospitals accountable for preventable system failures.
Medical malpractice and professional accountability in Indonesia: An overview of civil, criminal, and ethical liability of health care providers
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.
Copyright (c) 2025 Jurnal Dharmaputra Hukum Kesehatan
Informed Consent in Indonesian Medical Practice: Alignment Between Legal Norms, Clinical Reality, and Patient Rights
Introduction: Informed consent is a cornerstone of ethical medical practice and patient autonomy, yet its implementation varies significantly across healthcare systems. In Indonesia, a complex interplay of legal requirements, clinical realities, and cultural factors shapes how informed consent is obtained and documented. This narrative review examines the alignment between legal norms, clinical practice, and patient rights regarding informed consent in Indonesian medical settings. We synthesize evidence on statutory frameworks, implementation challenges, patient understanding, and gaps between legal ideals and on-the-ground practice. Methods: A comprehensive literature search was conducted across multiple databases ( PubMed, Google Scholar, Grey Literatures) covering publications from 2020-2025. Search terms included "informed consent," "Indonesian medical practice," "patient rights," "medical law Indonesia," and related terms. A total of 139 unique papers were identified, including normative legal analyses, empirical case studies, comparative reviews, and policy commentaries. Results: Indonesian law establishes clear informed consent requirements through Law No. 29/2004 on Medical Practice, Minister of Health Regulation No. 290/2008, and the recent Law No. 17/2023 on Health. However, clinical practice reveals variable documentation quality, limited patient comprehension, time constraints in emergency settings, and persistent paternalistic attitudes. Key gaps include unclear competence assessment criteria, inadequate patient health literacy, and insufficient operational guidance for implementing statutory requirements. Cultural factors, including collective family decision-making norms and hierarchical doctor-patient relationships, further complicate the realization of individual patient autonomy. Conclusions: Indonesia has strong informed consent laws, but they are not consistently followed in practice. Common problems include rushed discussions, poor patient understanding, and cultural preferences for family-based decisions. To fix this, the healthcare system should use clearer forms, train doctors in better communication, and develop practical guidelines that respect both the law and local culture. More research is needed to measure what solutions work best.
Copyright (c) 2025 Dharmaputra Medical Law Journal
The legal status of electronic medical records and health data privacy in Indonesia: Current regulations, gaps, and future directions
Introduction: Indonesia’s healthcare system is undergoing digital transformation through mandatory Electronic Medical Records (EMR) under Regulation No. 24 of 2022 and the Health Omnibus Law (Law No. 17 of 2023). While EMR enhances data integration via SATUSEHAT, it raises privacy concerns under the Personal Data Protection Law. This study aims to assess the adequacy of Indonesia’s legal framework governing EMR and health data protection. Methods: This study applies a normative-juridical method complemented by empirical analysis. It reviews relevant statutes, implementing regulations, and academic literature on EMR and data protection, alongside secondary empirical data from institutional reports and documented cybersecurity incidents. The analysis focuses on regulatory harmonization, consent mechanisms, government access to health data, and data subject rights. Results: The findings indicate that EMR implementation in Indonesia is supported by a legitimate normative foundation but remains operationally fragile. Regulatory inconsistencies persist between health sector regulations and the personal data protection regime, particularly concerning state access to medical data, informed consent, and the right to erasure. Empirically, implementation is constrained by cybersecurity vulnerabilities, unequal digital infrastructure readiness in community health centers, and limited human resource capacity, increasing legal and liability risks. Conclusion: While Indonesia’s EMR policy reflects progress toward digital health governance, enforcement of privacy protection remains underdeveloped. Strengthening the system requires clearer implementing regulations, improved cybersecurity standards, and robust institutional oversight to ensure a rights-based and sustainable digital health ecosystem.
Hospital Governance and Legal Compliance in Indonesia: A Review of Accreditation Standards, Licensing Requirements, and Risk Management Obligations
Introduction: Hospitals, as healthcare institutions, hold a strategic position and face high levels of legal risk. The complexity of regulations in Indonesia demands the implementation of effective and legally compliant hospital governance, particularly in the areas of accreditation, operational licensing, and risk management. Non-compliance with these provisions has the potential to lead to administrative sanctions, legal disputes, and a decline in the quality and safety of healthcare services. Methods: This study employed a narrative literature review, examining laws and regulations, government policies, accreditation guidelines, and national and international journal articles relevant to hospital governance and legal compliance. The literature search was conducted through scientific databases and official government sources, with inclusion criteria emphasizing relevance to the Indonesian context and the academic quality of the sources. Results: The review indicates that the legal framework for hospital governance in Indonesia is built on three main pillars: accreditation as an instrument for improving patient quality and safety, licensing as operational legitimacy and state control, and risk management as a mechanism for preventing legal violations. The application of corporate governance and clinical governance principles is key to integrating legal compliance into managerial and clinical practices. However, implementation challenges remain, including inconsistent compliance, limited resources, and weak risk management integration. Conclusion: Legally compliant hospital governance requires a comprehensive and sustainable approach that integrates accreditation, licensing, and risk management.
Analisis Yuridis Normatif Standar Kualitas dan Keamanan Pangan Dalam Program Makan Bergizi Gratis: Evaluasi Implementasi dan Kerangka Hukum Perlindungan Konsumen
Introduction: The Free Nutritious Meal Program (Program Makan Bergizi Gratis/MBG), launched in January 2025, is a national initiative aimed at improving the nutritional status of Indonesian children as part of the vision toward the Golden Generation 2045. Despite its strategic importance, the program has faced serious food safety challenges, reflected in food poisoning incidents affecting 13,371 students since its implementation. These events raise concerns regarding regulatory compliance and the adequacy of food safety standards within the program. Methods: This study employed a normative juridical method using statute and conceptual approaches. The analysis focused on examining the conformity of the 2025 Technical Guidelines for the Implementation of Government Assistance for the MBG Program with Indonesia’s food law and health law framework. Primary, secondary, and tertiary legal materials including legislation, policy documents, and relevant scholarly literature were systematically reviewed to assess regulatory substance and implementation mechanisms. Results: The study identified a significant gap between the normative provisions stipulated in the technical guidelines and their implementation in practice. Key weaknesses were found in food safety standard operating procedures, supervision and monitoring mechanisms, and accountability of program implementers. Insufficient oversight capacity and weak enforcement of administrative sanctions were identified as contributing factors to recurring food safety incidents, thereby compromising beneficiary protection. Conclusion: Strengthening legal compliance in the MBG Program requires regulatory reinforcement, improved supervisory capacity, and effective enforcement of administrative sanctions. An integrated legal and institutional approach is essential to ensure the fulfillment of beneficiaries’ constitutional rights to safe and nutritious food and to support the sustainability of national nutrition programs. Pendahuluan: Program Makan Bergizi Gratis (MBG) yang diluncurkan pada Januari 2025 merupakan inisiatif nasional untuk meningkatkan status gizi anak Indonesia dalam rangka mewujudkan Generasi Emas 2045. Meskipun memiliki tujuan strategis, pelaksanaan program ini menghadapi tantangan serius terkait keamanan pangan, yang tercermin dari kejadian keracunan makanan yang menimpa 13.371 siswa sejak program dijalankan. Kondisi ini menimbulkan kekhawatiran terhadap kepatuhan regulasi dan kecukupan standar keamanan pangan dalam penyelenggaraan program. Metode: Penelitian ini menggunakan metode yuridis normatif dengan pendekatan perundang-undangan (statute approach) dan pendekatan konseptual (conceptual approach). Analisis dilakukan terhadap kesesuaian Petunjuk Teknis Penyelenggaraan Bantuan Pemerintah Program MBG Tahun Anggaran 2025 dengan kerangka hukum pangan dan hukum kesehatan di Indonesia. Bahan hukum primer, sekunder, dan tersier, termasuk peraturan perundang-undangan, dokumen kebijakan, serta literatur ilmiah yang relevan, dikaji secara sistematis. Hasil: Hasil penelitian menunjukkan adanya kesenjangan signifikan antara pengaturan normatif dalam petunjuk teknis dan implementasinya di lapangan. Kelemahan utama ditemukan pada standar operasional prosedur keamanan pangan, mekanisme pengawasan dan monitoring, serta akuntabilitas penyelenggara program. Keterbatasan kapasitas pengawasan dan lemahnya penegakan sanksi administratif berkontribusi terhadap terjadinya insiden keamanan pangan dan melemahkan perlindungan terhadap penerima manfaat. Kesimpulan: Penguatan kepatuhan hukum dalam Program MBG memerlukan penguatan regulasi, peningkatan kapasitas pengawasan, serta penegakan sanksi administratif yang efektif. Pendekatan hukum dan kelembagaan yang terintegrasi menjadi kunci untuk menjamin pemenuhan hak konstitusional penerima manfaat atas pangan yang aman dan bergizi.
Legal protection of patients in Indonesia’s National Health Insurance (JKN) era: a comprehensive review of regulatory framework and hospital practice
Introduction: Indonesia’s National Health Insurance (JKN) program, administered by BPJS Kesehatan, operationalizes the constitutional right to health for more than 278 million participants by 2025. Despite a comprehensive normative framework, hospital-level implementation remains constrained by persistent structural deficiencies that weaken patient protection. This study aims to critically evaluate the extent to which Indonesia’s National Health Insurance (JKN) framework provides adequate legal protection for patients. Methods: This review synthesizes contemporary literature published between 2021 and 2025, integrating normative legal analyses of key statutes, including Law No. 44/2009, with qualitative studies employing phenomenological methods, such as in-depth interviews with medical specialists. Sources were assessed to identify convergent themes relating to regulatory coherence, hospital practice, and enforcement capacity. Results: The analysis reveals a pronounced gap between legal guarantees and operational practice. Evidence consistently shows pervasive service discrimination against JKN participants, resulting in inferior treatment that violates non-discrimination mandates. Regulatory uncertainty surrounding the Standard Inpatient Class (KRIS) policy has slowed implementation, compounded by infrastructure non-compliance in roughly 30% of hospitals. Enforcement remains weak, and complaint mechanisms are structurally biased toward institutions, creating significant barriers for patient complainants and undermining accountability. Conclusion: Indonesia’s legal protection for JKN patients remains normatively strong but functionally fragile due to regulatory immaturity, institutional resistance, and inadequate oversight. Strengthening legal protection requires finalizing the KRIS financial framework, enforcing anti-discrimination measures through independent oversight, and reforming dispute-resolution systems to ensure equitable, accessible pathways to justice for all JKN participants.
Kesenjangan Perlindungan Pasien Asuransi dalam Rawat Inap: Studi Terapan di Lingkungan Rumah Sakit Umum
Background: The National Health Insurance (JKN) program, through the BPJS Kesehatan (Social Security Agency for Health), aims to provide equal and affordable access to inpatient services. However, in practice, BPJS participants often face gaps in legal protection, ranging from denial of services to disproportionate additional costs. This phenomenon raises questions about the effectiveness of legal protection for patients in public hospitals. Objective: This study aims to evaluate the implementation of legal protection for BPJS patients in inpatient services and examine its compliance with the principles of justice in Indonesian health law. Methods: The study used an empirical juridical approach. Primary data were obtained through direct observation and informal interviews with BPJS patients and healthcare workers at Wangaya Regional General Hospital between March and May 2024. Secondary data consisted of laws and regulations, BPJS policy documents, and legal literature. Data were analyzed descriptively and qualitatively using thematic categorization and normative interpretation techniques. Results: Four main gaps were identified: inconsistencies in inpatient care services with patient rights, the dominance of administrative procedures over clinical decisions, the absence of internal legal assistance mechanisms, and the failure to internalize the principle of substantive justice in BPJS services. These findings indicate that the service system is more oriented toward bureaucratic efficiency than protecting patients' legal rights. Conclusion: Legal protection for BPJS patients in inpatient care remains normative and not yet functional in practice. Institutional reform, legal education for medical personnel, and the establishment of patient advocacy units in hospitals are strategic steps to strengthen legal protection within the JKN system. Latar Belakang: Program Jaminan Kesehatan Nasional (JKN) melalui BPJS Kesehatan bertujuan menyediakan akses pelayanan rawat inap yang setara dan terjangkau. Namun dalam praktiknya, peserta BPJS kerap menghadapi kesenjangan perlindungan hukum, mulai dari penolakan layanan hingga pembebanan biaya tambahan yang tidak proporsional. Fenomena ini menimbulkan pertanyaan terhadap efektivitas perlindungan hukum pasien di rumah sakit umum. Tujuan: Penelitian ini bertujuan untuk mengevaluasi implementasi perlindungan hukum pasien peserta BPJS dalam layanan rawat inap dan menelaah kesesuaiannya dengan prinsip keadilan dalam hukum kesehatan Indonesia. Metode: Penelitian menggunakan pendekatan yuridis empiris. Data primer diperoleh melalui observasi langsung dan wawancara informal dengan pasien peserta BPJS serta tenaga kesehatan di Rumah Sakit Umum Daerah Wangaya pada periode Maret–Mei 2024. Data sekunder berupa peraturan perundang-undangan, dokumen kebijakan BPJS, serta literatur hukum. Data dianalisis secara deskriptif-kualitatif dengan teknik kategorisasi tematik dan penafsiran normatif. Hasil: Ditemukan empat bentuk utama kesenjangan: ketidaksesuaian pelayanan kelas rawat inap dengan hak pasien, dominasi prosedur administratif atas keputusan klinis, ketiadaan mekanisme pendampingan hukum internal, dan belum terinternalisasinya asas keadilan substantif dalam pelayanan BPJS. Temuan ini menunjukkan bahwa sistem pelayanan lebih berorientasi pada efisiensi birokrasi dibanding perlindungan hak hukum pasien. Kesimpulan: Perlindungan hukum pasien peserta BPJS dalam layanan rawat inap masih bersifat normatif dan belum fungsional secara praktik. Reformasi kelembagaan, edukasi hukum bagi tenaga medis, dan pembentukan unit advokasi pasien di rumah sakit menjadi langkah strategis untuk memperkuat perlindungan hukum dalam sistem JKN.
Evaluasi Tanggung Jawab Yuridis RSUD Wangaya: Studi Empiris terhadap Manajemen dan Tenaga Medis
Background: Hospitals, as healthcare service institutions, not only perform medical functions but also bear juridical responsibilities for every action undertaken by medical personnel and management. These responsibilities encompass civil, criminal, and administrative aspects, requiring legal accountability and the protection of patients’ rights. Wangaya General Hospital, as a government referral hospital in Denpasar City, constitutes a relevant subject for examining the implementation of such responsibilities. Objective: This study aims to evaluate the forms of juridical responsibility implemented at Wangaya General Hospital, both by management and medical personnel, and to identify structural and cultural barriers in its application. Methods: This research employed a juridical-empirical approach with qualitative methods. Data were collected through in-depth interviews with hospital management and medical staff, direct observation, and a review of the hospital’s internal legal documents. The analysis was conducted descriptively and qualitatively using data reduction, thematic categorization, and source triangulation techniques. Results: The study found that structurally, Wangaya General Hospital already possesses adequate legal instruments and internal policies. However, their implementation remains suboptimal. Medical personnel still demonstrate limited legal awareness, incident reporting has not been carried out effectively due to a weak culture of open reporting (just culture), and the implementation of standard operating procedures (SOPs) is often formalistic. Legal responsibilities tend to be managed reactively and are not yet grounded in an integrated legal risk management framework. Conclusion: Strengthening the legal risk management system at Wangaya General Hospital, improving legal literacy among medical personnel, and fostering an organizational culture that supports incident reporting and legal accountability are necessary steps. These efforts are crucial to ensuring fair legal protection for both patients and medical personnel while simultaneously enhancing the quality of healthcare services. Latar belakang: Rumah sakit sebagai institusi pelayanan kesehatan tidak hanya menjalankan fungsi medis, tetapi juga memiliki tanggung jawab yuridis atas setiap tindakan yang dilakukan oleh tenaga medis maupun manajemen. Tanggung jawab ini mencakup aspek perdata, pidana, dan administratif yang menuntut akuntabilitas hukum dan perlindungan hak pasien. RSUD Wangaya sebagai rumah sakit rujukan pemerintah di Kota Denpasar menjadi subjek yang relevan untuk mengkaji implementasi tanggung jawab tersebut. Tujuan: Penelitian ini bertujuan untuk mengevaluasi bentuk pelaksanaan tanggung jawab yuridis di RSUD Wangaya, baik oleh unsur manajemen maupun tenaga medis, serta mengidentifikasi hambatan struktural dan kultural dalam penerapannya. Metode: Penelitian menggunakan pendekatan yuridis-empiris dengan metode kualitatif. Data dikumpulkan melalui wawancara mendalam dengan pihak manajemen dan tenaga medis, observasi langsung, serta telaah dokumen hukum internal rumah sakit. Analisis dilakukan secara deskriptif-kualitatif dengan teknik reduksi data, kategorisasi tematik, dan triangulasi sumber. Hasil: Penelitian menemukan bahwa secara struktural, RSUD Wangaya telah memiliki instrumen hukum dan kebijakan internal yang memadai. Namun, pelaksanaannya belum optimal. Tenaga medis masih memiliki pemahaman hukum yang terbatas, pelaporan insiden medis belum berjalan efektif karena rendahnya budaya pelaporan terbuka (just culture), dan implementasi SOP sering kali bersifat formalistik. Tanggung jawab hukum cenderung dikelola secara reaktif dan belum berbasis manajemen risiko hukum yang terintegrasi. Kesimpulan: Diperlukan penguatan sistem manajemen risiko hukum di RSUD Wangaya, peningkatan literasi hukum bagi tenaga medis, serta pembentukan budaya organisasi yang mendukung pelaporan insiden dan akuntabilitas hukum. Upaya ini penting untuk menjamin perlindungan hukum yang adil bagi pasien dan tenaga medis sekaligus meningkatkan mutu layanan kesehatan.
Perlindungan Hukum Pasien dalam Pelayanan Asuransi Kesehatan: Perspektif Perundang-undangan dan Asas Keadilan
Background: Health insurance serves as a principal instrument to ensure public access to healthcare services. However, in practice, the relationship between patients and healthcare insurance providers often poses legal challenges, particularly when rigid or disproportionate administrative systems constrain patients’ rights. This situation generated disparities in legal protection and substantive injustice within healthcare services. Objective: This study aimed to analyze legal protection for patients in the context of healthcare insurance services based on the prevailing legislative framework in Indonesia, and to evaluate its conformity with the principle of justice as a fundamental legal norm in public service delivery. Methods: This study employed a normative-juridical approach through an analysis of laws, presidential regulations, and institutional documents governing the national health insurance system. Data were analyzed descriptively and qualitatively using thematic categorization and normative interpretation techniques. Results: Although regulations normatively stipulated patients’ rights, their implementation did not fully reflect substantive justice. Patients were often placed in a legally subordinate position, faced difficulties in filing objections, and lacked legal assistance. The principle of justice had not been comprehensively internalized within insurance-based healthcare services, particularly in the benefit system, tiered referral mechanisms, and medical treatment refusals. Conclusion: Legal protection for patients in healthcare insurance services continued to encounter gaps between normative law and practical implementation. Institutional reforms, improved legal literacy, and the establishment of dispute resolution mechanisms oriented toward substantive justice were required to realize an inclusive and responsive national health insurance system. Latar belakang: Asuransi kesehatan merupakan instrumen utama dalam menjamin akses pelayanan kesehatan masyarakat. Namun dalam praktiknya, relasi antara pasien dan penyelenggara jaminan kesehatan kerap menghadirkan tantangan hukum, terutama ketika hak pasien dibatasi oleh sistem administratif yang kaku atau tidak proporsional. Hal ini menimbulkan ketimpangan perlindungan hukum dan ketidakadilan substantif dalam layanan kesehatan. Tujuan: Penelitian ini bertujuan untuk menganalisis perlindungan hukum pasien dalam konteks pelayanan asuransi kesehatan berdasarkan kerangka perundang-undangan yang berlaku di Indonesia, serta mengevaluasi kesesuaiannya dengan asas keadilan sebagai prinsip hukum dasar dalam pelayanan publik. Metode: Penelitian menggunakan pendekatan yuridis-normatif melalui analisis terhadap undang-undang, peraturan presiden, serta dokumen kelembagaan yang mengatur jaminan kesehatan nasional. Data dianalisis secara deskriptif-kualitatif dengan teknik kategorisasi tematik dan penafsiran normatif. Hasil: Meskipun regulasi telah mengatur hak-hak pasien secara normatif, implementasinya belum sepenuhnya mencerminkan keadilan substantif. Pasien sering kali berada dalam posisi subordinat secara hukum, menghadapi kesulitan dalam mengakses keberatan, dan tidak mendapatkan pendampingan hukum. Asas keadilan belum diinternalisasi secara utuh dalam pelayanan berbasis asuransi kesehatan, terutama dalam sistem manfaat, rujukan berjenjang, dan penolakan tindakan medis. Kesimpulan: Perlindungan hukum pasien dalam layanan asuransi kesehatan masih menghadapi kesenjangan antara hukum normatif dan praktik implementatif. Diperlukan reformasi kelembagaan, peningkatan literasi hukum, serta sistem penyelesaian sengketa yang berpihak pada keadilan substantif demi mewujudkan sistem jaminan kesehatan yang inklusif dan responsif.
Membangun Budaya Hukum di Rumah Sakit: Strategi Preventif Menghadapi Risiko Hukum dalam Layanan Kesehatan
Background: Hospitals, as healthcare institutions, are not only responsible for providing medical services but also bear a legal obligation to ensure legal protection for both patients and healthcare professionals. In the context of increasing litigation risks and the growing complexity of healthcare services, the development of a hospital's legal culture serves as an essential preventive strategy that has rarely been established systematically. A strong legal culture reflects the awareness, attitudes, and legal behaviors of all organizational elements toward legal norms and risks in healthcare practice. Objective: This study aims to examine the importance of developing a legal culture as a preventive strategy in managing legal risks within hospitals and to formulate institutional approaches that can be applied to strengthen institutional legal protection. Methods: This research employed a juridical-empirical approach by analyzing statutory regulations, legal literature, and relevant institutional policy documents. Data were analyzed descriptively and qualitatively to assess the alignment between legal norms and their implementation at the institutional level within healthcare facilities. Results: The study revealed that most hospitals in Indonesia lacked institutional structures that supported a legal culture. The absence of internal legal units, limited clinical legal training, and the predominance of a blame culture hindered incident reporting and the professional management of legal risks. The concept of just culture, which should have served as the foundation of reporting systems, had not yet been widely implemented. Conclusion: Building a legal culture requires a multidisciplinary and systemic approach through the establishment of active legal units, provision of legal training for healthcare professionals, evaluation of standard operating procedures (SOPs) based on legal principles, and the adoption of a just culture. These strategies are essential to strengthening a healthcare system that is fair, accountable, and legally resilient. Latar belakang: Rumah sakit sebagai institusi pelayanan kesehatan tidak hanya bertanggung jawab dalam aspek medis, tetapi juga memiliki kewajiban yuridis untuk menjamin perlindungan hukum terhadap pasien dan tenaga medis. Dalam konteks meningkatnya potensi litigasi dan kompleksitas layanan, budaya hukum di rumah sakit menjadi strategi preventif penting yang masih jarang dibangun secara sistemik. Budaya hukum yang kuat mencerminkan kesadaran, sikap, dan perilaku hukum seluruh elemen organisasi terhadap norma dan risiko hukum dalam praktik pelayanan. Tujuan: Penelitian ini bertujuan untuk mengkaji pentingnya pembangunan budaya hukum sebagai strategi preventif dalam mengelola risiko hukum di rumah sakit, serta merumuskan pendekatan kelembagaan yang dapat diterapkan untuk memperkuat perlindungan hukum institusional. Metode: Penelitian menggunakan pendekatan yuridis-empiris dengan analisis terhadap ketentuan perundang-undangan, literatur hukum, serta dokumen kebijakan kelembagaan yang relevan. Data dianalisis secara deskriptif-kualitatif untuk menilai kesesuaian antara norma hukum dan implementasinya di tingkat institusi kesehatan. Hasil: Studi ini menunjukkan bahwa sebagian besar rumah sakit di Indonesia belum memiliki struktur kelembagaan yang mendukung budaya hukum. Ketiadaan unit hukum internal, minimnya pelatihan hukum klinis, serta dominannya blame culture menghambat pelaporan insiden dan pengelolaan risiko hukum secara profesional. Konsep just culture yang seharusnya menjadi fondasi sistem pelaporan belum terimplementasi luas. Kesimpulan: Membangun budaya hukum memerlukan pendekatan multidisiplin dan sistemik, melalui pembentukan unit hukum aktif, pelatihan hukum bagi tenaga medis, evaluasi SOP berbasis prinsip hukum, serta adopsi budaya just culture. Strategi ini penting untuk memperkuat sistem pelayanan kesehatan yang adil, akuntabel, dan berdaya tahan secara hukum.
Kesadaran Hukum dalam Pelayanan Rumah Sakit: Relevansi Asas Keseimbangan dalam Hukum Kesehatan Indonesia
Background: The principle of balance constitutes a fundamental concept in health law, emphasizing the importance of ensuring equality between patients’ rights and the obligations of hospitals and medical personnel. This principle serves as a legal foundation to guarantee fair and accountable legal protection in healthcare services. However, its implementation in Indonesia continues to face various challenges, both from normative and operational perspectives. Objective: This study aims to evaluate the application of the principle of balance in healthcare service practices at Wangaya General Hospital and to examine the level of legal awareness among healthcare professionals as a determining factor for its successful implementation. Methods: This research employed a juridical-empirical approach, involving an analysis of statutory provisions, legal literature, and relevant institutional policy documents. Data were analyzed descriptively and qualitatively to assess the alignment between legal norms and their implementation within healthcare institutions. Results: The study revealed that the application of the principle of balance has not yet been fully optimized. The main obstacles include limited legal awareness among medical personnel regarding their juridical responsibilities, the absence of an active internal legal unit, and unequal fulfillment of patients’ rights in clinical practice. Such gaps have the potential to trigger legal disputes and diminish public trust in healthcare institutions. Conclusion: Systemic efforts are required in the form of institutional reform, clinical legal training for medical personnel, and the formulation of legally grounded standard operating procedures (SOPs) to support the internalization of the balance principle. These strategies are essential to establish a healthcare system that is fair, transparent, and accountable within the framework of a rule-of-law state. Latar belakang: Asas keseimbangan merupakan prinsip fundamental dalam hukum kesehatan yang menekankan pentingnya kesetaraan antara hak pasien dan kewajiban rumah sakit serta tenaga medis. Prinsip ini menjadi landasan yuridis dalam menjamin perlindungan hukum yang adil dan akuntabel dalam pelayanan kesehatan. Namun, penerapannya di Indonesia masih menghadapi berbagai hambatan, baik dari sisi normatif maupun operasional. Tujuan: Penelitian ini bertujuan untuk mengevaluasi penerapan asas keseimbangan dalam praktik pelayanan Rumah Sakit Umum Daerah Wangaya serta mengkaji tingkat kesadaran hukum tenaga kesehatan sebagai faktor penentu keberhasilannya. Metode: Penelitian menggunakan pendekatan yuridis-empiris dengan analisis terhadap ketentuan perundang-undangan, literatur hukum, serta dokumen kebijakan kelembagaan yang relevan. Data dianalisis secara deskriptif-kualitatif untuk menilai kesesuaian antara norma hukum dan implementasinya di tingkat institusi kesehatan. Hasil: Studi ini menemukan bahwa penerapan asas keseimbangan belum berjalan secara optimal. Hambatan utama meliputi rendahnya pemahaman hukum tenaga medis terhadap tanggung jawab yuridis, belum tersedianya unit hukum internal yang aktif, serta tidak meratanya pemenuhan hak pasien dalam praktik klinis. Kesenjangan ini berpotensi memicu konflik hukum dan menurunkan kepercayaan publik terhadap institusi pelayanan kesehatan. Kesimpulan: Diperlukan upaya sistemik berupa reformasi kelembagaan, pelatihan hukum klinis bagi tenaga medis, serta penyusunan SOP berbasis hukum yang mendukung internalisasi asas keseimbangan. Strategi ini penting untuk membentuk sistem pelayanan kesehatan yang adil, transparan, dan akuntabel dalam kerangka negara hukum.