Legal Responsibility for Patient Rights for Negligence in Health Services According to Law Number 44 of 2009

Hospitals are health care institutions that organize comprehensive individual health services that provide inpatient, outpatient, and emergency care. Based on Article 46 of Law Number 44 of 2009 concerning Hospitals, which states that hospitals are legally responsible for all losses caused by the negligence of health workers in hospitals. As the law develops, the position of patients as consumers and doctors and other medical personnel as health servants becomes equal. This equal position then creates rights and obligations that must be fulfilled from each party. This study aims to determine the responsibility of hospitals for the negligence of their medical personnel and the legal protection of patients in the act of childbirth performed in hospitals by being linked to Law Number 36 of 2009 concerning Health. This research is made using normative juridical methods through legal and conceptual approaches with primary, secondary and tertiary legal materials to support the research. The result of this research is legal certainty related to the hospital's responsibility towards the patient and legal protection of the patient's rights for negligence committed by medical personnel.


INTRODUCTION
Health is a human right and one of the elements of welfare that must be realized in accordance with the ideals of the Indonesian nation as stated in Pancasila and the Preamble of the 1945 Constitution of the Republic of Indonesia in 28H paragraph (1) of the 1945 Constitution which explains that everyone has the right to live and has the right to defend his life and life, and has the right to obtain health services. 1ospitals are health care institutions that organize comprehensive individual health services that provide inpatient, outpatient and emergency services.Hospitals as business entity organizations in the health sector have an important role in realizing optimal public health status, therefore hospitals are required to be able to manage their activities, by prioritizing the responsibilities of professionals in the health sector, especially the responsibilities of medical personnel in carrying out their duties and authorities.The implementation of health management in hospitals, there is management related to three things that are the responsibility of hospitals in general.These three things are: hospital management related to duty of care (obligation to provide good ISSN: 2808-103X Proceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pssh/issue/view/2840 service); hospital management related to facilities and equipment; and management related to personnel (health workers). 2ealthcare has improved over time.Better care through more modern science or technology has created hope for a longer life span and made it easier for doctors to make more accurate diagnoses and perform appropriate medical procedures on patients.The implementation of this medical service forms a relationship between the patient and the doctor, namely the doctor as a provider of medical services and the patient as a recipient of medical services, and the relationship between the doctor and the patient forms an agreement.
The therapeutic agreement between a doctor and a patient is often overlooked, either by a doctor or a patient.The lack of understanding between the two, especially the patient, often causes problems in the world of health concerning the practice of medicine.Problems regarding non-disclosure of information that is the right of a patient, misdiagnosis, and approval of medical actions.Patients will tend to just obey what a doctor orders because of their ignorance.Therapeutic agreements have special properties and characteristics, not the same as the properties and characteristics of agreements in general, because the object of the agreement in therapeutic transactions is not the patient's recovery, but rather finding the right effort for the patient's recovery, also called Inspaningsverbintenis. 3 It is not always the case that medical services provided by health workers go well or can provide results as expected by the parties.There are times when there is negligence on the part of health workers that causes catastrophe; such as disability, paralysis or even death.When this happens, patients or their families often claim compensation.For example, in the case of a patient named Evi who was going to give birth normally in a hospital in the city of Bumiayu, then a few days later after the delivery process she experienced difficulty or pain when urinating, after being checked it turned out that there was gauze left in the urethra channel.This happened because of the negligence of one of the m idwives who handled the delivery process.The family also asked for compensation from the hospital.
This request for compensation is due to the consequences that arise, both physical and non-physical.Physical losses include the loss or malfunctioning of all or part of the body's organs.Non-physical losses are losses related to a person's dignity.The opportunity to claim compensation now has a basic provision. 4ased on Article 46 of Law No. 44 of 2009 concerning Hospitals, which states that hospitals are legally responsible for all losses caused by the negligence of health workers in hospitals.The provisions of this article become the juridical basis for someone to hold the hospital responsible in the event of negligence of health workers that causes harm. 5he hospital is legally responsible for damages caused by the negligence of medical personnel and this also applies according to the legal basis of Section 1367 of the Civil Code, Section 1367(1) of the Civil Code states that a person is not only responsible for losses caused by his own actions, but also for losses caused by the actions of those under his responsibility or property under his control.This provision is then emphasized in Article 1367 paragraph 3. 6 This study aims to determine the responsibility of hospitals for the negligence of their medical personnel and the legal protection of patients in the act of childbirth performed in hospitals by being linked to Law Number 36 of 2009 concerning Health.This research is made using normative juridical methods through legal and conceptual approaches with primary, secondary and tertiary legal materials to support the research.
Negligence committed by medical personnel today is not a new occurrence.Many studies have been conducted over the past few years to examine the responsibility of hospitals for negligence committed by medical personnel.However, after reviewing several studies, it was found that the studies of Stefany B. Sandiata, "Legal protection of the right to health services in Government Hospitals," Lokadata, November 09, 2013, https://ejournal.unsrat.ac.id/v3/index.php/administratum/article/view/3028/2573,previously focused only on the urgency of legal protection of patients' rights and legal protection of the right to obtain health services.
In addition, several other studies discuss the Legal Analysis of Therapeutic Contracts on Medical Actions in the Relationship between Patients and Doctors in Hospitals, Richard Nuha (2016) According to the Decree of the Minister of Health of the Republic of Indonesia No. 340/MENKES/PER/III/2010 is: "A hospital is a health care institution that organizes comprehensive individual health services that provide inpatient, outpatient and emergency services".In an emergency, hospitals must prioritize the interests of patients.This is because health care facilities (including hospitals) are obliged to provide health services for saving the patient's life and preventing disability first.(Article 32, Paragraph (1).Hospitals may not refuse patients under any circumstances or ask for an advance payment.(Article 32, Paragraph (2).Despite the prohibition of asking for an advance payment, hospitals still ask for an advance payment before providing health services to their patients.This is unfortunate because the hospital, which is based on social functions, has instead turned into a commercialist one.Hospitals also need payment for health services that have been provided to their patients.However, it is better if the hospital prioritizes the interests of its patients before asking for an advance payment to the patient or the patient's family, especially for patients who need immediate medical treatment (emergency patients). 8n Article 46 of Law No. 44 of 2009 concerning Hospitals, the responsibility of hospitals is: "The hospital is legally responsible for all losses caused by negligence committed by health workers in the hospital." 9he responsibility of the hospital as mentioned in Article 46 of Law No. 44 of 2009 is also responsible for negligence committed by health workers.The legal basis for hospital liability in health services performed by health workers against their patients is the existence of a legal relationship between the hospital as an organizer of health services / medical services and the patient as a user of health services.The legal relationship is born from an engagement or agreement on health services called a teraupetic agreement. 10uridically, a teraupetic agreement is defined as a legal relationship between health workers and patients in professional medical services based on competence in accordance with certain expertise and skills in the health sector.According to Hermien H Koeswadji, teraupetic transactions are agreements to find or determine the most appropriate therapy for patients by doctors and health workers.Meanwhile, according to Veronica Komlawati, teraupetic transaction is a legal relationship between doctors (health workers) and patients in professional medical services, based on competence in accordance with certain expertise and skills in the health sector.This means that the level of provision of health services, both by doctors and by nurses and other health workers must be based on professional standards.Thus, the hospital is legally responsible if there is a provision of 'cure and care' services that are unusual or below standard.c.Responsibility for facilities and equipment This area of responsibility includes basic hospitality equipment, hospitality, medical equipment, and so on.The most important thing is that the equipment should always be in a safe and ready-to-use condition at all times.d.Responsibility for building safety and maintenance For example, the building collapses, the roof tiles fall and injure people, the floor is so slippery that a visitor falls and suffers an invoice, and so on.
The legal relationship between hospitals and patients is a civil relationship that emphasizes the implementation of the rights and obligations of each party reciprocally.Hospitals are obliged to fulfill the rights of patients and patients are obliged to fulfill the rights of hospitals.The failure of one party to fulfill the rights of the other party, whether due to default or negligence, will result in a lawsuit or civil claim in the form of compensation for losses suffered by the patient.

Legal Protection of Patient Rights in Health Services
Rights and obligations in the life of society, nation and state are two things that are correlative.This means that in a legal relationship, the rights of one party are a necessity for the other party.In providing health services, doctors or health workers who are in direct contact with patients should do their best for patients or the community.That is a general obligation that must be fulfilled by doctors or health workers.Conversely, patients and the public, in addition to having the right to receive good health services, are also obliged to comply with all the recommendations of doctors and other medical personnel or health workers to prevent negative or unwanted treatment results. 12egal protection of patients' rights in health services based on Law Number 36 of 2009 is regulated in Article 58 which stipulates; 13 (1) Every person has the right to claim compensation against a person, health worker, and/or health provider who causes harm as a result of an error or negligence in the health services they receive.
(2) The claim for compensation as referred to in paragraph (1) does not apply to health workers who perform life-saving measures or prevent someone's disability in an emergency.
Based on the provisions of Article 58 of Law Number 36 of 2009, it can be understood that the legal protection of patients' rights in health services based on the Health Law is the protection of patients' rights through civil lawsuits to claim compensation.In the framework of protecting patients' rights, the law gives patients the right to sue, in the event of services that are not in accordance with service standards, or often called malpractice. 14very person has the right to the confidentiality of his/her personal health condition that has been disclosed to the health service provider.The right to confidentiality of personal health conditions does not apply in the event of: 15 1.Order of the law. 11
interests of the person.

in Medical Services according to Law No. 44 Year 2009 on Hospitals
, Lokadata, https://ejournal.unsrat.ac.id/index.php/lexetsocietatis/article/view/11527, while the author will discuss the Legal Responsibility for Patient Rights for Negligence in Health Services according to Law Number 44 Year 2009.Tinjauan Yuridis Sahnya Perjanjian Terapeutik dan Perlindungan Hukum Bagi Pasien.Surakarta.Jurnal Privat Law Volume 1, 2 Nomor 4. universitas Sebelas Maret, hlm 4. Based on the background that has been described, the problems to be discussed are: a) How is the responsibility of hospitals for the negligence of medical personnel in health services according to Law No. 44 of 2009 concerning Hospitals?b) How is the legal protection of the patient's rights against the negligence of medical personnel in relation to Law No. 36 of 2009 concerning Health?III.RESEARCH METHODS In this journal, the type of research used is normative juridical research, which is a method guided by the laws and regulations.This legal research uses qualitative descriptive techniques, namely research used to describe problems that occur in the present or are ongoing.In this research, the Statute Approach, and Conceptual Approach are used.Legislation used as primary legal material includes: 1) Constitution of the Republic of Indonesia 1945, 2) Law Number 36 of 2009 concerning Health, 3) Law Number 44 of 2009 concerning Hospitals, 4) Law Number 36 of 2014 concerning Health Workers, 5) Civil Code, 6) Regulation of the Minister of Health of the Republic of Indonesia 340/MENKES/PER/III/2010 concerning Classification.While from secondary legal materials, namely: text books, legal dictionaries, legal journals, internet, draft laws and regulations.This research uses the library research method.Library research where the collection of legal materials can utilize legal indexes (index of legislation, index of court decisions, and books) both print and electronic including the internet.Patients according to Article 1 number 10 of Law Number 29 of 2004 concerning Medical Practice are every person who consults their health problems to obtain the necessary health services either directly or indirectly to a doctor or dentist. 7 3Wijanarko, B., & Sari, M. P, 2014.ISSN: 2808-103XProceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pssh/issue/view/28 ISSN: 2808-103X Proceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pssh/issue/view/2842 According to Guwandi, a hospital has 4 (four) areas of responsibility, namely: a. Responsibility for personnel This is based on the 'employer-employee' relationship.This relationship was once universal and our country is still in effect based on the Civil Code Article 1366 jo Article 1365 jo.Article 1367.This responsibility includes all employees working in the hospital.b.Professional responsibility for the quality of treatment or