Medical Disputes on the Concept of Inspanningsverbintenis vs Resultaatsverbintenis: A Critical Review

Abstract

The relationship between patients and doctors in health services is a therapeutic contract-based relationship. The therapeutic contract begins with an (unwritten) agreement where both parties are assumed to be accommodated when the agreement is reached. Agreement that can be reached include agreeing to medical action or rejecting a medical action plan. Doctors as health workers who work in the health care sector are involved in a working relationship with the hospital as a place to carry out their profession. A doctor working in a hospital also has an administrative relationship that affects rights and obligations between the two parties and responsibilities to third parties. In the relationship between patients and the hospital, patients are the recipient of health services and the hospital is the provider of such services. Hospitals are obliged to provide health services in accordance with health care standards. Doctors, patients and hospitals are in a relationship based on trust, under an assumption that doctors can cure patients' illnesses and will do the best for patients. However, this mindset has changed along with the times, science, and technology that affect the human mind. Their social-moral-oriented relationship has turned into a material-oriented one because doctors face various demands to improve their professionalism. The change in orientation above is one of the causes of medical conflicts and disputes. Conflicts arise between doctors as health service provider and patients as health service receivers. Conflicts can turn into disputes if the party who feels aggrieved has expressed dissatisfaction with the party considered to be the cause. Medical disputes have risen sharply along with the disruption of services amid the turbulence of the COVID-19 pandemic throughout 2020 and 2021. The high rate of disputes also begs question of quality control of health services. This qualitative research-based article attempted to describe and analyze the phenomenon of medical disputes at the Dr. Iskak General Hospital of Tulungagung using the conception of inspanningsverbintenis vs resultaatsverbintenis. The findings show that, in the provision of health services, there may arise four violation categories, namely: ethical violations, disciplinary violations, administrative violations, and legal (both civil and criminal) violations.