Main Article Content
Abstract
The use of the term therapeutic contract in Indonesia originates from opinions underpinning the Guide to Conduct of the Indonesian Medical Code of Ethics (KODEKI). Based on a contractual relationship, agreements about medical treatment are generally conducted informally and without written document, given the occupied environment of medical services. Nevertheless, in certain cases, contractual issues give rise to legal arguments concerning informed consent. Such problems emerge when routine medical procedures resulted in harm to patients, and the absence of informed consent may generate further liability for medical practitioners and even the hospitals. Against this legal issue, this article examines the extent to which contract law influences the therapeutic contractual relationship, and whether the nature of the therapeutic contract ought properly to be regarded as an informal gentlemen’s agreement or as a legally binding obligation. The study employs doctrinal legal research methods, adopting both statutory and conceptual approaches. The analysis is further supplemented by a minor comparative study, drawing upon Book Seven of the Nieuw Burgerlijk Wetboek (NBW) and Act No. 17 of 2023 of Republic of Indonesia about Health. The findings suggest that the therapeutic contract constitutes a distinct form of contract which should be differentiated from informed consent, by virtue of its trust-based character akin to a gentlemen’s agreement. Through recommendations for an ideal codification, this study aspires to provide a prescriptive foundation for the legal recognition of therapeutic contracts in Indonesia.
Keywords
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(DCL), Dutch Civil Law. “Civil Code Book 7.” Dutch Civil Law, 2025. http://www.dutchcivillaw.com/civilcodebook077.htm.
Adu-Gallant, Charelity, Jaan Toelen, Judith Sluiter-Post, David De Coninck, and Peter de Winter. “Knowledge Gaps and Bridges: The Relationship between the Awareness of General Patient Rights and the Awareness of Minors’ Patient Rights in the Netherlands.” Children 11, no. 109 (2024): 1–12. https://doi.org/https://doi.org/10.3390/children11010109.
Ameln, Fred. Kapita Selekta Hukum Kedokteran. Jakarta: Grafikatama Jaya, 1991.
Amin, Md Al, Hemanth Tummala, Rushabh Shah, and Indrajit Ray. “Balancing Patient Privacy and Health Data Security: The Role of Compliance in Protected Health Information (PHI) Sharing.” In Proceedings of the 21st International Conference on Security and Cryptography (SECRYPT 2024), 211–23. Dijon, France, 2024. https://par.nsf.gov/servlets/purl/10581413.
Armitage, Richard. “Why We Must Stop ‘Consenting the Patient.’” British Journal of General Practice 73, no. 731 (2023): 268–69. https://doi.org/https://doi.org/10.3399/bjgp23X733053.
Asnawi, M. Natsir. “Aspek Hukum Janji Prakontrak Dalam Pranata Hukum Kontrak Indonesia.” Jurnal Hukum & Pembangunan 49, no. 3 (2019): 497–516.
Astuti, Endang Kusuma. “Legal Relationship Between Doctors And Patients In Medical Service Effort.” Diponegoro Law Review 2, no. 1 (2017): 123–40. https://ejournal.undip.ac.id/index.php/dlr/article/download/15330/11660.
Atiyah, P.S. An Introduction to the Law of Contract. 5th ed. Oxford: Clarendon Press, 1995.
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. 7th ed. Oxford: Oxford University Press, 2013.
Berke, Daryl M. “Drive-by-Doctoring: Contractual Issues and Regulatory Solutions to Increase Patient Protection from Surprise Medical Bills.” American Journal of Law & Medicine 42, no. 1 (2016): 170–89. https://doi.org/https://doi.org/10.1177/0098858816644720.
Buamona, Hasrul, Irma Febriana, and Rika Aulia Bihaqqis. “Membangun Peradilan Profesi Medis Di Bawah Kekuasaan Kehakiman.” Jurnal Yuridis 11, no. 1 (2024): 34–53. https://ejournal.upnvj.ac.id/Yuridis/article/download/7565/2995.
Clark, Chalmers C. “Trust in Medicine.” Journal of Medicine and Philosophy 27, no. 1 (2002): 11–29. https://doi.org/https://www.tandfonline.com/doi/abs/10.1076/jmep.27.1.11.2975.
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Herring, Jonathan. Medical Law and Ethics. 6th ed. Oxford: Oxford University Press, 2016.
Hernoko, Agus Yudha. Hukum Perjanjian: Asas Proporsionalitas Dalam Kontrak Komersial. Jakarta: Kencana Prenada Media Grup, 2010.
Holy A., Caretta-Weyer, Smirnova Alina, Barone Michael A., Frank Jason R., Hernandez-Boussard Tina, Levinson Dana, Lombarts Kiki M.J.M.H., et al. “The Next Era of Assessment: Building a Trustworthy Assessment System.” Perspectives on Medical Education 13, no. 1 (2024): 12–23. https://doi.org/https://doi.org/10.5334/pme.1110.
Hutchinson, Terry. “The Doctrinal Method: Incorporating Interdisciplinary Methods in Reforming the Law.” Erasmus Law Review 8, no. 3 (2015): 130–38.
Indonesia, Majelis Kehormatan Etik Kedokteran. Kode Etik Kedokteran Indonesia Dan Pedoman Pelaksanaan Kode Etik Kedokteran Indonesia. Jakarta: Ikatan Dokter Indonesia, 2002. https://aseanhealthcare.org/admin/country/country_document/download/67/Kode_Etik_Kedokteran_MKEK.pdf.
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Jang, Dooseok, Amrish Patel, and Martin Dufwenberg. “Agreements with Reciprocity: Co-Financing and MOUs.” Games and Economic Behavior 111, no. (2018): 85–99. https://doi.org/https://doi.org/10.1016/j.geb.2018.06.004.
Kakar, Heena, Ramandeep Singh Gambhir, Simarpreet Singh, Amarinder Kaur, and Tarun Nanda. “Informed Consent: Corner Stone in Ethical Medical and Dental Practice.” Journal of Family Medicine and Primary Care 3, no. 1 (2014): 68–71. https://pmc.ncbi.nlm.nih.gov/articles/PMC4005206/pdf/JFMPC-3-68.pdf.
Knapp, Charles L. “Enforcing the Contract to Bargain.” New York University Law Review 44, no. (1969): 673–728. https://repository.uclawsf.edu/faculty_scholarship/339.
Koeswadji, Hermien Hadiati. Hukum Kedokteran: Studi Tentang Hubungan Hukum Dalam Mana Dokter Sebagai Salah Satu Pihak. Bandung: PT Citra Aditya Bakti, 1998.
Komalawati, Veronica. Hukum Dan Etika Dalam Praktek Dokter. Jakarta: Pustaka Sinar Harapan, 1989.
Kovic, Živa, Motheo Kobua, Mary Fogarty, Claire L. Donohoe, Michael E. Kelly, Gerard J. Fitzmaurice, Mella Fitzgerald, Paul Zambra, Una Geary, and Marie E. Ward. “Valid Consent in the Acute Hospital Setting: Perspectives of Patients and Members of the Public.” Irish Journal of Medical Science 193, no. 1971 (2024): 1703–14. https://pmc.ncbi.nlm.nih.gov/articles/PMC11294267/pdf/11845_2024_Article_3658.pdf.
Kurniawan, I Gede Agus, and Ade Chandra. “The Civil Law Aspects of Informed Consent to Medical Procedures.” SASI 30, no. 3 (2024): 326–38. https://fhukum.unpatti.ac.id/jurnal/sasi/article/download/2277/1113.
Law, Jonathan, ed. Oxford Dictionary of Law. 10th ed. Oxford, UK: Oxford University Press, 2022. https://doi.org/10.1093/acref/9780192897497.001.0001.
Lichtblau, Steven. “The Unwritten Contract Between Physician and Patient.” Canadian Family Physician 29, no. (1983): 2219–24. https://pmc.ncbi.nlm.nih.gov/articles/PMC2154297/pdf/canfamphys00237-0220.pdf.
Majid, Ayesha. “Patient Rights: Consent and Informed Consent: A Legal Study.” Indian Journal of Law and Legal Research 3, no. 1 (2021): 1–14. https://heinonline.org/HOL/PrintRequest?collection=journals&handle=hein.journals/injlolw3&div=187&id=1956&print=section&format=PDFsearchable&submit=Print%2FDownload.
Makasenggehe, Christiana Jullia, Theodorus H. W. Lumunon, and Cobi E. M. Mamahit. “Aspek Hukum Transaksi Terapeutik Antara Tenaga Medis Dan Pasien.” Lex Privatum XII, no. 1 (2023): 1–10. https://ejournal.unsrat.ac.id/index.php/lexprivatum/article/download/49315/43161.
Marzuki, Peter Mahmud. Penelitian Hukum. Jakarta: Kencana Prenada Media Grup, 2005.
———. Pengantar Ilmu Hukum. Revised. Jakarta: Kencana, 2024.
McBryde, William W. “Void, Voidable, Illegal and Unenforceable Contracts in Scots Law.” University of Glasgow, 1976. https://theses.gla.ac.uk/2488/1/1976McBrydePhD.pdf.
Netherland, Kingdom of the. “Burgerlijk Wetboek Boek 7.” Overheid.nl, 2025. https://wetten.overheid.nl/BWBR0005290/2025-07-18.
Nugroho, Hari Pudjo, and Agus Yudha Hernoko. Karakteristik Kontrak Pelayanan Kesehatan: Tanggung Gugat Tenaga Medis, Tenaga Kesehatan, Dan Rumah Sakit Berbasis Keadilan Proporsional. Edited by Hari Pudjo Nugroho. Bali: Pustaka Ekspresi, 2024.
Pont, Anna Veronica, Kevin Mario Immanuel, Natasya Yunita Sugiastuti, Zabidin, and Stelvia W. Noya. “Legal Aspects of Informed Consent in Medical Procedures.” International Journal of Health, Economics, and Social Sciences 7, no. 4 (2025): 1944–48. https://doi.org/10.56338/ijhess.v7i4.8795.
Purwanto, Agus. “Informed Consent Sebagai Persetujuan Perjanjian Terapeutik.” UNES Law Review 7, no. 3 (2025): 1244–60. https://doi.org/https://doi.org/10.31933/unesrev.v7i3.2417.
Richman, Barak. “On Doctors and Judges.” Duke Law Journal 58, no. (2008): 1731–41. https://scholarship.law.duke.edu/cgi/viewcontent.cgi?article=1418&context=dlj.
Rogers, W. P. “Void, Illegal or Unenforceable Consideration.” The Yale Law Journal 17, no. 5 (1908): 338–46. https://doi.org/https://doi.org/10.2307/784055.
Roida, Alma Sanmowa, and Diana Tantri Cahyaningsih. “Tanggung Jawab Hukum Dalam Tahap Pra-Kontrak: Studi Atas Memorandum of Understanding (MoU) Menurut Sistem Hukum Perdata Indonesia.” Indonesian Journal of Social Sciences and Humanities 5, no. 2 (2025): 257–63. http://journal.publication-center.com/index.php/ijssh/article/download/1865/553.
Saifudin, Muhamad, Hardi Anugrah Santoso, Fajar Rachmad Dwi Miarsa, Nur Qoilun, and Sugiarto Raharjo Japar. “Comparative Study of The Good Faith Concept between Indonesia and The Netherlands in Civil Law.” YURIS: Journal of Court and Justice 3, no. 1 (2024): 1–17. https://doi.org/doi.org/10.56943/jcj.v3i1.481.
Scott, Robert E. “A Theory of Self-Enforcing Indefinite Agreements.” Columbia Law Review 103, no. 7 (2003): 1641–99. https://academiccommons.columbia.edu/doi/10.7916/D8C53XQW/download.
Siregar, Rospita Adelina. Hukum Kesehatan. Edited by Kurniawan Ahmad. Jakarta: Sinar Grafika, 2024.
Soeparto, Pitono, ed. Etik Dan Hukum Di Bidang Kesehatan. 2nd ed. Surabaya: Airlangga University Press, 2006.
Solichin, Sudjari. “Persetujuan Tindakan Kedokteran (Informed Consent).” In Ilmu Kedokteran Forensik Dan Medikolegal, edited by H. Hoediyanto and H. Hariadi Apuranto, 8th ed., 405–14. Surabaya: Departemen Ilmu Kedokteran Forensik dan Medikolegal Fakultas Kedokteran Universitas Airlangga, 2012.
Sullivan, Charles A. “The Puzzling Persistence of Unenforceable Contract Terms.” Ohio State Law Journal 70, no. 5 (2009): 1127–78. https://heinonline.org/hol-cgi-bin/get_pdf.cgi?handle=hein.journals/ohslj70§ion=44.
Susanti, Dyah Ochtorina, and A’an Efendi. Penelitian Hukum (Legal Research). Jakarta: Sinar Grafika, 2018.
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