When Medicine Becomes a Legal Battlefield: Fransiscus Nanga Roka and the Fight to Protect Indonesia’s Doctors and Nurses -By Fransiscus Nanga Roka

Doctors around the world are expected to make life saving decisions within seconds. They shoulder a huge responsibility for human life and for ethics, as well professional duty. And there is another load of worry added onto the act of healing, that legal proceedings might in future arise from it.

Here, as in many other countries, doctors and nurses in Indonesia are increasingly finding themselves faced not only with clinical confusion but also the growing force of law. When law instead of medicine is the battleground, this poses a threat to the health system as a whole.

At the heart of the emerging debate is Dr. Fransiscus Nanga Roka, a figure who straddles two worlds: medicine and law. As a physician and activist, and head of Yeshua Hamashia Law Firm, Miracles Law Firm and Law Firm Victorious, he has embarked on a mission that are as controversial as they are pressing–protecting Indonesia’s doctors and health workers from the legal risks inherent in treating patients.

The mission is, at heart, not just about defending individual people, but about defending the very integrity of health care itself.

Medical practice is inherently uncertain. Doctors often have to make decisions under severe time pressures, limited information and resources and the constant possibility of unexpected results. Even when medical professionals are following established clinical standards, complications may still arise. However, limited understanding of medical facts has sometimes led to adverse alterations being interpreted as negligence or malpractice in medical treatment. Yet in a climate that has become increasingly litigious, get perverted outcomes often without full comprehension of medical realities.

As a result, there is a very dangerous worldwide tendency known as “defensive medicine.” This is where doctors begin practice not primarily to help their patients, but to protect themselves legally. As a result of doctors’ fear being sued, medical judgement is hobbled; instead of brave clinical decisions, healthcare turns cautious, bureaucratic, slow.

Indonesia is willing to face this problem by means of law No. 17, 2023 on health which stresses the necessity of ensuring and providing legal protection for people in the national health system. The law acknowledges that delivering healthcare is a tightrope act. It strikes a balance between patient rights on one hand and protection for those medical personnel who act in good faith with their best information in mind on the other. The law also emphasizes the state’s responsibility to establish a system that is both safe, fair and legally certain for patients and health workers.

In essence, the law recognizes a fundamental fact. If those who are responsible for saving lives are always afraid they could be indicted for murder, a health system will not function at all.

However, written rules do not guarantee real life results. Misinterpretation of medical procedures, media sensationalism and public misunderstanding can quickly turn medical disputes into legal crises. Doctors are often left isolated and threatened even if it done in good faith, a professional lacking any legal knowledge.

At this point in time, it becomes clear that legal advocacy is absolutely necessary.

Dr. Fransiscus Nanga Roka ‘s work is to reach out to two disciplines that understand and misunderstand each other often: law and medicine. His plan is formed by multiple law firms, mobilizing these to provide legal aid, defense, and protection for doctors and nurses nursing people across Indonesia. It is not meant to cover up misbehavior or negligence; rather, it aims to ensure that legal evaluation of a doctor’s actions is carried out on scientific grounds with a professional background of medical experience.

In other words, the principles of medical science, rather than law, should provide medicine with justice.” The real issue here is not merely Indonesian. Healthcare workers all over the world have been facing an increasing amount of law suits. In the United States, Europe and Asia (to some extent) medical litigation has already changed relationships between doctors and patients. Accountability is necessary. It is wrong, however, to exaggerate the criminalisation of medicine at the expense of doctor’s autonomy, medical autonomy and the introduction of medicalised style into every slight surgical intervention have little to do with each other. If doctors begin avoiding complicated cases through fear of litigation, the patient ultimately suffers. For health care systems to function, trust between patients and health care providers is essential, while trust of the health care system by society as a whole becomes crucial. Medicine on this scale is defensive and brittle when such trust is removed. The pandemic made the world acutely aware of the extraordinary sacrifices made by health workers. Many risked their lives to treat patients without adequate protection from infection. Yet the postpandemic period has shown just how vulnerable medical professionals are when involved in litigation. The question facing Indonesia now, as many other nations embarks on a similar process of democratisation is: How can society control doctors without turning them into legal scapegoats? Dr Fransiscus Nanga Roka is an example of one response. By combining his knowledge of medicine and the law, he seeks to set up an environment where disputes are resolved in a fair, scientific and open way. This is part of a broader awareness that health justice must be addressed through interdisciplinary understanding. Doctors should be no more immune from the law than anyone else. But it is equally impossible for them to defend themselves when the law invades the wards. It is not so much that protecting the physician enters one professionism it is about protecting the crucial function of life saving systems. A society where doctors live under perpetual fear of being sued is a society that can’t keep its flow of blood alive for long.

This war would possess its own particular characteristics. If the law is to become battleground of fight, the wound will not only be borne by doctors. The people who count on their own courage, wisdom and very humanity would be among true victims.