Juridical Aspects of Diagnostic Errors in Specialist Dental Practice and the Implications for Patient Harm
DOI:
https://doi.org/10.54518/rh.6.4.2026.1517Keywords:
Dental Ethics, Diagnostic Error, Legal Liability, Patient SafetyAbstract
Diagnostic errors in specialist dental practice pose clinical, ethical, and legal challenges to patient safety. Indonesian Laws Number 29 of 2004 and Number 17 of 2023 establish professional standards and patient rights. Yet, existing literature remains predominantly clinical, with limited legal and ethical integration. This gap underscores the need for a multidimensional approach to understanding diagnostic failures. This study examines the juridical and ethical dimensions of diagnostic errors and their impact on patient harm. Using a qualitative phenomenological and normative juridical approach, this study analyzes statutory regulations alongside empirical and scholarly evidence. The findings show that cognitive, clinical, communication, and systemic factors influence diagnostic errors in specialist dental practice, particularly delayed diagnosis, radiographic misinterpretation, symptom misidentification, and inadequate communication. These errors may cause clinical harm, patient anxiety, financial losses, and doctor-patient conflict. Diagnostic errors may incur professional liability when they deviate from applicable standards and cause harm, while gaps between legal norms (das sollen) and clinical practice (das sein) may weaken patient protection. Misdiagnosis may compromise non-maleficence and patient autonomy through inadequate information. The study concludes that an integrated clinical, juridical, and ethical approach is needed to strengthen accountability, patient protection, and healthcare quality.
Downloads
References
Alharbi, T. A. F., Rababa, M., Alsuwayl, H., Alsubail, A., & Alenizi, W. S. (2025). Diagnostic challenges and patient safety: The critical role of accuracy-A systematic review. Journal of Multidisciplinary Healthcare, 18(30), 3051-3064. https://doi.org/10.2147/JMDH.S512254.
Auerbach, A. D., Lee, T. M., Hubbard, C. C., Ranji, S. R., Raffel, K., Valdes, G., ... & Schnipper, J. L. (2024). Diagnostic errors in hospitalized adults who died or were transferred to intensive care. JAMA Internal Medicine, 184(2), 164-173. https://doi.org/10.1001/jamainternmed.2023.7347.
Beauchamp, T. L., & Childress, J. F. (1994). Principles of biomedical ethics (8th ed.). Oxford: Oxford University Press.
Busby, L. P., Courtier, J. L., & Glastonbury, C. M. (2018). Bias in radiology: The how and why of misses and misinterpretations. RadioGraphics, 38(1), 236-247. https://doi.org/10.1148/rg.2018170107.
Castaneda, C., Nalley, K., Mannion, C., Bhattacharyya, P., Blake, P., Pecora, A., & Suh, K. S. (2015). Clinical decision support systems for improving diagnostic accuracy and achieving precision medicine. Journal of Clinical Bioinformatics, 5(1), 4–14. https://doi.org/10.1186/s13336-015-0019-3.
Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches. Thousand Oaks: Sage Publications.
Denzin, N. K. (2017). The research act: A theoretical introduction to sociological methods. New York: Routledge.
Elsbeth, K., Bunmi, T., Joel, W., Muhammad, W., & Chun-Teh, L. (2022). Dental diagnostic errors and patient safety: A systematic review. Journal of Dental Research, 101(10), 1153–1161. https://doi.org/10.1177/00220345221087691.
El-Wakeel, N., & Ali, A. (2025). Assessment of diagnostic errors in oral lesions by primary care dentists and its relation to educational paradigm in Egypt: A mixed methods study. Tanta Dental Journal, 22(1), 125–132. https://doi.org/10.4103/tdj.tdj_58_24.
El-Wakeel, N., & Ezzeldin, N. (2022). Diagnostic errors in dentistry, opinions of Egyptian dental teaching staff: A cross-sectional study. BMC Oral Health, 22(1), 621–631. https://doi.org/10.1186/s12903-022-02565-9.
Fahrul, M. (2025). Hubungan antara kelalaian dan risiko medik dalam perspektif pertanggungjawaban hukum. Malang: Universitas Muhammadiyah Malang (Doctoral dissertation).
Giardina, T. D., Haskell, H., Menon, S., Hallisy, J., Southwick, F. S., Sarkar, U., & Singh, H. (2018). Learning from patients’ experiences related to diagnostic errors is essential for progress in patient safety. Health Affairs, 37(11), 1821-1827. https://doi.org/10.1377/hlthaff.2018.0698.
Graber, M. L., Franklin, N., & Gordon, R. (2005). Diagnostic error in internal medicine. Archives of Internal Medicine, 165(13), 1493-1499. https://doi.org/10.1001/archinte.165.13.1493.
Hutagaol, R. R., & Fikri, A. M. M. (2025). Enhancing patient safety through legal reform: a comparative review of healthcare best practices and legal frameworks. Research Horizon, 5(6), 3289-3298. https://doi.org/10.54518/rh.5.6.2025.863.
Iivari, N. (2018). Using member checking in interpretive research practice: A hermeneutic analysis of informants’ interpretation of their organizational realities. Information Technology & People, 31(1), 111–133. https://doi.org/10.1108/ITP-07-2016-0168.
Kachalia, A., Gandhi, T. K., Puopolo, A. L., Yoon, C., Thomas, E. J., Griffey, R., & Studdert, D. M. (2007). Missed and delayed diagnoses in the emergency department: A study of closed malpractice claims from 4 liability insurers. Annals of Emergency Medicine, 49(2), 196–205. https://doi.org/10.1016/j.annemergmed.2006.06.035.
Kemenkes (2022). Laporan tahunan pelayanan kesehatan. Jakarta: Kementerian Kesehatan Republik Indonesia.
Khalid, H. (2023). Legal protection for victims of medical malpractice during the COVID-19 pandemic: A study on legislation. Sign Jurnal Hukum, 5(2), 263-275. https://doi.org/10.37276/sjh.v5i2.290.
Koesmoeryantati, & Siregar, R. A. (2025). Pandangan hukum kesehatan terhadap dugaan malpraktek versus komplikasi tindakan kedokteran. Jurnal Kolaboratif Sains, 8(6), 2897–2909. https://doi.org/10.56338/jks.v8i6.7815.
Li, Y., Yi, X., Fu, J., Yang, Y., Duan, C., & Wang, J. (2025). Reducing misdiagnosis in AI-driven medical diagnostics: A multidimensional framework for technical, ethical, and policy solutions. Frontiers in Medicine, 12(1), 159–174. https://doi.org/10.3389/fmed.2025.1594450.
Mikesell, L., & Bontempo, A. C. (2023). Healthcare providers’ impact on the care experiences of patients with endometriosis: The value of trust. Health Communication, 38(10), 1981–1993. https://doi.org/10.1080/10410236.2022.2048468.
Miles, M. B., Huberman, A. M., & Saldaña, J. (2014). Qualitative data analysis: A methods sourcebook (3rd ed.). Thousand Oaks: Sage Publications.
Murdoch, A. I. K., Blum, J., Chen, J., Baziotis-Kalfas, D., Dao, A., Bai, K., & Cirillo, N. (2023). Determinants of clinical decision making under uncertainty in dentistry: A scoping review. Diagnostics, 13(6), 1076–1099. https://doi.org/10.3390/diagnostics13061076.
Nakhapaksirat, D., Srimawong, P., Kitcharoen, N., Nobnom, S., & Pitakanonda Ballapapinan, T. (2025). Identification and evaluation of radiographic interpretation errors among undergraduate dental students. Medical Education Online, 30(1), 252–263. https://doi.org/10.1080/10872981.2025.2521353.
Newman-Toker, D. E., Nassery, N., Schaffer, A. C., Yu-Moe, C. W., Clemens, G. D., Wang, Z., & Siegal, D. (2024). Burden of serious harms from diagnostic error in the USA. BMJ Quality & Safety, 33(2), 109–120. https://doi.org/10.1136/bmjqs-2021-014130.
Ningsih, D. K., Pont, A. V., Suryoutomo, M., Susinta, A., & Musta, A. P. (2025). Analisis yuridis terhadap tanggung jawab rumah sakit atas kelalaian tenaga medis. Jurnal Kolaboratif Sains, 8(11), 7343–7352. https://doi.org/10.56338/jks.v8i11.8427.
Obadan-Udoh, E., Howard, R., Valmadrid, L. C., Walji, M., & Mertz, E. (2024). Patients’ experiences of dental diagnostic failures: A qualitative study using social media. Journal of Patient Safety, 20(3), 177-185. https://doi.org/10.1097/PTS.0000000000001198.
Page, L. A., & Wessely, S. (2003). Medically unexplained symptoms: Exacerbating factors in the doctor-patient encounter. Journal of the Royal Society of Medicine, 96(5), 223–227. https://doi.org/10.1177/014107680309600505.
Republic of Indonesia. (2004). Law of the Republic of Indonesia Number 29 of 2004 concerning Medical Practice.
Republic of Indonesia. (2023). Law of the Republic of Indonesia Number 17 of 2023 concerning Health.
Sari, N. E., & Fikri, A. M. M. (2025). The supremacy of patient safety: Juridical and empirical analysis of emergency medical care. Research Horizon, 5(6), 3117-3126. https://doi.org/10.54518/rh.5.6.2025.860.
Singh, H., Schiff, G. D., Graber, M. L., Onakpoya, I., & Thompson, M. J. (2017). The global burden of diagnostic errors in primary care. BMJ Quality & Safety, 26(6), 484–494. https://doi.org/10.1136/bmjqs-2016-005401.
Suzuki, R., Yajima, N., Sakurai, K., Oguro, N., Wakita, T., Thom, D. H., & Kurita, N. (2022). Association of patients’ past misdiagnosis experiences with trust in their current physician among Japanese adults. Journal of General Internal Medicine, 37(5), 1115–1121. https://doi.org/10.1007/s11606-021-06950-y.
Tokede, B., Yansane, A., Brandon, R., Lin, G.-H., & Lee, C.-T. (2024). The burden of diagnostic error in dentistry: A study on periodontal disease misclassification. Journal of Dentistry, 14(8), 105-116. https://doi.org/10.1016/j.jdent.2024.105221.
Vanderschaeghe, G., Dierickx, K., & Vandenberghe, R. (2018). Review of the ethical issues of a biomarker-based diagnosis in the early stage of Alzheimer’s disease. Journal of Bioethical Inquiry, 15(2), 219–230. https://doi.org/10.1007/s11673-018-9844-y.
Yuarsa, T. A. (2025). Kelalaian medik (medical negligence): Review UU No. 17 Tahun 2023 tentang kesehatan & pembentukan Majelis Disiplin Profesi (MDP). Indramayu: Penerbit Adab.
Downloads
Published
How to Cite
License
Copyright (c) 2026 Rudy, Arman Lany
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
