JAKARTA, JurnalPost.com — On August 8, 2026, a doctor participating in the Anesthesiology and Intensive Therapy Specialist Education Program (PPDS) at the Faculty of Medicine, University of North Sumatra (FK USU), identified as Dr. J, was reported deceased. This event has drawn significant public attention, particularly due to various unconfirmed reports regarding the alleged cause of death.
The Executive Board of the Indonesian Medical Association (PB-IDI) stated that it received initial information regarding the alleged self-administration of anesthetic drugs by the deceased, alongside reports of financial pressure and suspected bullying. However, PB-IDI emphasized that this information remains unverified and has urged the Ministry of Health to conduct an investigation. This article does not intend to preempt the investigation results or judge the deceased, but rather to examine a legal question: are anesthesiology residents permitted to self-administer anesthetic drugs?
[Photo placement after the second paragraph]
Photo caption: Illustration of a medical professional operating a syringe in a healthcare setting. The use of anesthetic drugs requires adequate safety standards, authorization, and medical supervision.
This question is significant because anesthetic drugs possess characteristics distinct from typical medications. Certain anesthetic agents can affect consciousness, respiration, and cardiovascular function, thus requiring medical indications, standardized procedures, and patient safety monitoring for their use.
On the other hand, medical personnel working in the field of anesthesiology have professional access to various drugs that require special oversight.
The Association of Anaesthetists guidelines explain that anesthesiologists face a higher risk of substance use disorders compared to doctors in several other fields. One factor associated with this risk is access to anesthetic drugs.
A scientific study titled Propofol Misuse in Medical Professions: A Scoping Review published in the Canadian Journal of Anesthesia in 2023 identified 88 cases of propofol misuse among medical professionals across 24 publications. Anesthesiologists and nurse anesthetists were among the groups most frequently cited in these reports.
The study also noted that death is one of the conditions identified in cases of misuse. However, findings from case reports cannot be used to determine the cause of an individual's death without an adequate examination.
Thus, the use of anesthetic drugs outside of medical service procedures is not merely a matter of compliance with drug usage regulations, but also concerns the safety and health of the medical personnel themselves.
Is Independent Anesthesia Use Permitted?
Normatively, the use of anesthetic drugs on oneself without a valid medical indication, safety procedures, and necessary supervision cannot be justified as medical practice that meets established standards.
However, it must be clarified that Indonesian law does not explicitly regulate all forms of such actions under a single provision using the term "independent anesthesia."
The assessment must be conducted through a series of interrelated regulations, ranging from professional ethics, healthcare service standards, and the clinical authority of PPDS participants, to drug management provisions.
Therefore, conclusions regarding legal violations in a specific event must still consider the facts, the type of drug, the purpose of use, the authority of the individual, and the applicable regulations.
Professional Medical Ethics Obligations
The first layer relates to professional ethics.
The Indonesian Medical Code of Ethics (KODEKI), specifically Article 20, mandates that every doctor must consistently maintain their health to perform their duties effectively.
This provision demonstrates that a doctor's professional responsibility is not only directed toward patients but also includes the obligation to maintain their own health and safety.
The use of high-risk drugs without medical indication and without necessary supervision is difficult to reconcile with this principle.
Nevertheless, ethical obligations should not be interpreted as a basis for blaming doctors who suffer from physical or psychological health issues.
Conversely, the principle of health maintenance must be accompanied by access to medical assistance, professional support, and a work and educational environment that supports the health of medical personnel.
Legal Protection in the Health Law
The second layer is health law.
Law Number 17 of 2023 concerning Health establishes professional standards, service standards, standard operating procedures, and professional ethics as essential elements in the practice of medical personnel.
Legal protection for medical personnel is related to the execution of duties and practices that comply with these provisions.
In anesthesiology services, medical actions must be based on clinical needs and carried out with due regard for patient safety.
Anesthesia procedures generally require evaluation of the patient's condition, determination of medical indications, adequate monitoring, and readiness to handle complications.
If a doctor uses anesthetic drugs on themselves outside of legitimate healthcare services, especially without necessary supervision, such an action cannot simply be considered an exercise of professional authority.
However, failure to meet practice standards does not automatically prove the existence of a criminal act. Legal consequences must be assessed based on the elements of violation specifically regulated in legislation.
Dual Status of PPDS Doctors and Limits of Clinical Authority
The third layer relates to the status of PPDS doctors.
PPDS participants hold the status of doctors undergoing advanced education to obtain competence as specialists.
During the education process, participants undergo clinical training in stages, with supervision and evaluation according to the provisions of the education program and the teaching hospital where the training takes place.
On the other hand, PPDS participants may still hold practice authority as general practitioners as long as they meet the requirements of the Registration Certificate (STR), Practice License (SIP), and the requirements of the educational institution.
The Ministry of Health explained in April 2025 that PPDS participants may apply for a practice license as a general practitioner outside of educational activities, in accordance with the requirements and provisions of their respective study programs.
However, the authority to practice as a general practitioner cannot be equated with the authority to conduct independent practice as an anesthesiology specialist.
Before completing their education and meeting the applicable requirements, PPDS participants do not automatically possess the authority for independent specialist practice.
Clinical authority during education must also be exercised according to the level of competence, assignments, and supervision established.
Therefore, the use of anesthesia on oneself outside of medical indications and legitimate service systems cannot be considered part of clinical authority simply because one holds the status of an anesthesiology PPDS participant.
Control of Anesthetic Drugs in Indonesian Law
The fourth layer relates to drug management.
Not all anesthetic drugs have the same legal classification.
Some drugs used in anesthesia services are classified as narcotics or psychotropics, while others may be categorized as potent drugs with their own management provisions.
The procurement, storage, distribution, and use of these drugs must follow the provisions of legislation and pharmaceutical service standards.
Drugs classified as narcotics and psychotropics have special control mechanisms because they have the potential for misuse.
Unauthorized possession or use of certain drugs can lead to legal consequences, including criminal charges if all elements of the criminal act are met.
Meanwhile, deviations in the management of potent drugs can also lead to administrative, disciplinary, or other legal consequences according to the nature of the violation.
Because the classification and regulation of each drug differ, legal assessment should not be conducted based solely on the general term "anesthetic drug."
The type of drug, source of acquisition, basis of authority, purpose of use, and evidence of violation are factors that must be examined.
Distinguishing Ethical Violations and Criminal Acts
Discussions regarding the independent use of anesthetic drugs also need to distinguish between actions that do not meet professional standards and acts that are punishable by law.
In Indonesian criminal law, an individual's act of ending their own life is not regulated as a criminal act against themselves.
However, there are specific provisions regarding the actions of other parties who encourage, assist, or provide the means for suicide, with accountability requirements as regulated in the Criminal Code (KUHP).
Furthermore, Article 132 of the Criminal Code stipulates that the authority to prosecute an individual is terminated if the suspect or defendant passes away.
This provision does not mean that an event resulting in death cannot be investigated further.
Examinations can still be conducted to determine the cause of death, assess the possibility of drug management violations, or identify the alleged involvement or negligence of other parties.
Thus, the purpose of the discussion regarding independent anesthesia use is not to find a basis for punishing someone who has already passed away.
The more important issue is to assess whether there are weaknesses in the drug safety system, clinical oversight, and protection for specialist medical education participants.
Responsibility of Hospitals and Educational Institutions
This is where attention needs to shift from the individual to institutional responsibility.
Hospitals have an obligation to ensure that drugs are managed safely in accordance with pharmaceutical provisions, including aspects of storage, recording, distribution, and supervision of their use.
In the context of specialist medical education, educational institutions and teaching hospitals are also obligated to provide a safe learning environment.
The prevention and handling of bullying are important parts of that responsibility.
The Ministry of Health previously issued Minister of Health Instruction Number HK.02.01/MENKES/1512/2023 concerning the prevention and handling of bullying against students in teaching hospitals within the Ministry of Health environment.
This regulation shows that bullying in medical education is a serious issue that requires mechanisms for prevention, reporting, examination, and enforcement.
The economic issues faced by PPDS participants also require attention.
The government has acknowledged that some specialist medical education participants face financial difficulties during their education. This condition is one of the considerations in the policy that provides opportunities for practice as a general practitioner with certain requirements.
If an investigation proves the existence of bullying, deviations in drug management, or negligence by parties with supervisory obligations, accountability can be examined according to applicable legal provisions.
The form of accountability can vary, ranging from administrative, ethical, and professional disciplinary actions to criminal charges if elements of a criminal act are proven.
However, all these possibilities must be placed within an objective examination framework.
Allegations should not be treated as conclusions, and every party retains the right to a fair examination process.
Safety of PPDS Participants Must Be a Priority
From these various provisions, it can be concluded that the use of anesthetic drugs on oneself without a valid medical indication and without meeting safety standards cannot be justified as medical practice that aligns with professional principles.
Such actions potentially conflict with ethical obligations, service standards, clinical authority limits, and drug management rules.
Nevertheless, the determination of legal consequences cannot be done automatically. Every alleged violation still requires an examination of the facts and relevant legal elements.
In the context of the death of the FK USU PPDS doctor in August 2026, it is important to maintain a clear boundary between initial information, allegations, and proven facts.
This event should prompt a comprehensive evaluation of the safety of specialist medical education participants, including drug use oversight, workload, economic conditions, bullying prevention, and access to mental health services.
An independent and transparent investigation is important not merely to uncover an event, but also to prevent similar incidents in the future.
Ultimately, the issue that deserves attention is not only what actions are prohibited by law, but also how the education and healthcare system ensures that every medical professional receives adequate protection.
The safety of doctors and PPDS participants is not just an individual responsibility, but also reflects the quality of oversight, care, and accountability of healthcare institutions.
Sources and References
Law Number 17 of 2023 concerning Health.
Government Regulation Number 28 of 2024 concerning the Implementation of Law Number 17 of 2023 concerning Health.
Law Number 1 of 2023 concerning the Criminal Code and its amendments.
Indonesian Medical Code of Ethics (KODEKI), Article 20.
Minister of Health Instruction Number HK.02.01/MENKES/1512/2023.
Ministry of Health, policy on general practitioner practice for PPDS participants, April 22, 2025.
Association of Anaesthetists, Substance Use Disorder in the Anaesthetist.
Burnett, G.W., et al. (2023), Propofol Misuse in Medical Professions: A Scoping Review, Canadian Journal of Anesthesia.
detikHealth, August 13, 2026, reporting on the PB-IDI statement regarding the death of the FK USU PPDS doctor.
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