<![CDATA[The implementation of therapeutic agreements in health services often raises disputes regarding the limits of civil liability between doctors and hospitals. The development of modern healthcare practices shows that hospitals no longer function only as providers of health facilities, but also as institutions that manage service systems, supervision of medical personnel, and patient safety. This study aims to analyze the construction of hospital civil liability in the implementation of therapeutic agreements and formulate an ideal model of accountability based on the balance of health service interests. The research uses normative legal research methods with a legislative approach, a conceptual approach, and a case approach through the analysis of various court decisions and laws and regulations in the health sector. The results of the study show that hospital liability in Indonesia has shifted from a fault-based liability approach that is oriented towards individual doctors' mistakes to institutional liability that places hospitals as legal subjects responsible for the quality of service, supervision, patient safety, medical records, informed consent, and clinical governance. Based on these findings, the Balanced Institutional Liability model was formulated, which is an accountability model that integrates the protection of patient rights, the protection of the medical profession, hospital institutional accountability, preventive risk management, and a fair dispute resolution mechanism in one proportionate accountability system. This model provides more equitable legal certainty in the implementation of therapeutic agreements. Research recommends the reconstruction of hospital accountability arrangements through strengthening the principle of balance of interests as the basis for health law reform in Indonesia.]]>
