Pasal 440 ayat (1) dan (2) Undang-Undang Nomor 17 Tahun 2023 tentang Kesehatan (UUK 2023) menetapkan sanksi pidana bagi tenaga medis yang kealpaannya mengakibatkan luka berat atau kematian pasien (Republik Indonesia, 2023). Ketentuan ini memicu lonjakan kedokteran defensif (defensive medicine) yang berkarakter pedang bermata dua: mendorong tertib administrasi (defensif positif/pro), sekaligus memicu over-testing dan penghindaran pasien berisiko (defensif negatif/kontra) (Chazawi, 2024; Joecy Editorial, 2025). Penelitian ini bertujuan menganalisis implikasi Pasal 440 UUK 2023 terhadap praktik tersebut, serta memperdalam analisisnya melalui doktrin hukum Islam (fikih medis) dan nilai-nilai Kemuhammadiyahan. Menggunakan metode yuridis normatif dengan pendekatan perundang-undangan dan konseptual, penelitian ini menghasilkan temuan: (1) hukum positif mengandalkan inspanningsverbintenis yang rentan terdistorsi oleh ketakutan terhadap ancaman pidana; (2) hukum Islam secara tajam membedah hal ini melalui konsep Dhaman (pertanggungjawaban), di mana kaidah Dar'ul Mafasid mengharamkan sisi kontra (defensif negatif) karena mengorbankan nyawa demi keamanan pribadi dokter; (3) Muhammadiyah mengharmonisasi ambivalensi pro-kontra ini melalui Teologi Al-Ma'un (untuk mengeliminasi sisi kontra yang menelantarkan pasien) dan prinsip wasathiyah berbasis Syura (untuk merawat sisi pro dengan melindungi dokter melalui Majelis Disiplin Profesi) (Studdert et al., 2005; Hakim & Rahman, 2026). Penelitian ini merekomendasikan Majelis Disiplin Profesi (MDP) sebagai ahlul halli wal aqd (penapis mutlak) guna meredam ekses destruktif dari ancaman pidana. ABSTRACT Article 440 paragraphs (1) and (2) of Law Number 17 of 2023 on Health (UUK 2023) stipulates criminal sanctions for medical personnel whose negligence results in serious injury or patient death (Republik Indonesia, 2023). This provision triggers a surge in defensive medicine, which acts as a double-edged sword: encouraging administrative order (pro/positive defensive) while also triggering over-testing and risk avoidance (contra/negative defensive) (Chazawi, 2024; Joecy Editorial, 2025). This study aims to analyze the implications of Article 440 of UUK 2023 on this practice and deepen the analysis through Islamic legal doctrines (medical fiqh) alongside Muhammadiyah values. Using a normative juridical method with statutory and conceptual approaches, this study reveals: (1) positive law relies on inspanningsverbintenis, which is vulnerable to distortion by the fear of criminal threats; (2) Islamic law acutely dissects this through the concept of Dhaman (liability), where the maxim of Dar'ul Mafasid prohibits the contra side (negative defensive) for sacrificing lives for personal security; (3) Muhammadiyah harmonizes this pro-contra ambivalence through the Theology of Al-Ma'un (to eliminate the contra side that neglects patients) and the principle of wasathiyah based on Syura (to maintain the pro side by protecting doctors through the Professional Discipline Council) (Studdert et al., 2005; Hakim & Rahman, 2026). This study recommends the Professional Discipline Council (MDP) as ahlul halli wal aqd (the absolute filter) to mitigate the destructive excesses of criminal threats.
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