End-of-life Care for Breast and Reproductive Cancer Patients in Jakarta, Indonesia (Raboan Discussion Forum)

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Wednesday (23/03) Raboan Discussion Forum was again conducted by the Center for Bioethics and Medical Humanities (CBMH FK-KMK UGM). The event, which was held online via Zoom and Youtube, raised the topic of Navigating end-of-life care: An Ethnography of Women with Reproductive and Breast Cancer in Jakarta, Indonesia. CBMH FK-KMK UGM invited speaker Hanum Atikasari, MPH, a PhD Candidate – Institute of Cultural Anthropology and Development Sociology, Leiden University. The discussion was also led by moderator Erlin Erlina, S.IP., M.A., Ph.D from CBMH FK-KMK UGM.

On that occasion, Hanum Atikasari explained his research plan on end-of-life care, especially palliative care for women with breast cancer and reproductive cancer which will be conducted in Jakarta, Indonesia. The research is part of the Globalizing Palliative Care project of Leiden University’s Institute of Cultural Anthropology and Development Sociology.

Hanum explained that he was interested in researching the problem because of several backgrounds. First, the problem of access to palliative care in Indonesia is still very limited even though the practice has been introduced since 1992. Second, discussions about the end of life are still considered taboo in society. Third, the number of patients with breast cancer and reproductive cancer is still high in Indonesia, where prevention efforts so that these diseases do not become terminal are still lacking. Then the last background is the stigma that still often afflicts breast cancer and reproductive cancer sufferers in Indonesia.

Some of the questions that Hanum would like to explore further include the forms of treatment that can be used and how these treatments are carried out for women with breast cancer and reproductive cancer at the end of their life. Another question to be explored is how gender and class affect the care of women with breast cancer and reproductive cancer. In addition, Hanum also explained that he wanted to know how the patient’s companion was involved in the decision-making process regarding end-of-life care and how the perception of the patient and the companion had towards good care.

The research conducted by Hanum uses the ethnographic method. It is hoped that this research can contribute to the study of the end-of-life and can provide information and recommendations to health program planners.

Ancient Java Tradition on Sex Education [Raboan Discussion Forum]

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Raboan Discussion Forum was again held by the Center for Bioethics and Medical Humanities (CBMH FK-KMK UGM) on (16/03). On that occasion, the theme raised was Javanese Ancestor Sex Education: An Ethical Perspective. The event which was held virtually invited speaker Chandra Halim, M.A who is a lecturer in the History Study Program at Sanata Dharma University, Yogyakarta. Meanwhile, the moderator is dr. Galuh Dyah Fatmala.

Chandra Halim’s presentation was motivated by a recent phenomenon, namely the many problems of sexual violence experienced by young people in Indonesia. According to Chandra Halim, this is one of the effects of sex education in Indonesia, which is still often considered taboo to talk about. So often the discussion of sex education is something that society avoids.

Based on a search conducted by Chandra Halim through historical evidence, found that in the past the Javanese ancestors gave sex education to young people. Sex education that was carried out at that time was not only knowledge about intercourse but also lessons about how to behave ethically between husband and wife.

In the past, Javanese ancestors in the Banjoemas district had known a tradition called Gowokan. This tradition is one of the traditions that teach ethics in married life, especially in sex education. The Gowokan tradition is carried out by a Gowok who has the duty of being a teacher to test how ready a young man is to be married.

A Gowok is often identified with a prostitute, even though according to Chandra Halim this is not the case. A Gowok is not a prostitute who just peddles the game of intercourse. But it is more obvious that Gowok teaches men to be men who are able to complete a woman and treat women well (lelaning jagad).

Besides Gowokan, another tradition that was also a practice of sex education in the past was Ngenger. The Ngenger tradition is a practice where the groom-to-be has to surrender to the prospective in-laws. He is allowed to sleep at the prospective in-laws’ house together with the bride-to-be. The tradition is carried out after the process of dowry. The practice of Ngenger is carried out so that the prospective groom familiarizes himself with the prospective bride’s family and the community around the prospective bride’s residence.

Not only in the form of tradition but the practice of sex education of Javanese ancestors is also found in ancient texts such as Serat Centhini, Serat Nitimani, and Serat Gatho loco. In the text, it was found that there were many things related to sex and women’s education. The Serat Panitisastra which is a legacy from the Pakubuwana V era also talks about many things related to women’s problems.

Pancasila in The New Sense of Bioethics and The UGM’s Duty [Raboan Discussion Forum]

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Wednesday (09/03) the virtual discussion forum Raboan Discussion Forum was again held by the Center for Bioethics and Medical Humanities (CBMH FK-KMK UGM). On this occasion, CBMH FK-KMK UGM invited Prof. Dr.dr. Soenarto Sastrowijoto, SpTHT-KL(K) raised the topic with the title UGM, Pancasila, and Bioethics. The forum is also chaired by dr. Wika Hartanti MIH as moderator.

Prof. Soenarto started his presentation by explaining the origins of UGM’s establishment. Government of Indonesia, and Prof. Dr. Sardjito as President of UGM (1949-1964). The university, which is now a leading university in Indonesia, is here to carry out the task of improving the quality of the younger generation.

The efforts made for UGM to reach this position are not easy. It is necessary to fight for UGM to become a leading university in Indonesia and even the world. However, thanks to these efforts, in 2020, UGM received a mandate from UNESCO to become the 8th UNESCO Chair on Bioethics. This is a difficult task because UGM has to become a university that continues to develop bioethics science.

When discussing development, it never hurts to look back at the basics. Prof. Soenarto then continued his explanation referring to the basic ideology of the Indonesian nation, namely Pancasila. The five precepts contained in Pancasila are the perspectives used in the life of society, nation, and state in Indonesia. As the basis of all views of the Indonesian people, Pancasila can be the basis for developing the science of Bioethics, which is better known as New Bioethics (The New Sense of Bioethics).

According to Prof. Soenarto, The New Sense of Bioethics prioritizes the contribution of local wisdom. Pancasila, which puts forward the principle of gotong royong (cooperation), can be applied more broadly or globally in everyday life. The principle of the New Bioethics which always in the side of vulnerable groups, is in line with the principle of gotong royong in Pancasila.

To develop the principles of Pancasila in the New Bioethics (The New Sense of Bioethics), the role of the younger generation is needed to continue to strive for it. In this case, UGM as higher education has an important role to continue to promote and support these efforts.

 

Bioethics Tree of Knowledge (Raboan Discussion Forum)

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The Center for Bioethics and Medical Humanities (CBMH FK-KMK) Universitas Gadjah Mada once again held the weekly Raboan Discussion Forum. The event, which was held virtually, raised the issue of bioethics science with the title Bioethics: Where is your Knowledge Tree. CBMH FK-KMK UGM invited speaker dr. Siti Pariani, MS., MSC., Ph.D who is a lecturer at the Faculty of Medicine, Universitas Airlangga. Meanwhile, the moderator was Erlin Erlina, S.IP, M.A., Ph.D who is a researcher at CBMH FK-KMK UGM and Lecturer at Faculty of Medicine, Public Health, and Nursing, UGM.

To the forum participants, dr. Siti Pariani explained her ideas regarding the discussion of the scientific tree of Bioethics which according to her still needs to be discussed. At the beginning of his presentation, dr. Siti Pariani tries to remind the nature of the science of Bioethics which is a science with the aim of solving problems that exist in society with an ethical basis as a concept that will examine the nature of goodness in social behaviour.

dr. Siti Pariani highlighted that each discipline has its own code of ethics which is the result of consensus from the thoughts of experts in the field. The code of ethics can be said to be a branch of a universal ethical tree.

The discussion then continues on the scientific tree of Bioethics. According to dr. Siti Pariani’s knowledge of bioethics has roots in several other disciplines including philosophy, sociology, anthropology and psychology. This knowledge then developed into branches of the tree of bioethics which later became the Universal Declaration on Bioethics and Human Rights as we know it today.

In addition, dr. Siti Pariani also added that Bioethics as science should also have a system that continues to process. dr. Siti Pariani said that the system is contained in the tri dharma, namely education, research, and service. These three aspects become the form of output for the science of Bioethics.

At the end of his presentation, dr. Siti Pariani reminded us that science must return to its main goal which is human welfare and safety.