Gendered Care and Ethics in Social Research [Raboan Discussion Forum]

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Wednesday (22/02) Center for Bioethics and Medical Humanities (CBMH FK-KMK UGM) just held Raboan Discussion Forum. The weekly online forum invited Gita Nasution, Ph.D from Australia National University. She presented her research titled Gendered Care and Ethics in Social Research. The discussion was lead by Erlin Erlina, Ph.D from FK-KMK UGM.

Gita presented her ethnographic study that explores the emergence and dynamics of the baby sitter profession in Indonesia, with a focus on the social and economic factors driving its growth and the aspirations of both employers and workers. The study highlights the gendered nature of care work, with women primarily taking on the role of careers in both domestic and public settings.

The study finds that the rise of the service sector in Indonesia has created a need for child care, which is particularly acute in middle-class families where both parents work. Hiring a child carer/nanny is seen as crucial to support dual income families in looking after their children. Meanwhile, from the worker’s perspective, becoming a baby sitter is often a result of limited employment opportunities and the need to provide for their families.

The study also reveals the dual role of agencies in the baby sitter profession: as a supplier of workers and as a training institution. However, there are challenges in the industry, including mismatched expectations, unskilled workers versus demanding employers, and persisting issues of discrimination and class hierarchy.

Overall, the study shows that the baby sitter profession is a social phenomenon that reflects the transformation of domestic work and sheds light on how people adapt to changing social and economic circumstances. While care work has become more professionalized, there remains a power dynamic between employers and employees, and care work remains a gendered profession.

 

A Dialogical Approach to Clinical Ethics Support for Critical Yet Respectful Learning [Raboan Discussion Forum]

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Center for Bioethics and Medical Humanities (CBMH FK-KMK UGM) held Raboan Discussion Forum last Wednesday (15/2). The discussed topic on the forum was “A Dialogical Approach to Clinical Ethics Support for Critical Yet Respectful Learning.” CBMH FK-KMK UGM, as the organizer, invited Prof. Bert Molewijk from UMC University of Amsterdam as the speaker. dr. Wika Hartanti MIH also moderated the online discussion forum.

Prof. Bert said that a dialogical approach to ethics is crucial for meaningful engagement and understanding. Ethics plays a vital role in clinical practice. Ethics can provides a framework for making morally sound decisions and ensures the well-being of patients. In addition, ethics is important because it upholds the integrity of the healthcare professionals and fosters trust in professional relationships.

Ethical challenges can arise in healthcare, and addressing them requires open dialogue, reflection, and a consideration of theoretical frameworks. There are various areas of ethics, such as decision-making, resource allocation, and end-of-life care. In healthcare in Norway, for example, ethical challenges include patient autonomy, confidentiality, and balancing individual rights with societal interests.

Moral distress can occur when healthcare professionals face personal values conflict with their professional duties. It highlights the significance of ethical discussions and decision-making processes to address moral dilemmas effectively. By engaging in ethics discussions and decision-making processes, healthcare professionals can navigate moral dilemmas, promote fairness and justice, and strive for the best possible outcomes for individuals.

 

Bioethical Problems in Women’s Surgical Methods of Contraception [Raboan Discussion Forum]

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Wednesday (8/2), the Center for Medical Bioethics and Humanities held the Raboan Discussion Forum. The topic that we raised was Bioethical Problems in Women’s Surgical Methods of Contraception. The speaker for this discussion was Dr. Annisa Ullya Rasyida, dr., M.Si. and moderated by dr. Tiea Khatija.

Women’s Surgical Methods of Contraception (MOW) or female tubectomy or sterilization to close the fallopian tubes, to preventing the pregnancy, because the ovum can’t meet sperm cells. Contraception can be done if there are indications and/or the couple doesn’t want to have more children (BKKBN, 2011). One of the indications for someone that use the MOW contraception is the presence of psychological/physical disturbances when the woman is pregnant again. Only 44.5% of MOW acceptors knew about the side effects of using that contraception. MOW contraceptive users can only give birth with caesarean section method is maximum of 3 times. The use of MOW contraception is recommended for mothers who have heart defects that are quite serious.

New Sense of Bioethics:

  1. Belief in God or Faith: doctors being an intermediator to help patients, but God determines the outcome. Patient like to stubborn, because they feel that death is in God’s hand, so they still want to try.
  2. Respect for others: doctors respect the wishes of patients and do not force patients to sign informed consent. The patient has been explained the action procedure, but when the formula Is not clearly written and there is a risk, the patient blames the doctor.
  3. Beneficence: doctor tries to help patient, in this case the patient feels loss in the future because she can’t get pregnant again
  4. Non maleficence: the doctor tries to save the patient’s life. In this case the patient was saved by being advised to be sterile because he had a history of the disease. But, turns out patient wants to get pregnant again and she knows that she can’t, the patient feels aggrieved.
  5. Social justice for all: doctors help patients regardless of status.

The absence of the word “permanent sterile” on the informed consent sheet make an opportunity to bring the matter into the realm of law. The response: verbal consent is sufficient, so written informed consent is only a confirmation of what has been previously agreed upon. However, it would be better if the informed consent was written in full of the purpose, benefits and risks of an action/operation. Then effective communication builds trust between doctors and patients.

Abandonment of Ethics, Early Directions to Violation of the Law [Raboan Discussion Forum]

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Wednesday (01/02) Center for Bioethics and Medical Humanities Faculty of Medicine Public Health and Nursing held a Raboan Discussion Forum. The virtual forum raised the topic Abandonment of Ethics, Early Directions to Violation of the Law, presented by Dr. dr. Siswanto Sastrowijoto, Sp. ENT-KL (K), MH. Meanwhile, the moderator for the discussion was dr. Galuh Dyah Fatmala.

The dominant factor in professionalism is a combination of relevant intellectual capacity, necessary skills, adherence to moral and ethical standards, and the ability to act as an agent of change. In the context of medical professionals, neglecting ethical standards can lead to unprofessional behavior, which may result in malpractice. Several criteria support the legal action of medical malpractice, such as violating professional standards, operational procedures, informed consent, doctor-patient confidentiality, and ethical and moral principles. In addition, failure to meet patients’ medical needs and violating their rights are grounds for legal action.

Indonesian Law No. 29/2004 stipulates the obligations of doctors and patient’s rights, including providing medical services according to professional and standard procedures, referring patients to other doctors with better expertise, maintaining patient confidentiality, providing emergency medical assistance, and continually improving their knowledge. Ethical violations by medical professionals against patients are classified as mild, moderate, and severe, with corresponding sanctions ranging from counseling to dismissal from professional organizations. Ethics violations can lead to disciplinary and legal sanctions, including revocation of practice permits and imprisonment. In addition, providing false medical statements is punishable by up to four years in prison under the Penal Code.