CBMH UGM Research Team Conducts Public Engagement Activity with Cancer Survivors at the Indonesian Cancer Foundation

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The research team discusses patient autonomy with cancer survivors

Yogyakarta, February 28, 2025 – A research team from Universitas Gadjah Mada, led by drg. Agnes Bhakti Pratiwi, MPH, Ph.D, with research members Prof. Dick Willems, MD, Dra. Retna Siwi Padmawati, MA, Nabila Puspakesuma, S.Psi., MSc, Ns. Wahyu Dewi S., M.SN, Ardhini Nugrahaeni, M.K.M, and Fahmi Baiquni, S.Psi., MPH, conducted a public engagement activity as part of the research entitled Conceptualizing Patient Autonomy in Decision-Making in South-East Asian Culture: Bringing Experience from the Indonesian Context.

The activity was held at the Indonesian Cancer Foundation on February 28, 2025, involving 10 cancer survivors who have experience in the medical decision-making process, particularly related to non-emergency surgical procedures. This public engagement aimed to understand aspects considered important by patients in healthcare services during the medical decision-making process in hospitals. This activity aligns with the Sustainable Development Goals (SDGs) number 3 (Good Health and Well-Being) and 5 (Gender Equality), which promote inclusive access to healthcare services and active patient participation in medical decision-making.

During the discussion, participants shared their experiences regarding the obstacles faced during medical treatment. One of the key findings was the significant role of close family members, such as husbands or children, in the decision-making process. Family support greatly influenced patients decisions, especially in approving elective surgery procedures. Some participants also mentioned that before undergoing medical treatment, they first sought alternative medicine.

The decision-making dynamics showed that children’s involvement often became the deciding factor when support from husbands was not optimal. This illustrates that medical decisions in the Southeast Asian cultural context, particularly in Indonesia, tend to be collective, considering the perspectives of close family members.

This public engagement activity serves as an important step in understanding patient perspectives on autonomy in medical decision-making. The results of this activity are expected to enrich the understanding of patient autonomy concepts that are more contextual and based on patient experiences in Indonesia.

 

Reporter           : Ardhini Nugrahaeni, M.K.M.

Editor                 : Alvira Rahmasari, S.H.G.

Challenges and Opportunities of Humanities in Medical Education and Services

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RABOAN – 5th March 2025

Yogyakarta, March 5, 2025 – The Raboan Research and Perspective Sharing event returned at the beginning of March 2025, featuring a distinguished speaker, Prof. Dr. dr. Taufiq Suryadi, Sp.F (K), Dipl.BE, a Professor of Forensic Medicine and Medicolegal Studies at the Faculty of Medicine, Syah Kuala University. The presentation and discussion were highly interactive, moderated by Mahmasoni Masdar, S.Kep.Ns., M.Kep from CBMH UGM.

This session of Raboan, themed “The Role of Humanities in Medical Education and Ethical Healthcare Services,” highlighted the importance of a multidisciplinary approach in enhancing more humane and ethical healthcare services, as well as the significance of integrating humanities and culture into medical education. Prof. Taufiq emphasized three key aspects of learning humanities:

“Learning humanities, teaching in a humanistic way, and learning through humanities.”

Humanities are not merely a complementary subject but a fundamental element in shaping empathetic and integrity-driven doctors. As medical professionals, it is essential to view patients not only in terms of their illness but also in consideration of their mental, cultural, spiritual, and social conditions.

During his presentation, Prof. Taufiq provided insights into the most preferred and necessary learning models for medical students in humanities education, as well as the learning styles they favor in acquiring information.

Prof. Taufiq’s presentation aligns with the Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 4 (Quality Education). Strengthening humanities education in the medical curriculum is expected to cultivate healthcare professionals who can comprehend the humanitarian, ethical, and legal aspects of medical practice.

Addressing Ethical Challenges in Healthcare

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First Video

Yogyakarta, February 26, 2025 – The Center for Bioethics and Medical Humanities (CBMH) Universitas Gadjah Mada once again held its regular webinar, Raboan Sharing & Perspective Sharing. This webinar was conducted online via Zoom Meeting and featured Dr. Bondan Agus Suryanto, S.E., M.A. (Lecturer at the Faculty of Medicine, UII and FMPHN UGM) as the main speaker, with Mahmasoni Masdar, S.Kep., Ns., M.Kep as the moderator.

Presentation by dr. Bondan Agus Suryanto, S.E., M.A.

This session explored “Ethical Issues in Healthcare Services”, highlighting challenges and solutions in achieving fairness in the distribution of healthcare services. In his presentation, dr. Bondan emphasized the importance of a bioethical approach based on social justice to ensure equitable healthcare access amid limited resources. Additionally, he discussed the role of professional organizations in maintaining a balance between the interests of healthcare professionals and the needs of the broader community.

Interactive Discussion with Participants

Mahmasoni Masdar, as the moderator, led an interactive discussion involving participants from various backgrounds, including healthcare professionals, academics, and students. The session delved deeply into different perspectives on healthcare ethics in Indonesia, covering public policy roles, the influence of culture and religion, and challenges in implementing a health insurance-based system such as BPJS.

The discussion on ethical issues in healthcare services aligns with the Sustainable Development Goals (SDGs), particularly SDG 3: Good Health and Well-being and SDG 10: Reduced Inequalities. This webinar aimed to foster cross-sector dialogue to help design more equitable healthcare policies, ensuring that every individual, regardless of social and economic background, can access quality healthcare services.

CBMH UGM hopes this forum will serve as a platform for stakeholders to engage in discussions and share insights on bioethics in Indonesia. Through cross-sector collaboration, the goal is to develop healthcare policies that are fair and easily accessible to all.

Reporter          : Alvira Rahmasari, S.H.G.

Editor              : Rafi Khairuna Wibisono, S.Kom.

Understanding the Concept of Do Not Resuscitate (DNR) in Terminal Patients: Ethical and Medical Practice Perspectives

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First Video

Presentation of Raboan material by dr. Lucia.Yogyakarta, 19 February 2025 – As part of the Raboan: Research and Perspective Sharing series, a discussion was held on the topic The Concept of Do Not Resuscitate (DNR) Orders in Terminal Patients with DPJP”. The event featured dr. Lucia Pudyastuti Retraningtyas, SpA., M.Bio.Et, a lecturer at the Faculty of Medicine, Universitas Surabaya, as the keynote speaker. The discussion was moderated by drg. Agnes Bhakti Pratiwi, MPH, Ph.D., from the Center for Bioethics and Medical Humanities (CBMH), Faculty of Medicine, Public Health, and Nursing (FKKMK), Universitas Gadjah Mada, as well as the UNESCO Chair on Bioethics at UGM.

This webinar highlighted various perspectives on DNR orders for terminal patients. DNR is a medical decision made by the medical team after consulting with a team appointed by the Medical Committee or Ethics Committee. Ideally, the decision-making process should involve both the patient and their family. Communication between the patient, family, and healthcare providers is crucial in identifying the patient’s values, preferences, and critical medical care decisions. dr. Lucia emphasized that DNR orders must be clearly documented and recorded in the patient’s medical records.

Discussion Session With Participant

One key point discussed was the importance of respecting patient dignity in end-of-life care. Physicians have different perspectives on DNR orders, with some agreeing and disagreeing them. Reasons for agreeing DNR Orders : reducing patient suffering and ensuring a peaceful passing; alleviating the burden on the family during the patient’s final moments, facilitating the work of other medical personnel in providing appropriate care; religious considerations that align with end-of-life dignity; legal aspects that support the implementation of DNR. Reasons for disagreeing DNR Orders: concerns over family misconceptions and potential conflicts; the belief that doctors must provide the maximum possible care to every patient; fear of causing family distress or uncertainty regarding medical decisions.

DNR is also linked to the Sustainable Development Goals (SDGs), particularly:  SDG No. 3: Good Health and Well-Being, which emphasizes the importance of access to quality healthcare services, including palliative care and the patient’s right to decide on end-of-life care. SDG No. 10: Reduced Inequalities, which highlights that every patient has the right to make medical decisions without pressure or discrimination, including decisions regarding DNR orders.

This Raboan discussion reaffirmed that a bioethical approach to implementing DNR orders is essential in end-of-life nursing and medical decision-making. Through effective communication between doctors, patients, and families, it is hoped that medical decisions can be made ethically and in alignment with human values.

 

Reporter          : Ardhini Nugrahaeni,M.K.M

Editor              : Alvira Rahmasari, S.H.G.

Building Bioethics for All through Cultural Sensitivity

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RABOAN Discussion Forum 12 February 2025

Yogyakarta, February 12, 2025 – The Raboan Perspective Sharing session once again sparked an insightful discussion on bioethics with the theme “FOR ALL HUMANITY: Toward a Culturally Sensitive Bioethics.” This event featured Prof. Syafaatun Almirzanah, MA, M.Th, Ph.D, D.Min, Head of the Center for Spirituality, Science, and Humanity at UIN Sunan Kalijaga Yogyakarta, as the keynote speaker. The discussion was moderated by dr. Galuh Dyah Fatmala from the Center for Bioethics and Medical Humanities (CBMH), Faculty of Medicine, Public Health, and Nursing (FKKMK) UGM, as well as the UNESCO Chair on Bioethics UGM.

This webinar highlighted the importance of a culturally sensitive approach to bioethics in an increasingly pluralistic and complex society. Bioethics is not solely a concern of the medical field but extends to various disciplines, including social sciences, politics, and religion. In her presentation, Prof. Syafaatun emphasized that bioethical understanding must consider the diverse identities present in society, as each individual carries unique cultural, religious, and social values.

One key takeaway from the discussion was the need to respect and appreciate diversity in society. In this context, Prof. Syafaatun underscored the importance of inclusive democracy and active participation from all groups to create a more just social order. The discussion also explored human rights in bioethics, particularly regarding equal access to healthcare and education without discrimination.

This topic is closely linked to the United Nations’ Sustainable Development Goals (SDGs), particularly SDG 3: Good Health and Well-Being and SDG 16: Peace, Justice, and Strong Institutions. A culturally sensitive approach to bioethics ensures that healthcare services are delivered fairly and with dignity, supporting the well-being of all individuals regardless of their backgrounds. Additionally, through the lens of pluralism, the discussion emphasized the importance of building inclusive and strong institutions to sustain better healthcare and social systems.

The session also addressed various ethical dilemmas in medicine, including euthanasia, physician-assisted suicide, and organ transplantation challenges. Prof. Syafaatun stressed that despite the differing perspectives on these issues, justice, empathy, and respect for human rights should always be prioritized.

Through this discussion, CBMH UGM aims to continuously promote awareness and understanding of the importance of an inclusive and culturally based bioethics. Collaboration between academics, practitioners, and the wider community is key to developing a fairer and more sustainable bioethics system in the future.

This Raboan discussion reaffirmed that a culturally sensitive approach to bioethics is crucial in building a more inclusive and harmonious society. By understanding the intersection of cultural identity, religion, and social values, we can create a more human-centered and just ethical system for all.

Reporter : Rafi Khairuna Wibisono, S.Kom
Editor : Alvira Rahmasari, S.H.G.

Without Calibration, Medical Devices Can Become a Threat, Not a Solution

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(A presentation on medical device calibration by Anggie Maulana Subkhan, SKM, M.Bio.Et.)

(A presentation on medical device calibration by Anggie Maulana Subkhan, SKM, M.Bio.Et.)

Yogyakarta, January 15, 2025 – Raboan Research and Perspective Sharing returned with an engaging topic titled “Ethical Issues in Medical Device Calibration Services”. This event was attended by healthcare professionals, practitioners, and students interested in bioethics and medical device calibration.

The webinar featured Anggie Maulana Subkhan, SKM, M.Bio.Et, as the keynote speaker. Anggie, a calibration technician at the Yogyakarta Health Office and an alumnus of the Master of Bioethics program, brought valuable insights into the ethical challenges faced in the medical sector. He emphasized that medical device calibration is not just crucial for accreditation but also essential for patient safety, ensuring accurate measurement results.

Anggie also discussed ethical dilemmas in the calibration process, including the lack of trained personnel, unaccredited calibration institutions, and budget constraints often faced by healthcare facilities. With existing regulations, such as the Ministry of Health Regulation No. 54 of 2015 on medical device testing and calibration, it is vital for all stakeholders to understand the critical role of calibration in preventing serious health risks caused by device errors.

This discussion strongly aligns with the Sustainable Development Goals (SDGs), particularly SDG 3: Good Health and Well-being. Accurate and ethical medical device calibration ensures precise diagnoses, reduces medical errors, and enhances patient safety. Additionally, the webinar supports SDG 16: Peace, Justice, and Strong Institutions, by highlighting the importance of fair regulations, institutional capacity building, and ethical accountability in healthcare services. The collaboration among institutions discussed during this session reflects collective efforts to sustain a global health system.

The Raboan session provided profound insights into the importance of ethics in medical device calibration and its contribution to the quality of healthcare services. The event also emphasized the need for collaboration between healthcare institutions, calibration agencies, and the community to ensure calibration processes are conducted effectively and in compliance with standards.

(Group photo session with Raboan participants)

For more information, visit our Instagram pages @cbmh_ugm and @bioetika.ugm or contact us via email at cbmhfkugm@mail.ugm.ac.id.

Reporter          : Alvira Rahmasari, S.H.G.

Editor              : Rafi Khairuna Wibisono, S.Kom.

2025 Raboan Webinar: Ethics and Challenges in Safeguarding Education Quality

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First Video

Yogyakarta, January 8, 2025 – The Center for Bioethics and Medical Humanities of the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada (CBMH FM-PHN UGM), kicked off the year 2025 with its inaugural Raboan Webinar titled, “Ethics and Challenges in Safeguarding Education Quality.” Held online on Wednesday, January 8, 2025, the webinar featured Dr. dr. Veronika Ika Budiastuti, MPd, as the keynote speaker. The discussion covered ethical dimensions in higher education quality assurance, highlighting challenges and proposed solutions.

QnA session with Raboan participants

The webinar underscored the significance of both Internal Quality Assurance Systems (SPMI) and External Quality Assurance Systems (SPME) in maintaining the quality of higher education. SPMI focuses on continuous improvement within institutions, while SPME serves as an external evaluation tool to assess SPMI’s effectiveness. Collaboration between universities and accreditation bodies is crucial to achieving holistic education quality. The discussion also addressed the ethical dilemmas faced in implementing SPMI and SPME, such as the tension between institutional autonomy and the obligation to meet external standards, as well as the challenge of ensuring equitable access to education across Indonesia, particularly in remote areas compared to metropolitan regions. Dr. Veronika emphasized the need for flexibility in accreditation standards to accommodate the diversity of resources among universities.

Presentation from Dr. Veronika as speaker

Presentation from Dr. Veronika as speaker

This webinar aligns with the Sustainable Development Goals (SDGs), particularly Goal 4: Quality Education. By addressing ethics in quality assurance, the event highlighted the importance of equal and quality educational access for all. The holistic approach recommended in the webinar supports the development of competitive and ethical human resources, creating a positive impact on society and the environment on a global scale.

Dr. Veronika concluded the webinar by stressing the importance of collaboration among stakeholders, including accreditation bodies, universities, and the government. A flexible and holistic approach can help overcome challenges in safeguarding education quality, creating a better education system for future generations. This webinar offered deep insights into the role of ethics in maintaining education quality.

Reporter : Alvira Rahmasari, S.H.G.
Editor : Rafi Khairuna Wibisono, S.Kom

CBMH UGM Finalizes Response to UNESCO’s Recommendation on Neurotechnology Ethics, Highlights the Need for International Oversight and Protection of Vulnerable Groups

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Yogyakarta, December 20, 2024 — The Center for Bioethics and Medical Humanities (CBMH UGM) successfully held a discussion to finalize its response to UNESCO’s Preliminary Report on the First Draft of The Recommendation on the Ethics of Neurotechnology. This activity aimed to provide written feedback and suggestions for the improvement of the draft recommendations on neurotechnology ethics, which will be submitted to UNESCO as a guiding document for neurotechnology ethics.

The event was attended by the UNESCO Chairs Bioethics UGM team, key stakeholders, policymakers, and expert practitioners in the application of neurotechnology in Indonesia. This collaboration supports Sustainable Development Goals (SDGs) 17, Partnership for the Goals, by fostering cooperation for sustainable development.

The feedback and recommendations provided cover two key documents: the Preliminary Report on the 1st Draft of the Recommendation on the Ethics of Neurotechnology and the First Draft of the Recommendation on the Ethics of Neurotechnology. The main points highlighted the need to expand the scope of the documents, followed by a call for more precise definitions, objectives, and the importance of respecting religious and local cultural values. This emphasis was driven by the recognition of differing values and standards between developing and developed countries.

The proposed policy also calls for the establishment of an international regulatory body responsible for overseeing the ethics of neurotechnology. Additionally, it recommends explicit protections for vulnerable groups, including individuals with critical illnesses and those in a brain-dead state. Support is also required for the use of technology in the field of neurology, including education and training for neurosurgeons.

During the development of neurotechnology, it is essential to prioritize aspects such as privacy, well-being, acceptance, and user-friendliness from the user’s perspective. In practice, neurotechnology should be designed to be easily implementable, with clear indicators for measuring success.

Furthermore, the importance of longitudinal studies was emphasized to better understand the long-term effects of implanted neurotechnology. Additional suggestions were also provided to support the refinement of UNESCO’s documents.

Reporter          : Ardhini Nugrahaeni, M.KM

Editor              : Alvira Rahmasari, S.H.G.

Exploring Public Health Ethics: Center for Bioethics and Medical Humanities UGM Welcomes Prof. Angus Dawson as a Visiting Professor in 2024

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Group Photo of the Guest Lecture with Prof. Angus Dawson

Center for Bioethics and Medical Humanities at Universitas Gadjah Mada (UGM) successfully held a Visiting Professor Program from November 12 to 14, 2024. The program featured Prof. Angus Dawson from the National University of Singapore (NUS) as the main speaker. The event was conducted in a hybrid format, with in-person sessions at the Faculty of Medicine, Public Health, and Nursing (FM-PHN) UGM, as well as online via Zoom Meeting.

The event kicked off on November 12, 2024, with a workshop entitled “Joint Manuscript and Research/Project on Public Health Ethics.” This workshop aimed to strengthen research collaborations on public health ethics. The following day, a lunch discussion on bioethics and humanities education was held. In addition, a “Rabuan” seminar, a routine discussion series on public health topics, took place. The event was further enriched by an “exchange works/experience” session, where participants shared their insights and experiences.

The peak of the event occurred on November 14, 2024, with a Guest Lecture by Prof. Angus Dawson. This session was the most anticipated part of the event, drawing attendance from students, academics, and practitioners. Prof. Angus presented a lecture on “The Importance of Public Health,” which delved into the concepts, values, and impact of public health. In his presentation, Prof. Angus highlighted the fundamental differences between public health and clinical care. While clinical care focuses on individual patients, public health takes a community, social, and cultural approach, aiming to protect and improve health on a larger scale.

Presentation of “The Importance of Public Health” by Prof. Angus Dawson

Key takeaways from the presentation included the notion that public health is not solely about individual treatment but also about managing health risks within communities. The ethical dimensions of public health were also emphasized, given that decisions in this field often involve moral dilemmas. For example, quarantine policies for controlling infectious diseases must balance individual freedom with the protection of public health. As a result, social justice and equity in access to healthcare services become crucial principles in decision-making processes.

This Guest Lecture played a significant role in supporting several Sustainable Development Goals (SDGs). These include SDG 3 (Good Health and Well-Being), as it discusses patient care within the social, community, and cultural context of public health. It also relates to SDG 10 (Reduced Inequalities), addressing efforts to reduce inequalities in access to healthcare services and outcomes within the “societal, community, cultural context.” Lastly, it supports SDG 16 (Peace, Justice, and Strong Institutions) through discussions on “autonomy and confidentiality” for patients, with a focus on personal data protection and human rights in healthcare.

The interactive discussion session was a highlight of the Guest Lecture. Students, academics, and practitioners actively asked questions and shared their perspectives. Several participants appreciated the relevance and depth of the discussion. One participant stated, “This guest lecture has broadened my perspective on how public health requires not only medical knowledge but also ethical considerations and policy-making skills. It is a field where science meets society.”

Through this series of events, Center for Bioethics and Medical Humanities UGM reaffirmed its role in fostering ethical discussions on public health issues. This program successfully bridged academic discourse, field practice, and policy, thereby promoting research collaboration and raising public awareness of the importance of public health in sustainable development.

Reporter        : Alvira Rahmasari, S.H.G.
Editor             : Rafi Khairuna Wibisono, S.Kom.

Webinar Raboan Center for Bioethics and Medical Humanities (CBMH) UGM: Family Decision Making

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RABOAN “Family Decision Making”

Center for Bioethics and Medical Humanities Universitas Gadjah Mada (CBMH UGM) held its regular Raboan event with the theme “Family Decision Making” on Wednesday, October 8, 2024. The event was hosted via Zoom and featured Lintang Sagoro, MD, a master’s student from Harvard Medical School, as the speaker. The webinar was attended by students, academics, and healthcare practitioners interested in medical ethics and policy issues.

Lintang Sagoro, MD, opened the discussion by highlighting the crucial role of the family in decision-making for the care of patients with serious illnesses. “Medical decisions are not just about the therapies to be administered, but also about how to maintain the quality of life of the patient, both physically and emotionally,” he explained. Lintang Sagoro, MD emphasized that honest and transparent communication between patients, families, and healthcare providers is essential for ensuring the well-being of the patient, especially in the context of palliative care.

In the first session, Lintang Sagoro, MD discussed the importance of bioethical principles in medical decision-making, grounded in the values of Pancasila. The concepts of respect, beneficence, and justice, which advocate for the respect of all forms of life, including humans, animals, and the environment, serve as the foundation that must be considered in every medical decision. “The principle of patient autonomy must be balanced with family responsibility, and we need to ensure that decisions reflect the noble values that underpin bioethics,” he said.

The discussion then moved to the topic of palliative care, which aims to improve the quality of life for patients with serious illnesses. Lintang Sagoro, MD explained that palliative care is not meant to replace curative treatment, but rather to complement it by focusing on the comfort of the patient, as well as providing emotional and spiritual support for both the patient and their family.

Communication challenges between families and patients were also a key point of focus in this webinar. Lintang Sagoro, MD revealed that families often face dilemmas in disclosing the health condition of patients with severe illnesses, as they try to protect the patient from stress that may arise from unpleasant information. “It is important for healthcare providers to help families deliver information carefully and empathetically, so the decision-making process can proceed smoothly,” he said.

The webinar also highlighted the cultural differences in medical decision-making between Indonesia and Western countries. In Indonesia, medical decisions tend to involve the extended family, whereas in countries like the United States, patient autonomy plays a more dominant role in determining their care. This difference underscores the importance of understanding cultural context in medical practice.

The discussion was relevant to SDG 3 on Good Health and Well-Being, which emphasizes the importance of quality and inclusive healthcare. Family-based decision-making and honest communication in the care of patients with serious illnesses support efforts to achieve better access to holistic palliative care. This also contributes to reducing healthcare inequities and enhancing the well-being of both patients and families facing difficult conditions.

At the conclusion of the event, Lintang Sagoro, MD encouraged participants to better understand the importance of emotional support for families caring for patients with serious illnesses, as well as the need to integrate palliative care into the healthcare system. “Support for caregivers is crucial, as they not only care for the physical needs of the patient, but also face significant emotional challenges,” he remarked.

For more information, please visit the official of CBMH UGM

E-mail             : cbmhfkugm@ugm.ac.id

Youtube          : CBMH UGM

Instagram        : cbmh_ugm

 

Reporter          : Alvira Rahmasari, S.H.G.

Editor              : Rafi Khairuna Wibisono, S.Kom.