Webinar Raboan Center for Bioethics and Medical Humanities (CBMH) UGM: 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.

Webinar RABOAN “Ethics and Moral Dilemma: Approaches For Solving Ethical Dilemmas”

Yogyakarta, October 2, 2024 – The Center for Bioethics and Medical Humanities (CBMH) of the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada (FKKMK UGM) hosted the RABOAN webinar titled “Ethics and Moral Dilemma: Approaches For Solving Ethical Dilemmas”. The event featured Dr. Johanes Haryatmoko, SJ., a social ethics expert, as the keynote speaker, with Prof. Syafaatun Almirzanah, M.A., M.Th., Ph.D., D.Min. serving as the moderator.

This webinar explored ethical approaches to addressing moral dilemmas, particularly in the healthcare field, using principles such as deontology, utilitarianism, proportionalism, and communitarianism. The discussion emphasized the importance of deep reflection in making ethical and fair decisions, aligning with the Sustainable Development Goals (SDGs) 3 on Good Health and Well-Being, and SDG 16 on Peace, Justice, and Strong Institutions.


Dr. Haryatmoko highlighted that “what is legal is not necessarily moral.” Ethical decisions, especially in the medical field, cannot be based solely on formal law but must also involve a deep analysis of social and cultural contexts. One example discussed was the case of a mother who refused an abortion despite significant pressure from her family. Dr. Haryatmoko emphasized the importance of respecting individual autonomy while considering collective values.

Prof. Syafaatun added that often, moral dilemmas arise from a lack of effective communication. “Before an issue becomes an ethical dilemma, the main problem is often poor communication,” she stated. She stressed the need for open and inclusive dialogue between healthcare providers and patients, which is in line with the SDGs’ efforts to promote peace and justice through effective communication.

The discussion also touched on ethical dilemmas in medical practice in Indonesia, such as preeclampsia procedures, abortion, and vasectomy, which often conflict with religious values. The webinar stressed the importance of adopting locally grounded ethical approaches to formulating humane solutions, in line with global efforts to ensure equitable and dignified healthcare access.

In conclusion, Dr. Haryatmoko reminded the participants that open discourse and deep reflection are key to navigating moral dilemmas. “Social ethics requires a bridge in the form of values and competencies to connect vision with action,” he stated.

The webinar was attended by participants from various sectors, including healthcare professionals, academics, and students, who actively asked questions regarding ethical dilemmas in medical practice. Dr. Haryatmoko’s book, which delves further into social ethics, also garnered significant attention from attendees.

 

For more information, please visit the official of CBMH UGM

E-mail             : cbmhfkugm@ugm.ac.id

Youtube          : CBMH UGM

Instagram        : cbmh_ugm

 

Reporter          : Rafi Khairuna Wibisono, S.Kom.

Editor              : Alvira Rahmasari, S.H.G.

PRESS-RELEASE CONFERENCE EVENT IBHC 2024 Bioethics to Preserve Humanity: Navigating through environmental crisis and rapid technology advancement

Yogyakarta, November 6-8, 2024 – The International Bioethics and Humanities Conference (IBHC) 2024 gather global experts to discuss critical issues in bioethics, humanity, technology, and environmental sustainability. Held at Alana Hotel Yogyakarta, this multidisciplinary event explores themes such as biobanking, bioethics education, precision medicine, and ethical considerations for environmental sustainability.

Prof. dr. Ova Emilia, M.Med.Ed., Sp.OG(K)., Ph.D officially opened the IBHC 2024 conference by striking the gong

Prof. dr. Ova Emilia, M.Med.Ed., Sp.OG(K)., Ph.D officially opened the IBHC 2024 conference by striking the gong

IBHC 2024 Participants

IBHC 2024 Participants

The IBHC 2024 symposiums cover key topics in bioethics, such as biobanking ethics in Southeast Asia, focusing on informed consent, privacy, and equitable data management to support health innovation. Bioethics education is discussed in the context of its integration into higher education through interactive methods to nurture ethical leadership. Precision medicine addresses challenges in data privacy, dynamic consent, and equitable access to genomic technologies, while healthcare ethics explores dilemmas in palliative care, rare diseases, and the importance of cultural values in medical decision-making. Other topics include the integration of traditional medicine, ethical research practices, and the role of local culture in environmental sustainability through eco-village development and natural dye revitalization.

Discussions with plenary symposium speakers: Dicky Sofjan, Ph.D., Ir. Laretna T. Adishakti, M.Arch., and Prof. Dr. Ir. Edia Rahayuningsih, MS., IPu., on critical topics in bioethics and sustainability.

Discussions with plenary symposium speakers: Dicky Sofjan, Ph.D., Ir. Laretna T. Adishakti, M.Arch., and Prof. Dr. Ir. Edia Rahayuningsih, MS., IPu., on critical topics in bioethics and sustainability.

 

As part of the conference, oral and poster presentation competitions are also held on November 7. The oral presentation competition features participants from various institutions, evaluated by judges who are experts in their respective fields. Meanwhile, the poster presentations take the form of a poster exhibition, where participants are similarly assessed by expert judges. Both oral and poster presentations follow specific themes based on the established guidelines. The winners, three top participants from both categories announced on the final day of the conference.

The winner of oral presentation and poster presentation

The winner of oral presentation and poster presentation

 

Aligned with key Sustainable Development Goals (SDGs)—SDG 3 (Good Health and Well-being), SDG 10 (Reduced Inequalities), and SDG 16 (Peace, Justice, and Strong Institutions)—IBHC 2024 reinforces bioethics as a foundation for addressing global challenges through inclusive and sustainable approaches.

Welcoming Dinner IBHC 2024

Welcoming Dinner IBHC 2024

Photo session showcasing participants and speakers united in discussing bioethics, humanity, and sustainability

Photo session showcasing participants and speakers united in discussing bioethics, humanity, and sustainability

PRESS-RELEASE PRE-CONFERENCE IBHC 2024 Bioethics to Preserve Humanity: Navigating through environmental crisis and rapid technology advancement

The International Bioethics and Humanities Conference (IBHC) 2024 successfully commenced at the Alana Hotel, Yogyakarta, bringing together academics, professionals, and practitioners from across the globe to address pressing issues in bioethics, health, and humanities. Held from November 5-8, 2024, the event featured a pre-conference day on November 5 and the main conference from November 6-8.

A group photo with participants at the pre-conference workshop

A group photo with participants at the pre-conference workshop

The pre-conference included workshops on several key topics. “Decolonizing Bioethics” which organized by South-East Asian Bioethics Network (SEABION) focused on the need to prioritize local perspectives in addressing ethical challenges. Another session, “Clinical Ethics Support” introduced tools like Moral Case Deliberation (MCD) to help healthcare professionals handle ethical dilemmas and make better decisions. This session was delivered by Professor Albert Molewijk from Amsterdam UMC. A workshop on “Palliative and End-of-Life Care” highlighted the importance of compassionate communication, involving family and spirituality to provide better support for patients. There was also a session on Pelatihan dan Pengembangan Komite Etik Penelitian which covered how to build strong, independent committees to oversee ethical research, especially in the era of big data and advanced technology.

 

Participants engaging in discussions during the pre-conference workshop at IBHC 2024.

Participants engaging in discussions during the pre-conference workshop at IBHC 2024.

 

Opening remarks by Professor Dr. Sharon Kaur from South-East Asia Bioethics Network

Opening remarks by Professor Dr. Sharon Kaur from South-East Asia Bioethics Network

The pre-conference activities contributed to advancing several Sustainable Development Goals (SDGs). Discussions on palliative care and ethical health research aligned with SDG 3 (Good Health and Well-being) by improving patient care and societal health outcomes. Comprehensive bioethics training supported SDG 4 (Quality Education) by enhancing healthcare professionals’ capacities and ethical research practices. The principles of transparency, accountability, and cross-disciplinary collaboration emphasized throughout the sessions reflected SDG 16 (Peace, Justice, and Strong Institutions).

The pre-conference set the stage for deeper discussions on how ethics can shape better healthcare and research practices. By bringing people from different fields together, IBHC 2024 aims to inspire more compassionate, fair, and sustainable approaches to healthcare around the world.

The Asia-Pacific Regional Stakeholder Consultation on The First Draft of UNESCO Recommendation on The Ethics of Neurotechnology

UNESCO Chair on Bioethics Universitas Gadjah Mada (UCB UGM), in collaboration with the UNESCO Jakarta office, had successfully held an Asia-Pacific Regional Consultation to discuss the draft UNESCO Recommendation on the Ethics of Neurotechnology. The event took place on June 21st 2024, virtually via Zoom Meeting platform. This consultation session was part of the process to develop the timely standard-setting instrument, UNESCO
recommendation on the Ethics of Neurotechnology. The 1st draft text of the recommendation had been produced by UNESCO Ad Hoc Expert Group (AHEG), through its 1st meeting earlier this year on 22nd – 26th April. This activity was in alignment and contributing to the realization of Sustainable Development Goals, particularly SDG 3 in ensuring healthy life and promote wellbeing for all at all age, SDG 10 in reducing inequality within and among countries and SDG 17 in strengthening implementation measures and revitalizing the global partnership for sustainable development.

This regional consultation was commenced with opening remarks from The Dean of Faculty of Medicine, Public Health and Nursing (FMPHN) UGM, Dr. Yodi Mahendradhata, M.Sc, Ph.D, FRSPH, and the Director of Center for Bioethics and Medical Humanities (CBMH), Dr. Dra. Retna Siwi Padmawati, MA, who also represented Prof. Dr. Yati Soenarto S, Sp.A (K)., Ph.D as the Chairholder of UNESCO Chair Bioethics UGM.

The UNESCO resource persons and also members of UNESCO AHEG attended this consultation session to provide background context and highlights for the draft recommendation text, as well as discussing interactively with participants. Dr. Dafna Feinholz Klip, as Chief of the Bioethics and Ethics of Science Section, within UNESCO’s Social and Human Science Sector, conveyed the process of preparing UNESCO’s draft recommendations on the Ethics of Neurotechnology. Dr. Ryota Kanai, experienced expert in neuroscience and member of UNESCO AHEG spoke on highlights of “Setting the scene: Neuroscience in the context of the draft UNESCO Recommendation”. Prof. Qingming Luo, experienced expert in neuroimaging and UNESCO AHEG member emphasized on the importance of integrating ethical frameworks into neurotechnology practice, and the role of international collaboration. The consultation session were led by two moderators dr. Rusdy Ghazali Malueka, Ph.D, Sp.S(K), expert neurologist, and dr. Wika Hartanti, MIH, bioethics faculty and executive manager of UCB UGM, both also teaching faculty at Master Bioethics UGM.

The event was attended by 58 invited participants who originated from 14 countries in Asia-Pacific region, and represented various stakeholders concerning neurotechnology development and implementation. Participants were from various backgrounds representing scientific community, healthcare providers, bioethicists, patient groups, and civil society. The interactive and lively consultation session facilitated participants’ inquiries and
feedbacks from various perspectives to improve the draft recommendation text. The discussion highlights important aspects about definition and scope of neurotechnology, and ethical concerns arising from it. Suggestions regarding values, principles and policy recommendations were made to encourage ethical, humane and sustainable development and practice of neurotechnology. Feedbacks and suggestions from this consultation session were documented, and reported back to UNESCO as representation of stakeholders’ perspectives from Asia – Pacific Region. Further details and information regarding subsequent process towards the final recommendation for Ethics in Neurotechnology is available in the UNESCO page (https://www.unesco.org/en/ethics-neurotech/expert-group?hub=83294#).

Keywords: Bioethics, Ethics, Neuroethics, Neurotechnology, Neuroscience, UNESCO, SDGs, SDGs 3, SDGs 10, SDGs 17.

Leadership Skill for Medical Student [Raboan Discussion Forum]

The Center for Bioethics and Medical Humanities (CBMH FK-KMK UGM) held a Raboan Discussion Forum on Leadership in Academic Medicine on Wednesday (06/09). The event, which was held online, invited speakers Prof Chandramani Thuraisingham and Dr Sasikala Amirthalingam. The discussion was led by moderator Prof. Dra. Yayi Suryo Prabandari, M.Si., Ph.D.

The presentation was divided into two sessions. The first session was by Prof. Chandramani titled Leadership as a Primary Care Physician. Prof. Chandramani emphasized that Leadership is important in medical school. Prof Chandramani explains that Leadership is not a talent anyone is born with. It is a skill one needs first to acquire and then hone further. 4 crucial points on ethical Leadership: 1) Ethical leaders have high standards for their team & set the same standards for themselves daily. 2) Ethical leaders would also do the job they ask someone to do. 3) Ethical Leaders hold equal respect for others & the team. 4) Ethical leaders are honest and straightforward in their communication.

The second session is by Dr. A Sasikala. Her presentation is titled Learning Leadership During Community Engagement Activities. She presented her community engagement project in Kampung Sebir. This project provided valuable experiential learning opportunities for the students, helping them develop essential Leadership and interpersonal skills such as communication skills, listening skills, delegating tasks and responsibilities, being transparent leader, creating a collaborative environment, teamwork, being empathetic, Having confidence, Firmly believing in their vision Developing mutual trust relationships, and openness to feedback.

Ethical Dilemma During Limited Resource in Covid-19 Pandemic and The Urgency of Bioethics Education [Raboan Discussion Forum]

Wednesday (30/08) The Center for Bioethics and Medical Humanities held a regular Raboan Discussion Forum. The activity, which was held online, invited speakers, Dr. Ervin Dyah Ayu M. D., M.Sc, who is an alumnus of the UGM bioethics master’s study program and a lecturer at the University of Surabaya. The topic presented was The Urgency of Bioethics Education in Allocating Limited Resources. Acting as moderator is Noviyanti Fahdilla, S.Tr.Keb, MPH.

The COVID-19 pandemic has raised various ethical dilemmas in treating patients. In conditions where human resources (HR) and facilities are limited, doctors and medical personnel face demanding situations that result in services not being optimal and many patients needing to be treated.

It is also prone to misunderstandings and conflicts between doctors and patients. With limited resources, doctors are forced to choose which patients receive treatment first. A doctor’s decision needs to be understood by patients, and patients require an explanation from doctors and health workers.

Dr. Ervin explained that there is a guide to resource allocation when in limited condition. However, these guidelines need to be adapted to Indonesian culture. Thus, bioethics training or education with an Indonesian cultural background is essential for students, doctors, and health workers to improve their communication skills and cultural competence.

 

Translational Value of Animal Models in Research [Raboan Discussion Forum]

Wednesday, (23/08) Center for Bioethics and Medical Humanities (CBMH FK-KMK UGM) held Raboan Discussion Forum. The routine webinar was held in collaboration with International Medical University Malaysia. The speaker was Dr. Renu Agarwal and the moderator was Erlin Erlina, PhD. The raised topic is Translational Value of Animal Models in Research: Ethical Viewpoint.

Understanding how the human body functions, identifying diseases that affect humans, and developing effective treatment options are pivotal endeavors in medical and scientific research. To advance these goals, animal testing has played a significant role in various fields, including research and development (R&D), fundamental research, quality control (QC), production, and toxicity testing. Commonly used animals for these purposes include mice, rats, ectotherms, rabbits, and birds.

One of the most poignant stories related to animal testing is that of Laika, the first dog in space. Laika was sent into orbit aboard the Soviet spacecraft Sputnik 2 to study the prolonged effects of weightlessness on a living being. Unfortunately, her mission ended tragically as she succumbed to stress and overheating. This story sparking a debate on the ethical considerations surrounding animal testing.

This debate can be distilled into two primary viewpoints: those in favor of animal testing (pro-animal testing) and those against it (kontra animal testing).

Proponents of Animal Testing (Pro):
– Argue that human life has greater intrinsic value than animal life and that medical research saves countless human lives.
– Emphasize that legislation is in place to protect lab animals from cruelty or mistreatment.
– Point out that many animals are euthanized before experiencing significant suffering, making their sacrifice more humane.
– Highlight the irony that millions of animals are killed every year for food, questioning whether their deaths for medical research are a more worthy cause.

Opponents of Animal Testing (Kontra):
– Contend that animals have as much right to live as humans and that their lives should not be sacrificed for research purposes.
– Argue that strict controls have not always prevented some animals from being abused, even if such instances are rare.
– Assert that death for research is unnecessary, and alternative methods should be explored to replace animal testing.
– Express concerns about the suffering experienced by animals while they are confined and question our ability to accurately gauge when they do or don’t feel pain.

Despite the ethical divide, international guidelines acknowledge the role of animal testing in advancing medical knowledge and ensuring the safety and efficacy of medicines, vaccines, and surgical techniques. These guidelines stipulate that such testing must involve two different species of mammals. While contentious, it is an unavoidable reality in the pursuit of scientific progress.

The guiding principles underscore the need to regulate animal testing rather than abolishing it and emphasize the humane treatment of animals involved in experiments.

For scientific integrity, researchers must address internal and external validity in animal testing. Key questions include considering the relevance of the chosen animal species, designing experiments to eliminate bias, and outlining plans for data collection and analysis.

In conclusion, the debate over animal testing is complex and multifaceted, touching on ethical, scientific, and regulatory considerations. Striking a balance between advancing medical knowledge and respecting the welfare of animals remains a challenging and ongoing endeavor in the field of research.

Islamic Perspective on the Use of Tube Feeding [Raboan Discussion Forum]

Wednesday (16/08), Center for Bioethics and Medical Humanities, Faculty of Medicine, Public Health, and Nursing held a Raboan Discussion Forum titled “Tube Feeding in Dementia at the End of Life from an Islamic Perspective.” The event, which was held online, invited speakers, Dr. Hadil Lababidi from Erlangen University, Germany. Meanwhile, the discussion was led by Ns. Wahyu Dewi Sulistyarini, M.SN.

Dementia is an umbrella term for a disease of decreased cognitive ability. One type of disease in dementia is Alzheimer’s. People living with acute dementia will experience severe symptoms such as being confined to bed, wetting the bed, and having difficulty swallowing food.

Artificial Nutrition and Hydration (ANH) was created to help people living with dementia get food intake. ANH will be given through a gastronomic tube or nasogastric tube, so this process is often called Tube Feeding. ANH can cause several side effects, such as nausea, vomiting, diarrhea, and infection. Apart from that, it can also make patients stressed and uncomfortable and increase social isolation.

From an Islamic point of view, hunger and lack of nutrition is something that is opposed. However, continuous use of ANH should be avoided. Islam teaches that close relatives who care for dementia patients must respect the patient’s dignity and prevent the side effects of ANH.
There are several alternatives that can be used besides tube feeding, including Assisted Hand Feeding (AHF), Feeding Positions and Skills, and Modification of Food Texture.

Professionalism and Ethical Responsiveness for Medical Student [Raboan Discussion Forum]

Wednesday (09/08), Center for Medical Bioethics and Humanities, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University held Raboan: International Collaboration in collaboration with International Medical University Malaysia. The boldly held event raised the topic of Student Empowerment: Professionalism & Ethical Responsiveness, which was presented by Dr. Serena In from IMU Malaysia. Meanwhile, the moderator who led the discussion was Dr. Wika Hartanti MIH from CBMH FK-KMK UGM.

Professionalism is an important thing to be mastered by students, especially medical students. Professionalism and Ethical Responsiveness emphasize the commitment of physicians and healthcare professionals to excellence, patient well-being, and the health needs of society. For students to have professionalism and ethical responsiveness, such as integrity, accountability, respect, and professional commitment, it is necessary to involve various stakeholders in medical education and patient care.

Dr. Serena highlighted the competencies of good ethical education, including the ability to identify ethical issues, knowledge of aspects, self-reflection, and making ethical decisions in critical situations. Methods that can be taken include conducting open dialogues, simulations, case studies, and workshops in order to develop skills and understanding of complex ethical issues. So students can explore their attitudes, manage emotions, and engage with different perspectives.
Dr. Serena suggested that lecturers can encourage students to be aware of how ethical issues can be resolved in clinical practice. She also encourages students to dialogue and interact with others to determine whether students have ethical abilities in clinical practice.