Communication Challenges in Interprofessional Collaboration in the Healthcare Sector

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Wednesday, April 23, 2025 — Raboan Research and Perspective Sharing session was held with the theme “Communication Challenges in Interprofessional Collaboration (IPC) in the Healthcare Sector.” The event featured dr. Nasrun, S.H., M.Sc, an alumnus of the Master’s Program in Bioethics at UGM and currently a lecturer at the Department of Bioethics, Faculty of Medicine, Unisa Palu. The session was moderated by Ika Setyasari, S.Kep.Ns., M.N.Sc from CBMH UGM. More than 50 participants attended the event, including students, clinicians, and academics from various backgrounds.

BIOETIKA HUMANIORA MEDICAL ETHICS

In his presentation, dr. Nasrun emphasized that the primary challenge in implementing IPC is cross-professional communication. IPC is crucial to support the shift from a paternalistic model of healthcare delivery toward a partnership model. It aims to improve the quality of care and optimize patient-centered care, positioning patients as the central focus in clinical decision-making.

Four main communication challenges in IPC include differences in meaning, professional ego, misaligned perceptions, and territorial boundaries between healthcare workers. Misunderstandings often arise, such as the use of the word “sorry,” which can be interpreted either as an admission of fault or, conversely, as an indication of incompetence. In emergency situations, these communication challenges become even more complex, requiring strategies like shared understanding and open interprofessional dialogue.

BIOETIKA HUMANIORA MEDICAL ETHICS

This topic aligns with Sustainable Development Goal (SDG) No. 3: Good Health and Well-being, which emphasizes the importance of a strong and responsive health system. It also relates to SDG No. 4: Quality Education, as effective IPC requires Interprofessional Education (IPE) to support the early development of collaborative competencies among healthcare professionals. Robust IPE programs will prepare health workers to communicate and collaborate effectively across professions.

RABOAN Discussion Forum 23 April 2025

Reporter: Ika Setyasari, S.Kep.Ns., M.N.Sc

Editor: Rafi Khairuna Wibisono, S.Kom

 

Is Immunization Necessary for Infants?

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RABOAN Research and Perspective Sharing “Etika Imunisasi”

Yogyakarta, April 16, 2025 – The Center for Bioethics and Medical Humanities (CBMH), Universitas Gadjah Mada, once again held its weekly discussion forum, Raboan Sharing & Perspective Sharing, this time raising the theme “The Ethics of Immunization.” The online discussion, conducted via Zoom, featured Dr. dr. Fx. Wikan Indrarto, Sp.A – a pediatrician and lecturer – as the main speaker, moderated by Ns. Wahyu Dewi Sulistyarini, MSN.

BIOETIKA HUMANIORA MEDICAL ETHICS

In his presentation, dr. Wikan emphasized that immunization is one of the most important efforts to build immunity against diseases. However, its implementation raises various challenges from a biomedical ethics standpoint, including the principles of non-maleficence (do no harm), justice, autonomy, and beneficence.

BIOETIKA HUMANIORA MEDICAL ETHICS“As medical professionals, our duty is not only to provide medical benefits, but also to ensure that our actions are fair and respect the rights of patients,” said dr. Wikan.

He further discussed the issue of medical paternalism, where doctors may limit a patient’s autonomy for the patient’s or public’s benefit. dr. Wikan explained that such a paternalistic approach can be ethically justified under certain conditions, such as when there is a serious preventable risk, when patients are unable to make autonomous decisions, or when the action significantly benefits the patient. The discussion also touched on national immunization regulations, including Indonesia’s Ministry of Health Regulation No. 12 of 2017, and the Indonesian Ulema Council (MUI) Fatwa No. 4 of 2016, which states that immunization is permissible (mubah) in Islam.

Wikan concluded by highlighting the importance of transparency in immunization practices. He reminded the audience that the success of the national immunization program requires the active involvement of doctors in providing thorough education and respecting parents rights to make informed and voluntary decisions.

“We need to ensure the success of the national immunization program, but we must also critically examine its implementation from an ethical perspective. Are we being wise enough?” he asserted.

This event served as a reminder that health is not solely a medical issue, but also one of values, rights, and moral choices in a pluralistic society. The topic of immunization ethics is closely related to the Sustainable Development Goals (SDGs), particularly SDG 3 on Good Health and Well-being, and SDG 4 on Quality Education. Through sound ethical education in medicine, healthcare professionals are expected to make wiser and fairer clinical decisions, including in immunization practices.

Reporter             : Ardhini Nugraheni, M.K.M.

Editor                  : Alvira Rahmasari, S.H.G.

 

Health Communication and Ethical Challenges: Building a Responsible Dialogue

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Yogyakarta, March 19, 2025 — The Center for Bioethics and Medical Humanities (CBMH) at Universitas Gadjah Mada once again hosted its regular Raboan Sharing & Perspective Sharing session, a weekly discussion exploring various bioethics issues. This event, held online via Zoom, featured dr. Steffi Rifasa, M.H., a lecturer and Head of the Division of Bioethics and Law at the Faculty of Medicine, Universitas Islam Pasundan, as the keynote speaker, with Nathan Agwin Khenda, Ftr., M.Bio.Et., serving as the moderator.

BIOETIKA HUMANIORA

On this occasion, Raboan explored the theme ‘Health Communication and Ethical Challenges: Building a Responsible Dialogue.’ The discussion emphasized the critical role of bioethics in health communication while examining various solutions for addressing medical ethical dilemmas that require effective communication between healthcare professionals and patients. The session began with an analysis of alleged malpractice cases involving medical personnel, illustrating how perspectives can differ between patients and healthcare institutions. Furthermore, it underscored that clear and transparent communication is essential in preventing misunderstandings between medical professionals and patients, which can significantly impact medical decision-making.

 

BIOETIKA HUMANIORA

Moderated by Nathan Agwin Khenda, the discussion was highly interactive, engaging participants from diverse backgrounds, including medical professionals, academics, and students. Various perspectives on bioethics and communication crises were explored in depth, particularly regarding the application of bioethical principles and the role of healthcare professionals in building patient trust through effective and responsible communication.

Steffi Rifasa, M.H., also highlighted the challenges in health communication, particularly in delivering bad news without diminishing patients’ hope. She emphasized the importance of using appropriate methods, such as the SPIKES approach (Setting, Perception, Invitation, Knowledge, Empathy, and Strategy), to ensure that difficult conversations are conducted ethically and responsibly. Additionally, she addressed the growing challenges in digital health communication, where the rise of telemedicine and the widespread use of social media as an information source—often lacking accuracy—necessitate a more proactive role for healthcare professionals in providing accurate health education.

These ethical and communication challenges are closely linked to the Sustainable Development Goals (SDGs), particularly SDG 3: Good Health and Well-Being, which underscores the importance of effective health communication in ensuring quality healthcare and appropriate patient treatment. Furthermore, SDG 4: Quality Education highlights the need for healthcare professionals to receive proper training in ethical and empathetic communication to enhance patient interactions.

This Raboan discussion reaffirmed that effective communication in healthcare not only helps patients better understand their conditions but also strengthens the relationship between healthcare providers and patients. An ethical approach in health communication is essential, ensuring that information is conveyed in a way that fosters a deeper understanding for both patients and their families.

 

Reporter : Nadia Ulfah, Mafrida Nabilah Hanan

Editor : Alvira Rahmasari, S.H.G.

Examining the Phenomenon of Aesthetic Surgery: Medical, Ethical, and Religious Perspectives

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RABOAN Perspective Sharing – 12 March 2025

Yogyakarta, March 12, 2025 – The Center for Bioethics and Medical Humanities (CBMH) at Universitas Gadjah Mada held a RABOAN webinar featuring Dr. Prima Maharani Putri, M.H., C.Med. as the keynote speaker.

In her presentation, Dr. Prima discussed the growing trend of aesthetic surgery, which has gained increasing popularity in modern society. “Today, achieving a flawless appearance has become a priority in professional and social interactions. Many individuals choose plastic surgery to attain the beauty standards they aspire to,” she stated.

With the rapid advancement of information technology, the promotion of aesthetic surgery on social media has become more widespread, showcasing stunning physical transformations and shaping public perceptions of beauty. However, beyond its rising popularity, various bioethical considerations and religious perspectives must also be taken into account.raboan bioetika 12 maret 2025

The webinar also explored different religious viewpoints on aesthetic surgery. In Islam, such procedures are permitted if they serve a rehabilitative purpose and provide medical benefits, but they are deemed forbidden if performed solely for beautification. Buddhism considers plastic surgery a positive action when done for health reasons but discourages it if pursued merely for aesthetic purposes. Meanwhile, in Protestant and Catholic Christianity, plastic surgery is acceptable for medical needs, such as reconstructive procedures due to congenital disabilities or injuries. In contrast, Hinduism generally discourages altering one’s physical form through plastic surgery.

Dr. Prima emphasized the importance of applying bioethical principles in aesthetic surgery practices. “Patients have the right to decide whether to undergo plastic surgery as long as it is not intended to deceive or harm themselves or others. Doctors must provide informed consent and consider ethical aspects, especially for patients who lack medical indications,” she explained.

The discussion in this webinar also aligns with the Sustainable Development Goals (SDGs), particularly Goal 3 (Good Health and Well-being) and Goal 10 (Reduced Inequalities). By examining aesthetic surgery through the lens of bioethics, religion, and mental health, this event aimed to raise public awareness of the social impact of beauty standards shaped by social media. Additionally, the webinar served as an educational platform for medical professionals and the public to better understand the importance of ethical healthcare services, ensuring that all medical procedures, including plastic surgery, provide genuine benefits to patients with clear medical indications.

The event concluded with the key message that medical professionals play a crucial role in educating the public and upholding ethical standards in aesthetic surgery. “Upholding ethics and moral values can encourage people to accept themselves as they are. Plastic surgery is not the ultimate measure of physical perfection,” Dr. Prima concluded.

Reporter : Ardhini Nugrahaeni, M.K.M.
Editor : Rafi Khairuna Wibisono, S.Kom

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.