Center for Bioethics and Medical Humanities just held the Raboan Discussion Forum on Wednesday, (31/08). The title of this discussion is Determination of  Death and End of Life Care. The material was presented by the speaker: Prof. Dr. dr. Dedi Afandi, DFM, Sp.FM(K) the moderator is dr. Galuh Dyah Fatmala.

The beginning of life and the end of life are a dilemma that existed long ago. The dilemma also exists in the financing of patient care using whether or not his life aids are still being given. Karen Ann quinlan is one example of when the ventilator she was unplugged turned out to be able to breathe spontaneously, this caused concern for patients in end-of-life care.

There is a confusion in clinicians in determining death, according to article 117 of the Health Law and Permenkes No. 37 of 2004 a person is declared dead if the function of the heart and breathing has stopped and there is death in the brainstem. Indonesia adheres to the death of the brainstem because if there is a malfunction in the brainstem, the respiratory and cardiac functions cannot function.

The determination of death can be made by a health care facility or outside a health care facility. The determination of death in health care facilities must be carried out by doctors, nurses or midwives. The determination of the patient’s death is written when there has been a death of the brainstem instead of the cessation of the work of the heart and breathing. The determination of the death of the brainstem can only be done by 3 competent doctors consisting of a neurologist and an anesthesiologist.

Ethical and medical legal studies are needed in determining brain death. The earlier in the determination of mortality increases the effectiveness in organ donors. The problem that needs to be considered is that brain damage still allows a person to survive using life aids and the difficulty of definitively determining that the patient’s cerebral lesions are permanent.

Indonesia prohibits health care from deliberately killing someone for life, one example of which is euthanasia. Requests for Do Not Rescucitate are the right of patients whether they are willing or not, but rarely patients in Indonesia want dnr. The decision of the DNR is not only made by the party concerned but there must also be a team of doctors who discuss the right with the family. There needs to be informed consent regarding the provision of life support therapy.

Center for Bioethics and Medical Humanities just held the Raboan Discussion Forum on (10/09). The title of this discussion is What do patients value regarding primary health care? A Sysmetic Review evidence. The material was presented by the speaker: drg. Agnes B Pratiwi, MPH the moderator is dr. Galuh Dyah Fatmala.

Many countries are focused on achieving universal health couferage, therefore requiring efficient resources, sustainable health financing, and strong primary care. Primary health care is very important and must be improved because it is closest to the community. Primary care is available but patients are sometimes uninterested regarding the service.

The value of patients is very important in primary care. In this study, the point of view was seen from the patient’s side. Articles used started from 2009 – 2010. For critical appraisal use JBI aprraisal chechk list. 18 relevant articles in this study 9 qualitative 9 quantitative.

The results of this study show that there is some value from the point of view of patients, doctors, interactions between doctors and patients and primary health care. The values of the patient include autonomy and privacy. Values from the doctor’s point of view include patient individuality, Apropriate communication, competence. Virtous characteristic. The interaction between doctors and patients includes, shared decision making, empowerment. The values of primary health care include accessibility, time, continuity of care and adequate.

Primary care is make patients have very high expectations of good interpersonal skills of it. Therefore, primary care provides services that pay attention to the  needs of patients. In this study, no one predicted the views of children or parents as proxy. It is also important that this primary care moves to patient-centered care.

Center for Bioethics and Medical Humanities just held the Raboan Discussion Forum on (27/07).The title of this discussion is Ethics learning system model in medical doctors student. The material was presented by the speaker: Dr. B. Triagung Ruddy Prabantoro, dr.,SpOG(K) the moderator is dr. Nur Azid Mahardinata.

Doctors are a precious profession because they accompany humans from birth to death. Bioethics and humanities are very important in supporting medical education. Ethics is very imporatant because it can made trust between medical doctor and patients. If there is no trust between medical doctor and patients, it can makes the effectiveness of healthcare low. Medical doctors must have ability to change behavior of patient better than before, because bad behavior of patients make the disesase worst.

Moral dilemma discussion goals is students have  higher moral reasoning. The discussion  between students and lecture as facilitator. Facilitators must give students opportunity to grow and awereness to help students study. Every student has unique method to learn something, therefore student base learning is important. The facilitators make sure that students understand about the discussion.

The main goals of ethics model learning is create medical doctors that understand about human values and environment values. Because health care not only about human but also about environments that support it.

Center for Bioethics and Medical Humanities just held the Raboan Discussion Forum on (13/07). On that occasion, the title raised was Learning Professionalism Through Role Modeling. The material was presented by the speaker: Prof. dr. Gandes Retno Rahayu, M.Med.Ed., Ph.D. Meanwhile, the moderator is dr. Wika Hartanti MIH.

In the rapid development of medical science, there are still many teachers who do not have the sensitivity to be professional. This is the impact of the old view which assumes that professionalism is obtained during the learning process. Prof Gandes explained that nowadays professional attitude of a doctor is an aspect that needs to be taught and taught as a specific topic and taught explicitly.

To teach professionalism Prof. Gandes the importance of understanding the right learning method for medical students. One of the effective methods to develop professionalism is role modeling. Prof. Gandes revealed the four processes that occur in the role modeling method. The first is to inspire, then to learn, to follow professionally, and the last is to portray oneself.

Prof. Gandes explained that there are three characteristics of a role model. The first is to have superior competence. Both have humanistic personalities such as interpersonal skills, positive outlook, commitment to growth, and leadership. The third is effective teaching skills.

At the end of his presentation, Prof Gandes revealed that role modeling is one of the important teaching tools to teach professionalism in the field of medicine and health professional education.

“Teachers must be aware of being role models and the impact of what they emulate” Said Prof. Gandes.

 

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