The Center for Bioethics and Medical Humanities (CBMH FK-KMK) Universitas Gadjah Mada once again held the weekly Raboan Discussion Forum. The event, which was held virtually, raised the issue of bioethics science with the title Bioethics: Where is your Knowledge Tree. CBMH FK-KMK UGM invited speaker dr. Siti Pariani, MS., MSC., Ph.D who is a lecturer at the Faculty of Medicine, Universitas Airlangga. Meanwhile, the moderator was Erlin Erlina, S.IP, M.A., Ph.D who is a researcher at CBMH FK-KMK UGM and Lecturer at Faculty of Medicine, Public Health, and Nursing, UGM.

To the forum participants, dr. Siti Pariani explained her ideas regarding the discussion of the scientific tree of Bioethics which according to her still needs to be discussed. At the beginning of his presentation, dr. Siti Pariani tries to remind the nature of the science of Bioethics which is a science with the aim of solving problems that exist in society with an ethical basis as a concept that will examine the nature of goodness in social behaviour.

dr. Siti Pariani highlighted that each discipline has its own code of ethics which is the result of consensus from the thoughts of experts in the field. The code of ethics can be said to be a branch of a universal ethical tree.

The discussion then continues on the scientific tree of Bioethics. According to dr. Siti Pariani’s knowledge of bioethics has roots in several other disciplines including philosophy, sociology, anthropology and psychology. This knowledge then developed into branches of the tree of bioethics which later became the Universal Declaration on Bioethics and Human Rights as we know it today.

In addition, dr. Siti Pariani also added that Bioethics as science should also have a system that continues to process. dr. Siti Pariani said that the system is contained in the tri dharma, namely education, research, and service. These three aspects become the form of output for the science of Bioethics.

At the end of his presentation, dr. Siti Pariani reminded us that science must return to its main goal which is human welfare and safety.

Wednesday, February 16, 2022, the Raboan Discussion Forum was again held by the Center of Bioethics and Medical Humanities (CBMH FK-KMK UGM) with the title Religions and Xenotransplantation. The title was presented by the speaker Prof. Syafaatun Almirzanah Ph.D from Prof. Syafaatun Almirzanah Ph.D., Center for Religion and Sciences Sunan Kalijaga State Islamic University. Meanwhile, the moderator was Dr. Nur Azid Mahardinata from CBMH FK-KMK UGM.

Prof. Syafaatun or who is usually called by the name of Prof. Shafa raised an issue that has recently been widely discussed, namely the transplantation of a pig heart into the body of a heart failure patient named David Bennet, who is 57 years old. The male patient was reported to be in a terminal condition so xenotransplantation had to be performed. Based on developments, it is known that David Bennet has improved after surgery. Prof. Shafa added that the procedure carried out on David Bennet had been authorized by the United States Food and Drug Administration (FDA).

“It says here that if he is transplanted with a human heart his condition is too sick, so the FDA there authorized him to be given a transplant from a genetically authored pig,” said Prof. Shafa
The practice of Xenotransplantation has been done decades ago. The most famous example is Baby Fae who received a liver transplant from a primate. Baby Fae reportedly lived for 12 days after surgery.
Several ethical and social implications overshadow the development of this biotechnology. Among them is the patient’s consent which will continue to be monitored for life. Another issue is fairness and equity regarding the allocation of organs. In addition, this practice has potential in terms of social and psychological impact.

Prof. Shafa then brought the discussion to the discussion of Xenotransplantation in religion. According to Prof. Shafa, most religions can accept this technology despite the debate. The issue that is quite crucial is the process of human creation. Xenotransplantation is considered to be able to obscure the uniqueness of human identity because humans have been created by God in a form that later becomes their self-esteem. Another opinion from the Catholic Religion says that Xenotransplantation can be done but is not allowed for human brain organs and also human genitals. This is because the two organs involve self-esteem as human beings.

Another issue that is also a concern is the fear of technology making humans too late to create a Frankenstein (undead) that can attack its creator. There are fears of manipulation of human cells that could make the creation too late and harm other humans.

Wednesday, February 2, 2022, the Center for Bioethics and Medical Humanities held a Raboan Discussion Forum with the theme Consumer Behavior in Health Industry. This theme was presented by Dr. Shine Pintor S. Patiro, S.T., M.M from the Faculty of Economics at the Open University. Meanwhile, the moderator was Puri Swastika GKD, S.E., M.Sc.

The Covid-19 pandemic has brought new dynamics to the Health industry players. This happens because there is a change in consumer behavior as a result of the increasing need for health goods and services. Dr. Pintor explained that during the pandemic, consumer behavior in the health industry became an issue that was widely discussed.

Consumers are customers or actors who use the goods and services offered by the company. Consumer behavior is an activity ranging from searching, choosing available alternatives, determining the final decision to buy goods or services, using or spending an item or service, to evaluating. Consumer behavior includes emotional and mental aspects because it involves the process of growing perceptions and attitudes.

Before delving deeper into consumer behavior, Dr. Pintor explained the importance of knowing the consumer market and marketing strategy. For this reason, several factors need to be considered, namely market size, changes in purchasing behavior and purchasing decisions, emphasis on market orientation, and designing an effective marketing strategy.

Dr. Pintor explained that two main factors influence Consumer Behavior, namely external factors, and internal factors. External factors are cultural and social. The factors included in the cultural factors are culture, sub-culture, and social class, while the factors included in the social factors include reference groups, family, roles, and status and roles in the buying process. Meanwhile, internal factors include personal and psychological. Factors that are included in personal factors include age, occupation, economic situation, and lifestyle. While the factors included in the psychological factors are motivation, perception, learning, belief, and attitudes.

During the COVID-19 pandemic, consumer behavior changed. According to Dr. Pintor during the covid pandemic, consumers tend to focus on things that are essential and have value. In addition, due to reduced physical activity outside the home, industry adoption towards a digital direction is very important.

“Consumers also need fast, efficient, and contact-free service,” said Dr. Pintor

Improvement of Human Rights terminology which is often translated into Indonesian ‘Hak Asasi’ is very much needed. It is as said by Dr. CB Kusmaryanto SCJ, a Bioethics expert and lecturer in the Sanata Dharma University School of philosophy at the Raboan Discussion Forum organized by the Center for Bioethics and Medical Humanities (CBMH FK-KMK UGM), Wednesday (19/01). The weekly forum, which is held virtually, takes the theme of Human Rights and Human Rights Fundamentals in Bioethics. The forum is led by dr. Ouve Rahadiani Permana, M.H.Kes., M.Sc, alumni of the Bioethics Masters Study Program as moderator.

Romo Kus, Dr. CB Kusmaryanto SCJ often called, said that there is a discrepancy in the translation of Human Rights terminology commonly used in Indonesia. Generally, the terminology is translated with the phrase ‘Hak Asasi’. In fact, according to Romo Kus, the correct English word for ‘Hak Asasi’ must be Fundamental Human Rights. Romo Kus also explained that the phrase Human Rights is more accurately translated into the phrase Hak Manusiawi.

According to Romo Kus, from a grammatical point of view, the word human can be a noun or an adjective. When the word is placed in front of the word rights which is a noun, then the word human functions as an adjective.

“So, the translation of Human Rights in Indonesian should be Human Rights, while the translation of Human Rights is Fundamental Human Rights,” said Romo Kus.

Father Kus then explained the difference between the two phrases. According to Romo Kus, human rights are only a small part of fundamental human rights. Human rights are the most basic rights for humans. In this case, Romo Kus explained that the most basic right for humans is the right to life. Meanwhile, human rights are very diverse.

In the second application in the field of Bioethics, according to Romo Kus, a person’s fundamental human rights should be prioritized over his or her human rights. Violations of Human Rights become legal if they are carried out in order to defend Fundamental Human Rights, which is the right to life. Romo Kus added that respect for Fundamental Human Rights is a prima facie, meaning that if it does not conflict with Human Rights, it must be respected. But if it collides with Fundamental Human Rights, then Fundamental Human Rights must be respected.

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Wednesday (05/02),  Center for Bioethics and Medical Humanities (CBMH FK-KMK UGM) held the weekly routine program Raboan Discussion Forum for the first week of January 2022. The theme on the occasion was Implementation of Informed Consent on Complementary & Alternative Medicine (CAM) and Homeopathic Services. The virtual discussion forum presented by speakers Desy Putri Ratnasari, M.Sc., Bioethics Masters Study Program Alumni and UGM CBMH Research Assistant. Meanwhile, the moderator is dr. Nur Aziz Mahadinata.

Based on Desy’s  finding in Indonesia there is a fairly high demand for Complementary Alternative Medicine (CAM). One type of CAM that is quite large in demand is Homeopathic medicine. Although this treatment has been widely found in the community, research on the ethical aspects of this practice has not been done much. This prompted Desy to research aspects of patient autonomy in the form of  Informed Consent.

Homeopathy is a treatment that relies on herbal medicines that work together with the immune system to fight disease. In Indonesia, the most popular practice of Homeopathic medicine is the Homeopathy of the Ahmadiyya Community. The Ahmadiyya Homeopathy practitioners are under the auspices of the  Departemen Homeopati Nasional (DHN). Homeopathic Medicine is in demanded by both Ahmadiyya congregants and non-congregants. Because, this treatment is considered to have low side effects.

Desy’s research results show that the implementation of Informed Consent is also used in Homeopathy CAM treatment. The practice is in accordance with Peraturan Kementrian Kesehatan No. 290/MENKES/PER/III/2008 concerning informed consent, which includes the diagnosis of the disease, the purpose of the action, other alternative actions, risks or complications that may occur, the prognosis for the action and the estimated cost. From the results of interviews with Homeopathic Practitioners, Patients, and DHN administrators, it was found that the use of informed consent was carried out to anticipate undesirable things in the future. Informed consent in the practice of Homeopathy is done in two forms, oral and written (form). The written Informed consent is generally used for homeopathic patients outside the Ahmadiyya Community.

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