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Dr. T. Ibnu Alferraly, M.Ked.PA, SpPA, D.Bioet.

Bioethics-Humanities-Medicolegal-Profesionalism Program

Medical Education Unit Fakultas Kedokteran Universitas Sumatera Utara

The Medical Humanities is an emerging field of enquiry in which humanities and social sciences perspectives are brought to bear upon an exploration of the human side of medicine.

These perspectives have a key role to play in analyzing expectations of medicine, and the relationship between medicine and broader ideas of health, well-being and flourishing

Humane :

marked by compassion sympathy/consideration of others

Humanity : The quality or state of being human or humane The branches of learning dealing with human concerns (as philosophy) as opposed to natural processes (as physics)
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Ilmu-ilmu pengetahuan yang dianggap bertujuan membuat manusia lebih manusiawi, dalam arti membuat manusia lebih berbudaya
Devisi BHMP FKUSU 2012

Istilah humaniora yang berasal dari program pendidikan yang dikembangkan Cicero, yang disebutnya humanitas sebagai faktor penting pendidikan untuk menjadi orator yang ideal.
humanitas berarti kualitas, perasaan, dan peningkatan martabat kemanusiaan dan lebih berfungsi normatif dari pada deskriptif (Sastrapratedja, 1998).
Devisi BHMP FKUSU 2012

Gellius mengidentikkan humanitas dengan konsep Yunani paideia , yaitu pendidikan (humaniora) yang ditujukan untuk mempersiapkan orang untuk menjadi manusia dan warga negara bebas. Pada zaman Romawi gagasan tersebut dikembangkan menjadi program pendidikan dasar sejarah

Devisi BHMP FKUSU 2012

Aliran pemahaman yang bertujuan menghidupkan rasa perikemanusiaan/ mencitacitakan pergaulan yang lebih baik sikap/ tingkah laku mengenai perhatian manusia dengan menekankan pada perasaan serta martabat individu

Devisi BHMP FKUSU 2012

FILSAFAT
Teologia
ILMU HUKUM

Psikologi

HUMANIORA

Sejarah

SENI

BAHASA

Sastra

Humaniora merupakan studi yang memusatkan perhartiannya pada kehidupan manusia, menekankan unsur kreativitas, kebaharuan, orisinalitas, keunikan. Humaniora berusaha mencari makna dan nilai, sehingga bersifat normatif. Dalam bidang humaniora rasionalitas tidak hanya dipahami sebagai pemikiran tentang suatu objek atas dasar dalil-dalil akal, tetapi juga hal-hal yang bersifat imajinatif

Devisi BHMP FKUSU 2012

Medical humanities is an interdisciplinary field of medicine which includes :

The humanities (literature, philosophy, ethics, history and religion), Social sciences (anthropology, cultural studies, psychology, sociology), and
Arts (literature, theater, film, and visual arts) and their application to medical education and practice.

The human body is an astonishing intertwining of natural and existential dimensions. This crucial fact is central to clinical medicine, but largely overlooked and poorly prepared for in the medical curriculum.
Humanities education tries to take the intertwining seriously in its concern to record and interpret all aspects of human experience.

Devisi BHMP FKUSU 2012

Devisi BHMP FKUSU 2012

To promote 1. Reflective practice and personal development 2. Empathy with patients 3. Compassionate understanding of individuals in society

Devisi BHMP FKUSU 2012

Everybody loves art No time and space limitation Made the space more beautiful Disadvantage??

http://www.google.co.id/imgres?imgurl=http://news.stanford.edu/news/2006/eCw

in contrast to other arts, music teaches us how to listen. Music is the perfect medium to learn to listen not only to a patients words but also to what is behind their words by noticing cadence, volume, inflection, and tone.

Music and the human mind have a unique relationship that is not yet fully understood Neuroscientists have discovered things about the brain that they cannot know through other cognitive processes. Musical insights into the human condition are uniquely powerful experiences that cannot be replaced by any other form of experience. Through music we are able to discover, share, express, and know about aspects of the human experience that we cannot know through other means. (Hodges, 2000, p. 21).

CANADA Medical School : Poor Patient with HIV/AIDS University of Sydney, through PBL method offer e-learning case to link with humanities resources humanities music. E.g Shakespeares Sonnets used to accompany PBL cases on ageing. New Jersey Robert Wood Johnson Medical School New Jersey.

An instrumental entitled The AIDS Song by the rock group Ween was played alongside folk musician Dan Berns (a world without AIDS). Both sides of the abortion issue are addressed in a song by the Philadelphia rock band the The Trolls.

using popular music to examine how physicians are seen by society.


Are we part of the Establishment(The Beatles), Are we mysterious Shamans (JJ Cale), or are we seen as threatening to our patients (The Who)

YOUTH patients and their relationship with physicians and the power and respect given to physicians by society Indonesia : MellyGoeslow , Ebiet , Gesang, IwanFals (OemarBakri), Sartono (Hymne Guru), (Indonesia Menangis), Suthasoma/Kusbini (HymneGadjahMada)

In Newell and Hanes (2003), in New Jersey Medical School and Hospital, music are played according to themes :

Song about World Music/World medicine Randy Newmans North American foreign policy: How graduate students think about the song? How people from different culture access to health care? Gender Lesson from music Tori Amos and Liz Phairs against discrimination : Can music help us to understand people who are different from us ? Do we discriminate against our patients

From a theoretical perspective, Music the humanities engage the emotions as well as the intellect, thereby achieving deep understanding of and insight into the experience of another (Charon, 2001); e.g. Empathy, caring, human dignity, compassion, respect Professionalism e.g., responsibility, integrity, altruism patient satisfaction , Music as an art USEDas providing a means of teaching medical humanities for fostering imagination, emotional capacity, and reflection.

QUESTIONS : 1. What the music/lyrics tell the listeners about ? 2. Who is the subject in the music theme ? 3. What is the writer going to share you through the music ?

Human Condition (Psychology) Emotion&Empathy : howdepressed the ODHA facetheirfuture life , howdifficulttheydeal with the illness , howdeepestsadthey life with HIV/AIDS, howdotheyneedfriend to talk with 2. Social Context Cultural Side : keeping secret , stigmatizes, discrimination
1.

Writtenby Andre Manika, Singers Katon Bagaskara& Ruth Sahanaya (1996). A Charity music, caring for people with HIV/AIDS dedicated to YayasanAIDS Indonesia.. Music Reflection:

Changing behaviour tak terbiasa ku dapati terdiam

mendura Fear apa gerangan bergemuruh di ruang benakmu- Want to share /Breaking Secret sekilas kilau mata ingin berbagi cerita- Discriminated and Stigmatization -- satu persatu jalinan kawan beranjak menjauh (The present study by Wagner
2010 found that psychological distress was associated with perceived HIV stigma. Canadian Institutes of Health Research New Investigator Awards ) Sad, desperate (depression) -- >kulihat mendung

menghalangi pancaran wajahmu, sekali sempat kau mengeluh kuatkah bertahan Stigma was associated with
depressive symptoms after controlling for potential demographic and clinical confounders, Studied by Rueda, Gibson et.al2011) collects data from 825 patients on the clinical profile and social determinants of health of people with HIV.

Giving Sympathy and Empathy -- kudatang


sahabat bagi jiwa saat batin merintih -- usahkau lara sendiri masih ada asa tersisa ... (usah kausimpan lara sendiri)

Supportingmasih ada asa tersisa - letakkanlah


tanganmu di atas bahuku-

A hope -> di depan sana cahya kecil 'tuk memandu tak hilang arah kita berjalan-- ... menghadapinya Helping biar terbagi beban itu dan tegar dirimu --

Diperkirakan, padatahun2006

sebanyak 4.360 anaktertular HIV/AIDS dariibunyayang HIV/AIDS positive (Source :


KomisiPenanggulangan AIDS Nasional 2007, StrategiNasionalPenanggulangan HIV dan AIDS 2007 2010)

People living with HIV (e.g. in London reported being discriminated against because of their infection. 1,385 out of the 1,687 people HIV/AIDS are discriminated ) ( Elford, et. al: 2008)

HIV/AIDS is not only about biomedical problem ? but also hampered as complex social problems HIV/AIDS as an emerging disease in the world attacking Youth Youth with HIV/AIDS
RI ) (SOURCE : Ditjen PPM & PL Depkes

aged 20-29 years 53,9%) aged 30-39 years 25,6% dan aged 40-49 years 8,5%

---------------------------------------------------------------------------------------------- ------------Figure 1 : Number of AIDS Cases in Indonesia in Last 10 Years up to June 30, 2005
4000 3500 3000 2500 2000 1487 1500 1000 500 0 1996 154 42 198 44 1997 258 60 1998 1999 352 94 2000 AIDS 607 255 826 345 219 2001 Kumulatif 2002 2003 2004 2005 316 1171 1195 677 2682 3358

Tabel 1 : Jumlah Kasus AIDS di Indonesia Berdasarkan Tahun Pelaporan sd 30 Juni 2005

RESOURCES : Ditjen PPM & PL Depkes RI

60 50
Persentase

53.87

40 30 20 10 0.83 0 < 1 th 1-4 th 5-14 th 15-19 th 20-29 th 30-39 th 40-49 th 50-59 th 60 th Unkown Kelompok Umur 0.57 0.18 8.46 3.90 1.94 0.74 3.93 25.58

RESOURCES : Ditjen PPM & PL Depkes RI


:

Youth as a hope of nation, but theyre marginalized

Seribu orang tua dapat bermimpi, satu orang muda dapat mengubah dunia.

The humanities and arts provide insight into the human condition suffering

personhood
responsibility to each other and offer a historical perspective on medical practice

Attention to literature and the arts

Helps to develop and nurture skills of observation, analysis, empathy, and self-reflection skills that are essential for humane medical care

Some of the ways people experience illness:


Disability Suffering Stigma, and Isolation.

How health provider response


Sensitive Empathy Analysis - wisdom Telling the trutrh

Emotional State

Behavior Manifestation

Manifestation of support needed Letting the feeling out Hearing without any judgment Making him/her release Understanding Helping to cope Giving information Discussing

Faster acceptance process Faster adjustment process Better coping

Values in Health Care


Inner values Peace Positivity Compassion Co-operative Valuing yourself Spirituality in health care

The Janki Foundation for Global Health Care

SPIRITUALITAS
Menurut Tart (1975) spiritualitas lebih menekankan pada pengalaman seseorang tentang arti hidup, bagaimana seseorang menjalani kehidupan, dan arti Tuhan dalam kehidupan. Bedanya dengan religiusitas:
Implikasi religiusitas lebih ke arah struktur sosial yang lebih luas meliputi : dogma, doktrin, institusi, ritual keagamaan, lembaga keagamaan, pendeta/ulama, tempat ibadah dan sebagainya.

Dokter dan Pasien sama-sama manusia juga kan ?