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All Journal INDONESIAN JOURNAL OF LEGAL AND FORENSIC SCIENCES Narra J
Wijaya, Richard
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Biochemistry, Genetics & Molecular Biology Chemistry Dentistry Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Public Health

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Otonomi VS Paternalisme: Pengambilan Keputusan Medis pada Pasien dengan Skizofrenia Yen, Liauw Djai; Simanjuntak, Vionita; Yantoro, Felicia Cynthiadewi; Junus, Kezia Adelize Aurelia; Wijaya, Richard; Allo, Kezia Nathania Limbong; Lukito, Patricia Michelle; Dananjaya, Anna Sakurai; Wijaya, Yurike; Sugiarto, James; Mahardika, Danadipa Yoga; Gani, Alicia
Indonesian Journal of Legal and Forensic Sciences (IJLFS) Vol 13 No 2 (2023): Indonesian Journal of Legal and Forensic Sciences
Publisher : Penerbit, sejak 2012 : Asosiasi Ilmu Forensik Indonesia dan UPT Lab. Forensik Sain dan Kriminilogi - Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/IJLFS.2023.v13.i02.p02

Abstract

Background: Balance between autonomy and paternalism in the context of decision making of individuals with schizophrenia is a complicated and ethical problem. Collaboration between healthcare workers, family members, and individuals with schizophrenia is crucial to ensure decision made is for the individual’s best interest whilst upholding their dignity and rights. Methods: This is a literature review study. References used are literature from journal articles, law texts, and other textbooks in Indonesian and English. Results and Discussion: In clinical practice, doctors and patients both have autonomy to make the best decision. In patients with schizophrenia, autonomy conflicts with paternalism due to errors in cognitive function and decision making. Some studies have shown that schizophrenia patients can increase their understanding through information repetition, or by using improved information delivery procedures. Loss of capacity of decision making in patients with schizophrenia is temporary and can recover with time. Conclusion: It is important to find balance between autonomy and paternalism in medical practice. Doctors need to give clear information to patients, discussing benefits, downfalls, and risks from a certain procedure, respecting patient preference. However, doctors also have the responsibility to use their clinical judgement to give the best medical outcomes for patients.
Examining the interplay between endometriosis and later-life cerebro-cardiovascular diseases: A systematic review, meta-analysis, and trial sequential analysis Winata, I GS.; Immanuel, Surya S.; Leonardo, Leonardo; Rinaldi, Fransiskus X.; Tandecxi , Gabriel; Wijaya, Richard
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1935

Abstract

Beyond gynecological issues, women with endometriosis have a significant risk of cardiac outcomes. Despite this evidence, the extent and mechanisms of the association remain unclear. The aim of this study was to evaluate the association between endometriosis and the incidence of cerebro-cardiovascular disorders. Using preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines, seven databases were searched as of October 14, 2024, for observational studies assessing the association between endometriosis and cerebro-cardiovascular disorders. The main outcome was major adverse cardiovascular and cerebrovascular event (MACCE) while the secondary outcomes included all-cause mortality, cerebrovascular accident (CVA), ischemic heart disease (IHD), myocardial infarction (MI), arrhythmia, and heart failure (HF). Bias was assessed with the risk of bias in non-randomized studies of exposures (ROBINS-E) tool. Odds ratios with 95% confidence interval (CI) were calculated using random-effects meta-analysis. Evidence certainty was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Robustness was assessed via sensitivity analyses and trial sequential analysis (TSA). Out of 3,141 studies, nine cohort studies encompassing 1,670,589 women (follow-up 7–28 years) were included. Endometriosis was associated with 24% higher odds of MACCE incidence (95%CI: 1.18–1.31, moderate certainty). In addition, having endometriosis increased the odds of CVA by 49% (95%CI: 1.20–1.85, high certainty), IHD by 64% (95%CI: 1.31–2.05, low certainty), MI by 53% (95%CI: 1.18–1.98, high certainty), arrhythmias by 24% (95%CI: 1.12–1.37, high certainty), and HF by 13% (95%CI: 1.03–1.25, high certainty). Endometriosis did not significantly associate with all-cause mortality. Sensitivity analyses and TSA reinforced all of these findings. In conclusion, endometriosis was significantly associated with increased odds of cerebro-cardiovascular disorders. Future research should clarify the underlying mechanisms and develop targeted prevention strategies.
Co-Authors Allo, Kezia Nathania Limbong Dananjaya, Anna Sakurai Gani, Alicia Immanuel, Surya S. Junus, Kezia Adelize Aurelia Leonardo Leonardo Lukito, Patricia Michelle Mahardika, Danadipa Yoga Rinaldi, Fransiskus X. Simanjuntak, Vionita Sugiarto, James Tandecxi , Gabriel Wijaya, Yurike Winata, I GS. Yantoro, Felicia Cynthiadewi Yen, Liauw Djai