The Phenomenon of 21 Caesarean Sections in 10 Hours, IPB University Faculty of Medicine Lecturer Explains Medical Regulations and Ethics

An incident involving an obstetrics and gynecology (obgyn) specialist who reportedly performed up to 21 caesarean sections in just 10 hours has sparked public concern regarding the workload of medical personnel and patient safety.

In response to this issue, dr Yunita Aryani, a lecturer at the Faculty of Medicine at IPB University, explained the regulations, professional ethics, and oversight mechanisms in Indonesia.

She emphasized that to date, no national regulations specifically limit the maximum number of caesarean sections a doctor can perform in a single shift.

“Basically, all doctors have the same rights and obligations based on professional ethics and regulations. A doctor has the right to determine the number of medical procedures performed, as long as there is no pressure from external parties,” she explained.

However, dr Yunita mentioned, a doctor also has the right to refuse a patient’s request if it contradicts ethics, law, or personal beliefs, as long as the refusal does not endanger the patient’s life.

Although there is no national standard figure, every hospital is still required to have internal standard operating procedures (SOP) to manage the workload of medical staff. For example, guidelines for surgical and anesthesia services stipulate that the workload must be adjusted to the capabilities of the medical personnel, with strict standards ranging from pre-surgery, post-surgery, to continuous monitoring.

“Hospital accreditation standards also mandate a patient-centered service system, including the arrangement of surgical schedules, rotation of medical staff, and mechanisms for staff release when necessary,” added dr Yunita.

Furthermore, hospitals are required to maintain complete medical documentation with clear mechanisms. This includes medical records covering informed consent, diagnosis, treatment plans, anesthesia, and post-surgery notes; pre-surgery checklists that verify the readiness of equipment, medication, and staff; the role of the medical and patient safety committees in overseeing service quality and internal audits; as well as support from external accreditation and the implementation of SIMRS through the digitization of medical records to ensure data is more secure and transparent.

If allegations of medical standards or patient safety violations arise, regulators such as the Health Office and the Ministry of Health are authorized to conduct investigations. This process typically includes field inspections, audits, and clarification of medical documents.

“In cases that attract public attention, the investigation usually involves internal and external investigation teams, as well as an official, transparent, and accountable statement from the hospital,” she said.

Currently, the alleged practice of 21 caesarean sections in 10 hours is still under investigation by health authorities and relevant regulators. The public is urged to await the results of the official investigation to confirm whether there have been any violations of medical standards or professional ethics. (AS) (IAAS/ANF)