Jakarta. To whom do we turn to when we fall sick? 

A series of sexual assault cases involving doctors have painted a grim picture of the Indonesian medical field. Doctors, who were supposed to treat us, have turned the examination room into a place for their sex offenses. Their medical touch turns into abuse as they hide behind their white coats that many consider to be prestigious.

Priguna Anugerah Pratama, a doctor who is undergoing an anesthetist medical training, recently made headlines for raping a woman at Bandung’s Hasan Sadikin Hospital. Priguna had made the victim unconscious using anesthesia drugs. Not long after, Muhammad Syafril Firdaus -- an obstetrician in Garut -- went viral following a video of him inappropriately touching one of his patients during an ultrasound scan. His modus operandi allegedly include offering free examinations to pregnant women. A Malang doctor, known by the initials AY, also sexually abused his patient. A University of Indonesia student on medical training recently got caught recording a female student showering.

Calls for better enforcement against these medical predators are mounting. Beyond the medical field, Indonesia is already struggling with rampant sexual abuse cases. In 2022, the Women Empowerment Ministry received 27,593 violence reports with 25,053 female victims. Sexual violence made up around 42.3 percent of the reports filed that year. The number grew to 29,883 violence case reports the following year, with 26,161 female victims. Sexual violence made up 44 percent of the reports. In 2024, the ministry recorded 31,947 violence cases with 27,658 female victims. Almost 45.3 percent of the reports were related to sexual violence.

Deputy Health Minister Dante Saksono Harbuwono recently said that the government and law enforcement authorities would take action against the inappropriate doctors. This includes having their certificate revoked, thus barring them from practicing legally. They are also subject to legal consequences. A 2022 Law on Sexual Violence Crimes -- popularly known as the TPKS law -- said that the doctors committing sexual violence could face up to 12 years in prison.

As more sexual cases pile up, the Health Ministry said it would strengthen the medical coaching system by instilling better ethics in doctors. This includes partnering with the medical schools so their graduates are not only professionally skilled, but uphold ethics and integrity. The ministry is also mulling having the so-called Minnesota Multiphasic Personality Inventory (MMPI) -- a standardized psychometric test of adult personality -- in the selection process for prospective doctors.

“This way, we can identify psychological disorders that might make the candidates unfit to work in the medical field. So if they show such signs, we will reject the applicant even if they have high academic scores,” Dante said.

The Indonesian Medical Council (KKI) reported last Thursday that they had revoked Priguna’s certificate. Syafril Firdaus’ certificate has been temporarily frozen as a result of his wrongdoings.  

IKI’s chairperson Arianti Anaya reminded people -- including the patients and their family members -- to not be afraid to report any immoral acts done by medical personnel. She also promised that the professional disciplinary council would follow up on the report. They will forward the case to the law enforcement officers if there are indications of crimes. 

“Medical personnel who are proven to have committed immoral acts must face strict sanctions,” Arianti said.

The Holes in The System

But what exactly went wrong? 

Sundoyo, a senior official at the Health Ministry, said that medical services had to pay attention to three pillars: ethics; discipline; law. All these aspects -- if upheld -- can guarantee safe and high-quality services for the patients. Any violation will only ruin the public trust in doctors. Sundoyo also pointed out the weak implementation of standard operating procedures, even revealing that many health facilities lacked valid step-by-step instructions. Some facilities even only had the document simply out of obligation, and did not carry out what had been set on the document.

“If we take a look at the Garut case, the doctor in question conducted an ultrasound scan on a patient without a family member or other medical worker in the room. This is a grave violation and is intolerable, even if it is done by a senior medical personnel,” Sundoyo said.

Yuni Asriyanti, a commissioner at the National Commission on Violence Against Women (Komnas Perempuan), also commented on this phenomenon. She pointed out the absence of a mechanism for preventing and handling sexual violence in healthcare facilities, thus making them prone to such crimes.

“Universities already have the regulations on this matter. Unlike healthcare facilities that are still neglectful when it comes to this,” Yuni said.

She urged the Health Ministry to immediately establish a sexual violence-free zone with a concrete reporting, response, and prevention system. Protecting the victims in the reporting process is important, including granting them the right to be accompanied by a family member during the examination. 

The rampant cases have triggered calls for a better implementation of the TPKS Law, which even specifies penalties for anyone who misuse their power to carry out sex crimes. Yuni said that it could convince victims to file a report as they regain confidence in the justice system. 

Criminal law expert Hery Firmansyah pointed out how the TPKS Law had been underused. Out of the 167 sexual cases recorded since its entry into force in 2022, only two have been processed with the said regulations. Hery also pointed out how standard operating procedures violations at hospitals could make initial evidence of a crime.

"Once there is a report and initial evidence,  a criminal investigation must be carried out immediately," he said.

Can Castration Be The Cure?

The increasing sexual violence cases has ignited the discussions on chemical castration punishment for the perpetrators. Deputy Women’s Empowerment Minister Veronica Tan had said that chemical castration could deter people from commiting sexual violence. But such plans still faced opposition, particularly due to human rights concerns.

“Castration violates constitutional rights, and has not been proven effective. Sexual violence is not just about libido, but is related to power relations,” Komnas Perempuan’s Sondang Friskha remarked. According to Sondang, it would be better for Indonesia to work on the preventive system rather than implementing such measures.

In 2020, Former President Joko “Jokowi” Widodo inked a regulation that would have convicted child molesters undergo chemical castration. The policy was a follow-up to a government regulation in lieu of law on child protection. While criminal law expert Hibnu Nugroho called castration to be legally valid under the said regulations, he admitted that the punishment’s implementation could face obstacles as its execution could spark a dilemma in medical ethics. 

"Doctors are bound by the principle of healing, not harming people. So there is a tug-of-war between the medical world and law enforcement. This creates a dilemma in its execution," Hibnu said.