LEGAL DIMENSIONS OF THERAPEUTIC COMMUNICATION IN MIDWIFERY CARE: PROTECTING PATIENT RIGHTS AND ENSURING PATIENT SAFETY IN INDONESIA
Keywords:
Therapeutic Communication, Health Law, Midwifery Care, Patient Rights, Patient Safety, Informed Consent
Abstract
Therapeutic communication is a fundamental component of quality midwifery care that extends beyond clinical interaction to encompass legal and ethical responsibilities. In Indonesia, the enactment of Law Number 17 of 2023 on Health has reinforced the protection of patient rights, informed consent, and patient safety, thereby increasing the legal significance of effective communication between midwives and patients. This study aims to examine the legal dimensions of therapeutic communication in midwifery care and its role in protecting patient rights while ensuring patient safety. Employing a normative legal research design, the study adopts statutory, conceptual, and comparative approaches to analyze relevant legislation, professional standards, ethical codes, and international guidelines concerning health communication and patient safety. The analysis demonstrates that therapeutic communication constitutes not only a professional competency but also a legal obligation that underpins informed consent, respect for patient autonomy, shared decision-making, and the prevention of medical disputes. Furthermore, effective communication strengthens patient trust, reduces the likelihood of adverse events, and enhances legal accountability in midwifery practice. The study proposes an integrated legal framework positioning therapeutic communication as a bridge between regulatory compliance and safe, patient-centered maternity care. Strengthening legal awareness and communication competence among midwives is therefore essential for improving healthcare quality and safeguarding both patients and healthcare professionals in Indonesia.
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Arnold, E. C., & Boggs, K. U. (2020). Interpersonal relationships: Professional communication skills for nurses (8th ed.). Elsevier.
Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
Berwick, D. M. (2009). What 'patient-centered' should mean: Confessions of an extremist. Health Affairs, 28(4), w555–w565. https://doi.org/10.1377/hlthaff.28.4.w555
Bohren, M. A., Vogel, J. P., Hunter, E. C., Lutsiv, O., Makh, S. K., Souza, J. P., Aguiar, C., Saraiva Coneglian, F., Diniz, A. L. A., Tunçalp, Ӧ., Javadi, D., Oladapo, O. T., Khosla, R., Hindin, M. J., & Gülmezoglu, A. M. (2019). The mistreatment of women during childbirth in health facilities globally: A mixed-methods systematic review. PLOS Medicine, 16(6), e1001847. https://doi.org/10.1371/journal.pmed.1001847
Brazier, M., & Cave, E. (2023). Medicine, patients and the law (7th ed.). Manchester University Press.
Council for International Organizations of Medical Sciences. (2021). International ethical guidelines for health-related research involving humans. CIOMS. https://cioms.ch
Downe, S., Finlayson, K., Tunçalp, Ӧ., & Gülmezoglu, A. M. (2018). Provision and uptake of routine antenatal services: A qualitative evidence synthesis. Cochrane Database of Systematic Reviews, 2018(6), CD012392. https://doi.org/10.1002/14651858.CD012392.pub2
Elwyn, G., Frosch, D. L., & Kobrin, S. (2017). Implementing shared decision-making: Consider all the consequences. Implementation Science, 11(1), 114. https://doi.org/10.1186/s13012-016-0480-9
Entwistle, V. A., & Watt, I. S. (2013). Treating patients as persons: A capabilities approach to support delivery of person-centered care. The American Journal of Bioethics, 13(8), 29–39. https://doi.org/10.1080/15265161.2013.802060
Epstein, R. M., & Street, R. L., Jr. (2011). The values and value of patient-centered care. Annals of Family Medicine, 9(2), 100–103. https://doi.org/10.1370/afm.1239
Faden, R. R., & Beauchamp, T. L. (1986). A history and theory of informed consent. Oxford University Press.
Frank, J. R., Snell, L., Sherbino, J., et al. (2015). CanMEDS 2015 physician competency framework. Royal College of Physicians and Surgeons of Canada.
General Medical Council. (2024). Good medical practice. https://www.gmc-uk.org
Gostin, L. O., Wiley, L. F., & Hodge, J. G. (2023). Public health law: Power, duty, restraint (4th ed.). University of California Press.
Institute of Medicine. (2004). Keeping patients safe: Transforming the work environment of nurses. National Academies Press. https://doi.org/10.17226/10851
International Confederation of Midwives. (2024). Essential competencies for midwifery practice. https://internationalmidwives.org
International Confederation of Midwives. (2024). International code of ethics for midwives. https://internationalmidwives.org
International Labour Organization, World Health Organization, & UNESCO. (2022). The health and care workforce in Europe: Time to act. World Health Organization. https://www.who.int
Joint Commission International. (2024). International patient safety goals (IPSG). https://www.jointcommissioninternational.org
Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. National Academies Press. https://doi.org/10.17226/9728
Mackenzie, C., Rogers, W., & Dodds, S. (Eds.). (2014). Vulnerability: New essays in ethics and feminist philosophy. Oxford University Press.
Mason, J. K., & Laurie, G. T. (2023). Mason & McCall Smith's law and medical ethics (12th ed.). Oxford University Press.
Montgomery, J. (2020). Health care law (3rd ed.). Oxford University Press.
National Institute for Health and Care Excellence. (2023). Shared decision making (NG197). https://www.nice.org.uk
Nutbeam, D., & Lloyd, J. E. (2021). Understanding and responding to health literacy as a social determinant of health. Annual Review of Public Health, 42, 159–173. https://doi.org/10.1146/annurev-publhealth-090419-102529
O'Daniel, M., & Rosenstein, A. H. (2008). Professional communication and team collaboration. In R. G. Hughes (Ed.), Patient safety and quality: An evidence-based handbook for nurses. Agency for Healthcare Research and Quality.
O'Neill, O. (2002). Autonomy and trust in bioethics. Cambridge University Press.
Organisation for Economic Co-operation and Development. (2023). Health at a glance 2023: OECD indicators. OECD Publishing. https://doi.org/10.1787/7a7afb35-en
Pozgar, G. D. (2023). Legal and ethical issues for health professionals (6th ed.). Jones & Bartlett Learning.
Reason, J. (2000). Human error: Models and management. BMJ, 320(7237), 768–770. https://doi.org/10.1136/bmj.320.7237.768
Renfrew, M. J., McFadden, A., Bastos, M. H., Campbell, J., Channon, A. A., Cheung, N. F., Silva, D. R. A. D., Downe, S., Kennedy, H. P., Malata, A., McCormick, F., Wick, L., & Declercq, E. (2014). Midwifery and quality care: Findings from a new evidence-informed framework for maternal and newborn care. The Lancet, 384(9948), 1129–1145. https://doi.org/10.1016/S0140-6736(14)60789-3
Republik Indonesia. (2023). Undang-Undang Republik Indonesia Nomor 17 Tahun 2023 tentang Kesehatan. Lembaran Negara Republik Indonesia Tahun 2023 Nomor 105.
Royal College of Obstetricians and Gynaecologists. (2022). Improving patient safety: Risk management in maternity services. https://www.rcog.org.uk
Silverman, J., Kurtz, S., & Draper, J. (2013). Skills for communicating with patients (3rd ed.). CRC Press.
Starfield, B. (1998). Primary care: Balancing health needs, services, and technology. Oxford University Press.
Sujan, M., Furniss, D., Grundy, K., Poulton, B., & Carthey, J. (2019). Human factors challenges for the safe use of digital health technologies. BMJ Health & Care Informatics, 26(1), e100081. https://doi.org/10.1136/bmjhci-2019-100081
United Nations Population Fund. (2021). State of the world's midwifery 2021. UNFPA. https://www.unfpa.org
Vincent, C., & Amalberti, R. (2016). Safer healthcare: Strategies for the real world. Springer. https://doi.org/10.1007/978-3-319-25559-0
Vincent, C., & Coulter, A. (2002). Patient safety: What about the patient? Quality and Safety in Health Care, 11(1), 76–80. https://doi.org/10.1136/qhc.11.1.76
White Ribbon Alliance. (2019). Respectful maternity care: The universal rights of childbearing women. White Ribbon Alliance.
World Health Organization. (2016). Standards for improving quality of maternal and newborn care in health facilities. World Health Organization. https://www.who.int
World Health Organization. (2021). Global patient safety action plan 2021–2030: Towards eliminating avoidable harm in health care. World Health Organization.
World Health Organization. (2022). Global strategy on infection prevention and control. World Health Organization. https://www.who.int
World Medical Association. (2022). WMA International Code of Medical Ethics. https://www.wma.net
Ziebland, S., & Coulter, A. (2021). Calibrating hope: A framework for involving patients in decisions about their care. BMJ, 372, n189. https://doi.org/10.1136/bmj.n189
Published
2026-07-30
How to Cite
Wanti, D., & Atina Rosadi , R. (2026). LEGAL DIMENSIONS OF THERAPEUTIC COMMUNICATION IN MIDWIFERY CARE: PROTECTING PATIENT RIGHTS AND ENSURING PATIENT SAFETY IN INDONESIA. NIVEDANA : Jurnal Komunikasi Dan Bahasa, 7(3), 726-747. https://doi.org/10.53565/nivedana.v7i3.3091
Section
Articles
DOI :
https://doi.org/10.53565/nivedana.v7i3.3091
