Ethical Principles in Public Health Response (Beneficence, Non-maleficence, Autonomy, Justice)
📌 Mass immunization programs exemplify beneficence by preventing disease spread and non-maleficence by minimizing permanent disability, such as polio-induced paralysis.
👩‍⚕️ A health worker (Nyonya A) demonstrated a failure in beneficence by only superficially convincing a family, not engaging in deep education or seeking written informed consent.
👨‍👩‍👧‍👦 Conversely, Nyonya A's decision to vaccinate her own children reflected autonomy (based on her knowledge/belief) and beneficence (protecting her children from severe disease).
⚖️ In handling Extraordinary Events (KLB) like the polio outbreak, principles of beneficence, non-maleficence, and justice should take precedence over individual autonomy.

Legal and Ethical Frameworks for Vaccination
📜 Indonesian Law (UU No. 17 of 2023, Article 276D) legally limits individual medical autonomy when necessary for preventing communicable diseases and managing KLB/outbreaks.
🌍 The law mandates central and regional governments to ensure complete basic immunization for every baby and child (UU No. 17 of 2003, Article 44, Section 1), emphasizing justice for equitable distribution.
🛑 For KLB cases, non-maleficence becomes a primary obligation, prioritizing the prevention of avoidable harm over minor side effect concerns, as per the Public Health Code of Ethics (Articles 9 & 10).

Critique of Health Promoter's (Nyonya A) Performance
❌ Nyonya A's educational approach was insufficient, merely fulfilling an obligation rather than engaging in two-way dialogue to address family-held myths and build trust.
😟 Her professional actions were compromised by personal history, causing her to be passive, less confident, and fail to maximally promote health due to family stories about vaccine-induced paralysis.
🛠️ The approach was deemed unprofessional, lacking the proactive engagement required of a health promoter to actively build rapport, inquire about rejection reasons, and provide tailored solutions.

Prioritizing Ethics in Public Health Practice (Primavacy and System Thinking)
🗣️ Effective public health action requires understanding that authority extends beyond health workers; addressing community resistance (e.g., based on religious beliefs) necessitates collaboration with religious/community leaders (ulama, priests).
🔄 Public health practice must utilize System Thinking, ensuring the entire health system—from policy to financing—is ethical and focused on "The Health of the Nation," ensuring no citizen is left behind (improving health and longevity for all).
🎯 Efficiency in public health means being precise (tepat sasaran, tepat waktu, tepat dosis), not merely saving money, which maximizes resource impact for the population.

Key Points & Insights
➡️ In KLB situations, the collective protection of non-maleficence, beneficence, and justice overrides individual autonomy concerning vaccination decisions.
➡️ Health workers must move beyond simply delivering information; they must adopt active, empathetic engagement to counter misinformation and build community trust.
➡️ When individual beliefs clash with public health mandates, public health professionals must identify and engage relevant social determinants and authoritative figures (like religious leaders) to deliver effective, context-appropriate communication.
➡️ The core ethical duty of Public Health Law is to enable every citizen to realize their right to health and longevity, demanding systemic solutions rather than relying solely on individual efforts.

📸 Video summarized with SummaryTube.com on Nov 28, 2025, 07:17 UTC