881 American Journal of Economic and Management Business e-ISSN: 2835-5199 Vol. 4 No. 7 July 2025 Criminal Law Enforcement of Illegal Traditional Medical Practices Examined from the Perspective of Legal Pluralism Theory Sri Ayu Astuti, Heristiawan Aryo Wirotomo*, Mela Lavenia Universitas Wisnuwardhana Malang, Indonesia Email: watunaryo@gmail.com* Abstract This study discusses the enforcement of criminal law against illegal traditional medicine practices in Indonesia from the perspective of the theory of legal pluralism. Although traditional medicine has become part of the cultural heritage and practices of indigenous peoples, its implementation often clashes with the country's legal system, especially when it does not meet the prescribed health and safety standards. This research aims to analyze the effectiveness of applicable criminal regulations, as well as offer a more responsive and contextual law enforcement model to the diversity of legal systems. With a juridical- normative approach and case studies, The findings reveal that integrating state law with customary law through normative recognition and continuous guidance can foster a criminal justice system that is inclusive, equitable, and socially just. The study highlights the need for policymakers to adopt a dual approach: (1) regulatory clarity—clearly defining legal boundaries for traditional medicine to prevent harmful practices while preserving cultural legitimacy, and (2) community engagement—collaborating with indigenous groups to develop certification programs and restorative justice mechanisms. These steps can bridge the gap between legal enforcement and cultural preservation, ensuring public safety without marginalizing traditional healers. Keywords: Criminal Law Enforcement, Illegal Traditional Medical Practice, Legal Pluralism. INTRODUCTION Indonesia is a country rich in traditions, culture, and traditional medicine practices that have been passed down from generation to generation in various regions. Traditional medicine practices, such as shamans, healers, sinshes, and herbal medicine, have their own place in society as part of cultural heritage that is considered to have more affordable health benefits in terms of cost (Chali et al., 2021; Chebii et al., 2020; Moncayo & Diago, 2022; Nigussie et al., 2022; Sen & Chakraborty, 2017). However, on the other hand, this practice also raises legal problems, especially when it is carried out illegally and results in losses to the community. In the context of criminal law, this raises questions about the limits of the legality of traditional medicine and how the state American Journal of Economic and Management Business Vol. 4 No. 7 July 2025 882 enforces laws against health practices that are not in accordance with the provisions of applicable laws. According to Article 1 number 1 of Law Number 17 of 2023 concerning Health, health is a healthy state, both physically, mentally, spiritually, and socially that allows everyone to live socially and economically productively. In this law, the government also recognizes the existence of traditional medicine as a form of alternative health services (Daeng et al., 2023; Noerul, 2023; Presiden RI, 2023; Satria Indra Kesuma, 2023; Widjaja, 2023). Further arrangements regarding traditional medicine can be found in the Regulation of the Minister of Health Number 15 of 2018 concerning the Implementation of Empirical Traditional Health Services, which emphasizes that traditional medicine practices can only be carried out by traditional health workers who are registered and have a practice license. Traditional Health Workers are required to list the type of service, not mix practices with modern medical medicine (for example, the administration of injections or the use of medical devices), not to conduct medical diagnoses (only limited to experiential/empirical complaint assessment), and uphold the principles of safety, benefits, and consumer protection. If a person practices traditional medicine without certification and permits, administrative sanctions may be imposed: reprimand, cessation of activities, revocation of licenses. Criminal sanctions (Health Law No. 17 of 2023) include a maximum prison sentence of 10 years and/or a maximum fine of IDR 2 billion if it causes fatalities or serious losses. These practices can be qualified as criminal offenses under Article 359 of the Criminal Code (due to negligence causing death), or Article 378 of the Criminal Code (fraud) (Pemerintah RI, 2023; Sari & Santosa, 2024; Satria Nugraha et al., 2023; Simanjuntak & Marpaung, 2023). In Law Number 1 of 2023 concerning the Criminal Code, there is a strengthening of the principles of legality and protection of the rights of victims, including victims of illegal health services. Law enforcement against illegal traditional medicine cannot be separated from the context of legal pluralism in Indonesia. The theory of legal pluralism, as put forward by John Griffiths, states that in modern society there is more than one legal system that lives and coexists. In Indonesia, state law runs hand in hand with customary law and socio-religious practices that have their own legitimacy. Traditional medicine practices are often within non-state jurisdictions, such as customary law or local wisdom. Therefore, a centralistic approach to law enforcement without understanding the local social and cultural context has the potential to cause resistance, marginalization of local traditions, and even violations of the rights of indigenous peoples. From the perspective of health law and criminal law, legal pluralism must be used as a framework for analysis to formulate law enforcement strategies that are not only repressive, but also educational and restorative. This is important so that law enforcement does not take away the social legitimacy of traditional practices that have been around for a long time and are needed by the community. As affirmed in Article 18B paragraph (2) of the 1945 Constitution, the state recognizes and respects customary law communities and their traditional rights. Therefore, it is important for law enforcement officials, both police and prosecutors, to assess not only the legal-formal aspects, but also the sociological and anthropological aspects of the traditional medical practices that are developing in society. Sri Ayu Astuti, Heristiawan Aryo Wirotomo*, Mela Lavenia 883 Several cases in the field show the clash between state law and local practice in the context of traditional medicine. For example, the case of a medical shaman in Central Java who was accused of carrying out treatment without permission and was detained because his patient died. The case sparked debate in the community: some saw it as a violation of the law, while others saw it as a criminalization of traditional medical practices. This is where the urgency of a legal pluralism approach becomes important, as the state needs to distinguish between traditional practices that are beneficial and those that are harmful. In the approach of responsive legal theory developed by Philippe Nonet and Philip Selznick, law must be able to respond to the social needs and values of society. This means that the law should not be rigid and repressive, but should be open to local social and cultural dynamics. Otherwise, the law of the state will actually become a tool of domination that erodes local wisdom. Therefore, in the context of traditional medicine, the state should provide a mechanism for legalization and supervision of traditional medicine, not just criminal action. Several studies have discussed the enforcement of criminal law against illegal traditional medicine practices. Harahap, Ardiansah, and Kadaryanto (2022) examined the legal enforcement against traditional healers without permits in Pekanbaru City, highlighting the lack of public awareness and weak supervision as major obstacles. Another study by Rarung (2017) analyzed the legal responsibility of traditional medicine producers under Health Law No. 36 of 2009, emphasizing the need for stricter regulatory enforcement to protect public health. However, these studies primarily focused on legalistic approaches without adequately addressing the socio-cultural dimensions of traditional medicine practices. Despite existing research, there remains a significant gap in understanding how legal pluralism can be integrated into criminal law enforcement to balance state law and customary law. Most studies adopt a rigid legal perspective, overlooking the cultural legitimacy of traditional medicine and the potential for restorative justice mechanisms. This gap underscores the need for a more nuanced approach that considers both legal and socio-cultural contexts. This study introduces a novel perspective by applying the theory of legal pluralism to analyze criminal law enforcement against illegal traditional medicine practices. Unlike previous research, this study emphasizes the importance of differentiating between harmful commercial practices and culturally rooted traditional medicine. It also explores the potential of restorative justice and state facilitation as alternative enforcement models, offering a more inclusive and context-sensitive framework. The problem of illegal traditional medicine cannot simply be solved by a repressive criminal law approach. There needs to be a legal framework that accommodates legal pluralism, so that the state can still protect the community from harmful practices without ignoring the existence of cultural values and local wisdom. This research is important as a scientific contribution in formulating fair and contextual criminal law policies in facing the challenges between cultural preservation and legal protection. Thus, the research entitled Criminal Law Enforcement on Illegal Traditional Medicine Practices Examined Based on the Perspective of Legal Pluralism Theory aims to: first, analyze the suitability of the national legal framework in regulating traditional medicine; second, evaluate the effectiveness of criminal law enforcement American Journal of Economic and Management Business Vol. 4 No. 7 July 2025 884 against illegal traditional medicine practices; and third, formulate a law enforcement model that is in line with the principle of legal pluralism, for the realization of substantive justice in the Indonesian legal system. This research contributes to the academic discourse by proposing a responsive criminal law enforcement model that integrates legal pluralism principles. Practically, it provides policymakers with actionable insights to develop regulations that protect public health while respecting cultural heritage. By bridging the gap between state law and customary law, this study aims to foster a more just and effective legal system for addressing illegal traditional medicine practices. RESEARCH METHODS This research uses the normative legal research method, which is research that examines law as a prescriptive system of norms, focusing on applicable legal principles, rules, and doctrines. Normative research aims to examine positive legal norms, both written in laws and regulations and those living in society, in order to find legal arguments for the issue raised, namely illegal traditional medicine in the context of legal pluralism. The research approaches used include: (1) Statute Approach, which is used to analyze various positive legal provisions that govern the practice of medicine, health, and criminal law, such as Law Number 17 of 2023 concerning Health, Law Number 1 of 2023 concerning the Criminal Code, Regulation of the Minister of Health on traditional medicine, and living law; (2) Conceptual Approach, which is used to study legal theories, especially the theory of legal pluralism, responsive law, and legal integration, which are relevant in understanding conflicts and potential harmonization between state law and customary law; and (3) Case Approach, which is conducted by examining concrete cases related to the criminalization of traditional medicine by the state, which has occurred in various regions in Indonesia. These cases will be analyzed to see how legal pluralism occurs factually in law enforcement practice. This research is prescriptive and applied legal research, because it not only aims to find legal principles, but also to formulate a policy model for criminal law enforcement against traditional medical practices that considers the existence of customary law within the framework of legal pluralism. RESULT AND DISCUSSION The Effectiveness of Criminal Law Enforcement on Illegal Traditional Medical Practices in the Perspective of Applicable Laws and Regulations The practice of traditional medicine is a form of Indonesian cultural wealth that has been inherited from generation to generation by ancestors in indigenous peoples. This treatment is known for various methods such as traditional massage, herbal herbs, gurah, acupuncture, to supernatural medicine. However, in practice in the field, not all traditional medicine is carried out in accordance with applicable health and legal standards. The emergence of illegal traditional medicine, which is carried out without official permission, without competence, and even contains elements of fraud or causes serious health impacts for patients, has posed serious challenges in the enforcement of criminal law. This raises crucial questions regarding the effectiveness of criminal Sri Ayu Astuti, Heristiawan Aryo Wirotomo*, Mela Lavenia 885 law enforcement against traditional medical practices carried out illegally, especially within the framework of a national legal system that recognizes legal pluralism. Normatively, traditional medicine practices are recognized as a form of implementing health efforts in accordance with Article 22 paragraph (1) letter w of Law Number 17 of 2023 concerning Health. Then in Article 160 s.d. Article 164 of the same law regulates how traditional medicine practices are protected by the state by paying attention to knowledge, expertise, and/or values derived from local wisdom. This practice is supervised by the local government and the central government so that it can be accounted for its benefits and safety and does not conflict with socio-cultural norms. Another derivative regulation is the Regulation of the Minister of Health (Permenkes) Number 15 of 2015 concerning Empirical Traditional Health Services, which regulates standards and procedures for traditional medicine to be able to practice legally. The articles in this regulation affirm that traditional medicine must have a competency certification and practice license from the local Health Office, and it is forbidden to perform medical procedures or claim healing without scientific basis. Medical practices that violate this provision can be charged through various articles in the Criminal Code (KUHP), including Article 378 concerning fraud, Article 360 concerning negligence that causes injury or death, and Article 359 which ensnares acts that cause the death of another person due to fault. In practice, the effectiveness of law enforcement against illegal traditional medicine in Indonesia still faces a number of obstacles. These obstacles include a lack of legal awareness among the public, weak supervision from law enforcement officials, limited capacity of health institutions to verify traditional medicine practices, and overlapping authority between central and regional agencies. For example, many traditional medicines are still operating illegally because they are considered public figures or have great cultural influence, making them difficult for law enforcement to touch. On the other hand, law enforcement officials are sometimes reluctant to prosecute criminally because such cases are considered administrative violations or professional ethics alone, not as pure criminal acts. One of the factual cases that had attracted national attention was the case of DI Banyuwangi in 2023BPOM raiding a factory in Banyuwangi that produced illegal traditional medicines such as Klanceng Wasp and Leaf Root. These products contain dangerous medicinal chemicals (BKO) and have been distributed to various regions in Indonesia. The total value of evidence reached Rp 1.4 billion. The Food and Drug Supervisory Agency (BPOM) together with law enforcement officials revealed an illegal traditional medicine factory in Banyuwangi. The factory is suspected of producing traditional medicines without meeting the safety, efficacy, and quality requirements set by laws and regulations. The products produced do not have a distribution permit and have the potential to endanger public health. The perpetrator in this case is charged with Law Number 17 of 2023 concerning Health, which stipulates that anyone who deliberately produces or distributes pharmaceutical preparations and/or medical devices that does not have a distribution permit can be sentenced to a maximum of 15 years in prison and a maximum fine of IDR 2 billion. Another case that is no less important is the case in Kampar Regency, Riau Province, in 2024. BPOM revealed the production of illegal herbal medicines in Kampar Regency, Riau, with American Journal of Economic and Management Business Vol. 4 No. 7 July 2025 886 a production value of Rp 2.4 billion. These drugs contain BKO and are manufactured at home to avoid supervision. The main perpetrator with the initials RS (31) became a fugitive after fleeing during the raid. This case shows how the practice of unlicensed production of traditional medicines can flourish in society, taking advantage of trust in herbal medicine, but violating the formal laws governing the safety and distribution of medicines. In the perspective of legal effectiveness according to Lawrence M. Friedman's theory, the legal system consists of three elements, namely structure, substance, and legal culture. The legal structure concerns law enforcement officials and institutions such as the police, prosecutor's office, and courts. The substance of law includes written legal norms that govern people's behavior, while legal culture concerns public awareness, values, and attitudes towards the law. In the context of illegal traditional medicine, Indonesia's legal structure is actually quite complete in terms of regulations and supervisory institutions, but implementation in the field still faces structural obstacles such as lack of investigation capacity and coordination between agencies. In terms of substance, the existing regulations are quite adequate but have not been thoroughly socialized. Meanwhile, from the aspect of legal culture, there are still many people who consider traditional medicine as part of cultural heritage that should not be criminalized, without considering its medical and legal aspects. Overall, criminal law enforcement against illegal traditional medicine practices in Indonesia is still not fully effective, even though there is a strong legal foundation. It takes political will, institutional capacity, and public awareness to create a legal ecosystem that is able to protect the public from the dangers of unsafe, misleading, and physically and economically harmful treatments. Keep in mind that the protection of public health is not only the responsibility of the state, but it is also a fundamental right of every citizen that must be guaranteed by law. Thus, increasing the effectiveness of criminal law enforcement against illegal traditional medicine practices must be carried out comprehensively through reforms in these three aspects. First, in terms of structure, it is necessary to strengthen the role and coordination between the health office, police, prosecutor's office, and BPOM in processing illegal medical cases in an integrated manner. Second, the substance of the law needs to be strengthened with more detailed regulatory updates regarding the classification of illegal medical practices, as well as the granting of strict authority for health authorities to take action. Third, in terms of legal culture, it is necessary to conduct massive legal education to the public about the risks and dangers of illegal medical practices, as well as encouragement to only use services that have been officially certified. An ideal and responsive criminal law enforcement model in handling cases of illegal traditional medicine while still taking into account the principles of legal pluralism and the protection of the rights of indigenous peoples Traditional medicine practices are a form of manifestation of local knowledge that has been passed down from generation to generation in various indigenous peoples in Indonesia. In the context of national law, this practice has its own place as part of the national health system, but it is still limited by the provisions of laws and regulations that regulate the legality and accountability Sri Ayu Astuti, Heristiawan Aryo Wirotomo*, Mela Lavenia 887 of treatment. Problems arise when traditional medicine practices are carried out illegally, both by actors from indigenous peoples and by outsiders who use the "traditional" label for commercial purposes without having competence or legal permission. Therefore, a criminal law enforcement model is needed that is not only repressive, but also ideal and responsive to the values of legal pluralism and respect for the rights of indigenous peoples. Positive legal approaches alone often fail to capture the sociocultural realities of traditional medicine practices, especially those originating from indigenous communities. This is where the principle of legal pluralism becomes relevant. According to John Griffiths, legal pluralism is the existence of more than one legal system in one particular social space, of which state law is only one. In a pluralistic Indonesian society, there is a surviving customary law system that regulates social relations, including traditional healing practices. Therefore, in the enforcement of criminal law against illegal traditional medicine, it is important to distinguish between genuine customary practices and commercial or exploitative practices that are harmful to society. The ideal and responsive criminal law enforcement model must be integrative, combining a legalistic approach with a sociological and cultural approach. This model is not only oriented towards the enforcement of criminal norms, but also considers the constitutional rights of indigenous peoples as stipulated in Article 18B paragraph (2) of the 1945 Constitution of the Republic of Indonesia, which states that "The State recognizes and respects the units of customary law communities and their traditional rights as long as they are alive and in accordance with the development of society and the principles of the Unitary State of the Republic of Indonesia." This is in line with the provisions in Law Number 39 of 1999 concerning Human Rights, especially Article 6 paragraph (1), which states that cultural identity and the rights of traditional communities must be respected. In its implementation, there are three strategies that can be applied in this ideal model. First, the differentiation of criminal law based on the character of practice. This means that law enforcement officials must map the difference between traditional medicine that is carried out based on customary norms that are still alive and carried out collectively by indigenous communities, and practices that are exploitative, individualistic, and endanger patient safety. Practices that fall into the first category need to be approached with a coaching and integration mechanism into the health service system, not directly criminalized. On the other hand, the second category of practices can be acted upon strictly through criminal or administrative channels. Second, the penal mediation mechanism or restorative justice can be a responsive approach to cases involving perpetrators from indigenous communities. Instead of imprisoning offenders who have no malicious intent (mens rea) but have caused harm due to a lack of knowledge or training, resolving cases through rehabilitation, education, and retraining approaches will be more relevant. This model is in line with the spirit of the National Police Chief's Regulation Number 8 of 2021 concerning the Handling of Crimes Based on Restorative Justice, which encourages case resolution by paying attention to the social and cultural conditions of perpetrators and victims. Third, strengthening the role of the state in the recognition and facilitation of traditional medicine practices of indigenous peoples. The state should not only play the role of a controller, but also a American Journal of Economic and Management Business Vol. 4 No. 7 July 2025 888 facilitator and protector of customary-based health practices. This can be done through a special registration scheme for traditional medicines, the provision of locality-based certification training, and the integration of traditional medicines into the health system at the health center or village level. Thus, the potential for unnecessary criminalization of indigenous peoples can be minimized, while improving the quality of alternative health services. The successful implementation of these models is highly dependent on the capacity of state institutions and political will to implement an inclusive approach. So far, there are still many law enforcement officials who consider state law as the only authority, so they tend to ignore customary law norms. On the other hand, this approach also requires the support of indigenous communities themselves to reform their systems, especially in terms of openness to accountability mechanisms and public health. This is where the role of academics, NGOs, and civil society institutions is needed in bridging the dialogue between state law and customary law. There are several regions that have implemented a pluralism approach to law in the supervision of traditional medicine. For example, in Bali and West Kalimantan, local governments collaborate with the Customary Assembly and the Health Office to collect data and provide guidance to shamans and traditional healers. They are not immediately legally prosecuted if they do not have a permit, but are given the opportunity to take part in training and obtain certification gradually. This suggests that criminal law enforcement that considers the social context and local laws will be much more effective in fostering and protecting communities. The ideal and responsive criminal law enforcement model in dealing with illegal traditional medical practices is one that is inclusive, based on substantive justice, and upholds the principle of legal pluralism. This model rejects a one-size-fits-all approach, and instead emphasizes contextual analysis, differentiation of legal treatment, and strengthening the role of indigenous peoples as autonomous legal subjects. By building a legal framework that respects the diversity of local laws while maintaining public health protection standards, Indonesia can create a criminal law enforcement system that is more fair, humane, and relevant to social realities. CONCLUSION Criminal law enforcement against illegal traditional medicine practices in Indonesia has not been fully effective because it still faces various obstacles, both normative, structural, and cultural. Although laws and regulations such as the Health Law have expressly regulated the terms and sanctions for illegal practices, their implementation is often hampered by weak supervision, lack of understanding of the socio-cultural context by the authorities, and lack of optimal coordination between agencies. Therefore, a responsive legal approach based on legal pluralism is indispensable so that law enforcement not only guarantees legal certainty, but also reflects substantive justice that respects the practice of local wisdom of the community. An ideal and responsive criminal law enforcement model in handling cases of illegal traditional medicine must accommodate the principle of legal pluralism and ensure the protection of indigenous peoples' rights. This model includes the differentiation of criminal law based on the character of practice, the mechanism of penal mediation or restorative justice, and the strengthening of the role of the Sri Ayu Astuti, Heristiawan Aryo Wirotomo*, Mela Lavenia 889 state in the recognition and facilitation of traditional medical practices of indigenous peoples. State criminal law needs to synergize with customary law through the recognition and fostering of traditional medicine practices that meet safety and health standards. This approach not only upholds the rule of law, but also ensures substantive justice and the sustainability of local wisdom within the framework of an inclusive state of law. 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