Transcript ISLAMIC CODE OF ETHICS: MEDICAL PRACTICE

ISLAMIC CODE OF ETHICS:
MEDICAL PRACTICE
FARHAT MOAZAM, M.D., PHD
Center of Biomedical Ethics and Culture, SIUT,
Karachi, Pakistan
Institute of Practical Ethics, University of Virginia, USA
DISCUSSION POINTS
Modern secular ethics versus Islamic religiousethical concepts
The contemporary English term “ethics” versus
the Arabic (Urdu) word “Adab/Akhlaq”
Rich Islamic heritage of Virtue Ethics (al-Fada’el)
and stress on the moral physician: the sources
A brief account, and some examples, of virtues
that must be included in the body of the Islamic
Code of Medical Ethics of IOMS
MODERN BIOETHICS:
BASIC CHARACTERISTCS
Multidisciplinary discipline conceived in the
1970s to address new ethical dilemmas in
medical practice and biomedical research
Grounded in secular, philosophical principles
relying on human reason
Focus on autonomy and individual rights to
ensure justice
Ethical theories satisfied with minimal obligations
to others
Asks the question – “is this action ethical?” (“Hal
al-’aml salih wa akhlaqi?”)
ISLAMIC RELIGIOUS ETHICS:
BASIC CONCEPTS
Historically, Muslim moral and ethical thought
rooted in Revelation and human reason (al-’aql
wa ‘l-shari’)
Recognizes rights of individuals, but emphasizes
human obligations to establish social justice
Those more privileged in life have greater
responsibilities towards the less fortunate
Asks the question – “is the acting
agent/physician a moral person?” (“hal al-Tabib
shakhsun salihun, shakhs du akhlaq?”)
ETHICS vs. AKHLAQ/ADAB
Ethics for physicians is translated in Arabic (and Urdu)
as Akhlaq al-Tabib
The historical and social construct of how Muslims
comprehend akhlaq is much broader than the
contemporary use of term “ethics”
An understanding of akhlaq incorporates both the
virtuous agent and his/her ethical act
The IOMS Islamic Code of Medical Ethics for physicians
must include, in addition to what constitutes ethical
actions, a list of virtues and moral traits that physicians
must adopt and cultivate
By highlighting the need for virtuous physicians and
researchers as well as ethical acts, IOMS can make an
important contribution to contemporary bioethical
discourse which peripheralizes the former
VIRTUES FOR PHYSICIANS:
MUSLIM SOURCES
“The physician is an instrument of God’s mercy on
earth.” Ibn Ali al-Ruhawi (d. late 9th century)
From ethical concepts in the names of Allah: al-Rahim
(compassionate), al-Rahman (gracious), al-Ghafur
(forgiving), al-Haq (truth, justice)
From the Qur’an and Hadith: Cultivate al-birr (piety,
godliness), ahsana (the ideal), hilm (gentleness,
patience, moral reasonableness), ‘adl wa qist (justice,
equity), tawazan (balance). Avoid kibr (pride), bakhila
(avarice), istaghna (unbound confidence in self), bagha
(injustice, intoxication with worldly power)
VIRTUES FOR PHYSICIANS:
MUSLIM SOURCES (CONT.)
From Muslim ulema and fuqaha: The usul al-akhlaq of
Imam Abu Hamid al-Ghazali – hikma (wisdom), shuja’a
(courage), ‘iffa (temperance), and ‘adl (justice)
From Muslim physicians: Kitab al-Tibb al-Ruhani of Abu
Bakr al Razi – the exemplary physician “must cultivate
good moral character, good health, and be cultured in
manners.” Must “listen more, talk less.”
Adab al-Tabib by Al-Ruhawi – “train by employing good
morals and actions with sympathy, mercy, gentleness,
chastity, courage, generosity, justice. Do not aim for an
excess of worldly riches.” The physician with “exemplary
adab is one who truly fears God.”
WHY STRESS MORAL CHARACTER
OF PHYSICIAN?
Physicians and patients are spiritually equal in
the eyes of Allah as His creatures
Relationship between physicians and patients by
nature is an unequal one; the patient is not
autonomous in illness. Physicians possess
knowledge and skills which patients do not, but
need for recovery and survival
Rules and guidelines alone are insufficient
safeguards against abuse of patients in the
hands of unethical practitioners. E.g. the
informed consent for therapy or research
FINAL WORDS
“The believers whose faith is most perfect
are those who have the best character.”
(Akmalu al-momineen imanan ahsanuhum
khuluqan)
Hadith of the Prophet (SAW)
(from Imam Ibn Hanbal)