islamic code of ethics: medical practice

1. 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

2. DISCUSSION POINTS Modern secular ethics versus Islamic religious-ethical 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

3. 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?�)

4. 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?�)

5. 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

6. 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)

7. 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.�

8. 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

9. 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)