Bio-Ethics
Abstract
Ethics is the issue of right and wrong. Before the introduction of machine age a number of philosophers and thinkers emerged and lift their indelible impressions upon human history.
Philosophy includes five fields of study: Logic, Ethics, Esthetics, Politics and Metaphysics
Ethics is study of ideal form; it is the philosophy of art, the study of ideal conduct, the highest knowledge of good & evil and the knowledge of wisdom of life.
The Hippocratic oath has guided physicians for thousands of yrs
New questions arises with growing technical powers of modern medicine e.g. life support, dialysis and organ transplant.
Surgery, ethics and law go hand in hand. The difference between the criminal and the surgeon is that their intensions differ. A criminal intentionally harm. The surgeon intension is limited to the treatment of illness.
If someone deliberatively cuts another person, draws blood, causes pain, leaves scars… criminal charge is applied. The pt submit to surgery because they trust their surgeons.
Four cardinals virtues.... are Courage, Justice, Temperance, Practical and wisdom.
The apprentice ship model of surgical residency teaches much more than technical mastery.
The surgical practical wisdom is acquired through experience.
In ninth century; one of the earliest known books written on medical ethics in the Islamic World was by Is-haq Ibn Ali Al-Rauhawi.
The dearest possession of man is considered to be health.
God did not consider all persons fit to learn medicine. He gave it to some virtuous ones.
Whose hearts are pure, who has sharp intellect, have mercy and sympathy.
Ethical values are Universal but deeply embedded in cultural contexts
They are adaptations which have roots in local circumstances.
Ethical values are determined by resources available to pts, families and communities
Four principals of health care ethics are comprehensive enough to encompass most of the moral issues that arise in health care
They are….Autonomy, Beneficence, Non-maleficence and Justice.
AUTONOMY: Respects the capacity of individuals to choose their own destiny. The right of pt to choose among various surgical options. It implies an obligation for doctors to allow pts to make choices about their medical care. There is considerable room for personal autonomy in Islam.
It offers equality before law and social justice. It requires that proposed actions aim at and achieve something good.
BENEFICENCE: The term beneficence is what is “birr” in Qur’an, It signifies truthfulness, goodness and right-doing and Beneficence refers to the moral duty of doing good. Islam lays great stress on doing good. Beneficence demands members of the medical profession to put the interest of the patients above their own interest. Animal research should not entail cruelty or torture.
NON-MALEFICENCE:
It is the exact opposite of beneficence. It aims at avoiding concrete harm. Avoidance of doing harm should take priority over beneficence. With holding a patient’s therapeutic need can never be justified.
JUSTICE:
It requires a fairness where both the benefits and burdens of a particular action are distributed equitably.
Justice is not measurable. The concept of justice and cost effectiveness is debatable.
Justice demands that service to an individual must continue even if the service is not cost effective.
INFORMED CONSENT:
Relatively recent development. The doctrine of informed consent is one of the most widely established tenets of modern biomedical ethics. 19th and 20th century physicians practiced a form of benign paternalism where by patients were rarely involved in the decision making process regarding their medical treatment. The doctors are obliged to disclose to pts all information regarding diagnosis, treatment options and risks that a reasonable pt would want to know in a similar situation.
The amount of information needs to be disclosed is controversial.
Exceptions to informed consent are: Emergencies, Pediatric age and Capacity of patient to understand.
Consent for organ donation needs specific criteria.
References:
- Zaidi SH, Jafary MH, Anwar UN, Jawaid SA 1995, Mubarak Ali at Laureate packages Karachi Pakistan.
- Ahsan HM, Anjum R, Amadi I. 2015. hunderd great Muslim scientist; 700years of Muslim history of science and knowledge. Shamshad printers 37 Mazang Road Lahore Pakistan.
