Asst. Prof., Dept. of Medical Ethics
King Fahad Medical City – Faculty of Medicine
King Saud Bin Abdul-Aziz University for Health Sciences
King Saud bin Abdulaziz University for Health Sciences
King Fahad Medical City
Faculty of Medicine
Definition of ethics, bioethics, and medical ethics1
What is an ethical issue in healthcare?2
International approaches to medical ethics3
Islamic approach to medical ethics4
Less embarrassing choices…
I need to pass the exam..cheat or not?
I need the organs of this dying patient... Let him
die fast? He’s dying anyway!
I need the money of this Pharma company... Shall
I change the results of my research on their drug?
I need to be trained ...tell the patient you’re a
Levels of moral response
The expressive level (unanalyzed
expressions or feelings that, by
themselves, don’t provide reasons or
The pre-reflective level (justification via
law, religious tenets, social values, codes
of ethics, etc.; accepted uncritically)
The reflective level (reasoned ethical
argument/defense based on ethical
principles, rules, virtues, values to which
we consciously subscribe; justification
It is the process we need to go through to
reach a decision about an ethical issue.
It helps us to differentiate:
description of the way the world is; an
actual state of affairs (“is”)
judgment about the way things should be
they are meant to guide
actions. Key values in bioethics have
corresponding (e.g., principle of respect for
Don’t judge things on what they
first appear to you!
There is always a reason why
people do things?
What is ethics?
What are the branches of ethics?
What is bioethics?
What is medical/clinical ethics?
What is an ethical issue?
Key definitions and concepts
What is ethics?
A system of moral principles or standards
a system of principles by which human actions
and proposals may be judged good or bad, right
A set of rules or a standard governing the
conduct of a particular class of human action or
Any set of moral principles or values recognized
by a particular religion, belief or philosophy;
The principles of right conduct of an individual.
(UNESCO/IUBS/Eubios Living Bioethics Dictionary version 1.4)
What is bioethics?
It is derived from Greek bio- life and ethicos
The science/art that aims at identification,
analysis, and resolution of the ethical issues in
almost any field that is related to human life
What is clinical/medical
It is that branch of bioethics that is related to
the identification, analysis, and resolution of
moral problems that arise in the healthcare of
Questions answered by Bioethics
deciding what we should do (what
decisions are morally right or acceptable);
Example: Should patient A or B have the ICU bed?
explaining why we should do it (how do
we justify our decision in moral terms); and
Why did we decide to admit A & not B?
describing how we should do it (the
method or manner of our response when we
act on our decision).
What are we going to do for patient B?
What is an “ethical issue” or a
There is an ethical issue when:
…we encounter conflicting
values, beliefs, goals, or responsibilities
…we are concerned that persons or their rights
are not being respected
…we are concerned about fairness and justice
…we are unsure what we should do or why we
should do it, morally speaking
Utilitarianism African, Asian,
Feminist ethics Catholic Indian
Virtue ethics Protestant Persian
Principlism Jehovah Witnesses
Why do we need to know about
A Doctor is an international currency (you may
be practicing anywhere)
Bridging the knowledge & cultural gaps
Western literature & experience are steps
ahead of ours
Ethical concepts & tools are quite universal
No self-development without knowing others
To reflect Islamic concepts to non-Muslims in
an appropriate manner
the value of an action is
determined by its utility; all actions should be
directed toward achieving the greatest happiness
for the greatest number of people.
Examples: quarantine, isolation, vaccination, etc.
Where does utilitarianism (dis)agrees with Islam?
actions are judged based upon
inherent right-making characteristics or principles
rather than on their consequences. Emphasis on
duty, rules and regulations, principles and moral
obligations which govern ones right action
Examples: Doctor’s duties to care for their patients
Where does Duty-Based Ethics (dis)agrees with
It emphasizes the
virtues, or moral character (who is your
Examples: Doctors as role models.
Should not a patient comply with a “don’t smoke”
advice from a smoking doctor?!
(Ethics of Care) commitment
to correcting male biases (e.g. women’s
subordination is morally wrong) and that the moral
experience of women is as worthy of respect as that
Where does feminisme (dis)agrees with Islam?
The greatest confidence in our
moral judgments resides not at the level of theory,
where we endlessly disagree, but rather at the level
of the case, where our intuitions often converge
without the benefit of theory.
Where does Casuistry (dis)agrees with Islam?
Autonomy: respect humans'
ability to choose,
Beneficence: Do Good for
Nonmaleficence (Do No Harm),
Justice (Be fair to your patients)
Where do these principles meet with
1)The Koran and 2) the
Unanimous agreement of Islamic jurists (Ijmaa)
Acceptance by the majority of trusted scholars
Remediation (Maslaha), (Istishab)
The are to
4. Wealth; &
All Islamic legislations came to achieve
What is Islamic Bioethics?
It is the methodology of
defining, analysing and resolving the ethical issues
that arise in healthcare practice, or research;
based on the Islamic moral and legislative sources
(Koran, Sunna & Ijtihad); and
aims at achieving the goals of Islamic morality (i.e.
preservation of human’s religion, soul, mind, wealth
& progeny )
1. The principle of Intention (Qasd): Each action
is judged by the intention behind it
2. The principle of Certainty (Yaqeen): Certainty
can not be removed by doubt
3. The principle of Injury/Harm (Dharar):
Injury should be relieved; An individual should not harm others or
be harmed by others
An injury is not relieved by inflicting or causing a harm of the same
Prevention of harm has priority over pursuit of a benefit of equal
the lesser harm is committed
4. The principle of Hardship (Mashaqqat):
Difficulty calls forth ease, Necessity
(Dharuraat) legalizes the prohibited
5. The principle of - Custom or precedent (Urf):
Custom is recognized as a source of law on
which legal rulings are based unless
contradicted specifically by text from the main
legislative sources, i.e. Koran and Sunna.
Give example of an ethical issue/problem you
faced or witnessed, mentioning the following:
What was the situation?
What was your feeling towards it?
What did you do?
Do you think you did the best thing? why?
What you think you need to know more to be able
to handle similar situations in the future?
To contact Dr. Ghaiath Hussein:
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