L1. Introduction to
Alfarabi College of Medicine, (Sep.2017)
What we will try to learn today?
• Section I: Definitions & Concepts
• Section II: Western approaches to medical
• Section III: Islamic approaches to medical
SECTIONI: OVERVIEWOF ETHICS&
Why do we do what we do?
Why can’t/don’t we do what we want to?
Factor Originates from Developed by Written as Binding/
Not written Voluntarily Community
Ethics Argued through
Professional values Professional
l) Codes of
Binding those in
Legal and moral
Legislators Laws Binding ALL
Binding Those in
Not written ? The person
SECTIONII: DEFINITIONS& CONCEPTS
What is ethics?
What is bioethics?
What is medical/clinical ethics?
What is an ethical question/dillema?
What is ethics?
A system of moral principles or standards governing
a system of principles by which human actions and
proposals may be judged good or bad, right or
A set of rules or a standard governing the conduct of
a particular class of human action or profession;
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)
• Ethical reasoning is necessary to resolve the
potential conflicts between personal values and
• Ethical decision making requires everyone to
consider the perspectives of others, even when
they have different values.
Values and ethical principles
The Fact-Value Distinction
• Fact: description of the way the world is; an actual state of
• Example: our health-related decisions involve many people, not only
• Value: judgment about the way things should be (“ought”).
• Example: Doctors ought to take consents from the individual patient
• Value = something a person/community has identified as
important (e.g., autonomy/self-determination)
Values, Morals, Ethics
• Values signify what is important and
worthwhile. They serve as a basis for moral
codes and ethical reflection.
• Morals are codes of conduct governing
behavior. They are values put into practice
• Ethics provide a systematic, rational way to
work through dilemmas and to determine the
best course of action in the face of
What is bioethics?
•It is derived from Greek bio- life
and ethicos moral.
•Applied bioethics aim at the
identification, analysis, and
resolution of the ethical issues in
almost any field that is related to
human life and health.
• the new scientific/technological developments in
biomedical and life sciences, and debates about:
• Kidney dialysis machine (Who had the priority?)
• Organ transplant, artificial ventilator, and brain death
• In virtro fertilization (IVF)
• Cloning and stem cell research
• Genetic engineering
What is clinical/medical ethics?
• Clinical ethics is a practical discipline that provides
a structured approach to assist physicians in
identifying, analyzing and resolving ethical issues
in clinical medicine.
• The practice of good clinical medicine requires
some working knowledge about ethical issues
such as informed consent, truth-telling,
confidentiality, end-of-life care, pain relief, and
• 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?
Questions answered by Bioethics
• deciding what we should do (what
decisions are morally right or acceptable);
• explaining why we should do it (how
do we justify our decision in moral terms);
• describing how we should do it (the
method or manner of our response when
we act on our decision).
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
What is an Ethical Question?
And what is not?
Ethical questions have the following components:
• often involve the words ought or should.
• There are several alternate solutions, none of that is
without some challenging or problematic aspect.
• They contain conflicting moral choices and
dilemmas, and conflicting underlying values of the
• They have no right or wrong answer which satisfies
all parties, but better or worse answers based on
well- reasoned justifications.
L3. SECTION III: WESTERN APPROACH
TO ETHICS AND ETHICAL REASONING
How right and wrong are distinguished?
How to approach the ethical dilemmas?
Other philosophies Devine (dogmatic)
Utilitarianism African, Asian, etc. Islamic Buddhist
Deontology Human Rights Jewish Confucius
Feminist ethics Catholic Indian
Virtue ethics Protestant Persian
Casuistry Jehovah Witnesses
Why do we need to know about
• A Doctor is an international currency (you may be
• Bridging the knowledge & cultural gaps
• Western literature & experience are steps ahead of
• Ethical concepts & tools are quite universal
• No self-development without knowing others
• To reflect Islamic concepts to non-Muslims in an
General characteristics of western
• Secularism: people are free to practice
their religion but no particular religious
guidance to right & wrong
• Individualism: It’s all about I, me and
• The individual and nuclear family structure
are the societal building block.
• The individual's interest is what should
come first (vs. more collective extended
family ethics in our region)
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,
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
Examples: Doctor’s duties to care for their patients
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
(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 of men.
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
Respect for Autonomy: respect
humans' ability to choose,
Beneficence: Do Good for others,
Nonmaleficence (Do No Harm), &
Justice (Be fair to your patients)
Where do these principles meet with Islam?
Islamic approach to ethical analysis and
Ethics in Islam… not a separate
How should Muslims decide their acts?
1)The Koran and 2) the
• Ijmaa االجماع means a unanimous agreement among
Muslim Scolars on any Shariah ruling
• Qiyas القياس likening a new case in question without
textual evidence to an original ruling which is supported
by explicit legal text which shares the same cause.
• Maslahah المصلحة deciding a ruling based on the
principle of general public interest in issues which do
not have clear and specific textual ruling
• Istihsan االستحسان setting aside an established ruling
backed by dalil (evidence) on a matter in favor of an
alternative ruling which is stronger and more
convincing than the first ruling, based on the
support by dalil.
• Istishabاالستصحاب the presumption of continuity of
the original ruling as long as there is no other dalil to
establish the contrary
• Sadd Zari`ah الذرائع سد signifies an approach used to
prevent any means to evil in order to avoid from
forbidden acts. It is regarded as an early preventive
measure to keep away a Muslim from committing
actions prohibited by Allah SWT.
• `urf العرف is defined as established norms and
common to the majority of people in a community
either in the form of sayings or doings as long as it
does not contradict the Shariah ruling.
The are to preserve
1. Religion الدين حفظ
2. Soul النفس حفظ
3. Mind العقل حفظ
4. Wealth المال حفظ
5. Progenyالنسل حفظ
All Islamic legislations strive to achieve these
goals and prohibit what contradicts them
•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 )