1. 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

2. 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

3. Which one would you drink?

4. 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
doctor?

5. What do you think?

6. Levels of moral response
 The expressive level (unanalyzed
expressions or feelings that, by
themselves, don’t provide reasons or
justification)
 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

7. Ethical/Moral reasoning
 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
(“ought”).
they are meant to guide
actions. Key values in bioethics have
corresponding (e.g., principle of respect for
autonomy)

8. Don’t judge things on what they
first appear to you!
There is always a reason why
people do things?

9. 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

10. What is ethics?
 A system of moral principles or standards
governing conduct.
 a system of principles by which human actions
and proposals may be judged good or bad, right
or wrong;
 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)

11. Ethi
cs
Bioethic
s
Clinical Ethics
Research ethics
Resource
Allocation ethics
Public Health
ethics
Nursing ethics
other
Business
ethics
Environmental
ethics
Social ethics
Organizational
ethics
IT ethics
Other

12. What is bioethics?
 It is derived from Greek bio- life and ethicos
moral.
 The science/art that aims at identification,
analysis, and resolution of the ethical issues in
almost any field that is related to human life
and health.
What is clinical/medical
ethics?
 It is that branch of bioethics that is related to
the identification, analysis, and resolution of
moral problems that arise in the healthcare of

13. 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?

14. What is an “ethical issue” or a
“moral problem”?
 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

16. Main Western
Philosophies
Other
philosophies
Abrahamic
Philosophies
Oriental
philosophies
Utilitarianism African, Asian,
etc.
Islamic Buddhist
Deontology Human
Rights
Jewish Confucius
Feminist ethics Catholic Indian
Casuistry
Virtue ethics Protestant Persian
Principlism Jehovah Witnesses

17. Why do we need to know about
western philosophies?
 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

18. 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
Islam?

19. It emphasizes the
virtues, or moral character (who is your
virtuous model?)
 Examples: Doctors as role models.
 Should not a patient comply with a “don’t smoke”
advice from a smoking doctor?!

20. (cont.)
(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.
 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?

21.  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?

23. 1)The Koran and 2) the
Sunna,
 Unanimous agreement of Islamic jurists (Ijmaa)
 Acceptance by the majority of trusted scholars
(Rayul Jomhour)
 Measurement/Analogy (Qiyas),
 Remediation (Maslaha), (Istishab)

24.  The are to
preserve person’s:
1. Religion;
2. Soul;
3. Mind;
4. Wealth; &
5. Progeny.
All Islamic legislations came to achieve
these goals.

25. 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 )

26. 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
degree
 Prevention of harm has priority over pursuit of a benefit of equal
worth
 the lesser harm is committed

27. 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.

28.  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?

29. Thank You
To contact Dr. Ghaiath Hussein:
Office: (+966)-(1)-2889999 Ext. 7588 Email: ghussein@kfmc.med.sa
Personal: 00966566511653 – email: ghaiathme@gmail.com
More Resources:
http://med-ethics.com/
http://omarkasule.tripod.com/
http://www.islamset.com/ethics/index.html