Amanullah Khan, M. D., Ph.D.

One of the hottest issues in medicine, these days, is the subject of medical ethics, morality, and liability. If one looks back, it becomes apparent that Hadith refers to these problems. It will also be of interest to note that problems faced by the physicians and the patients today are not any different from the problems faced in earliar periods of history. would like to quote some ahadith on the responsibility of the physicians.

"A person who practices art of healing when he is not acquainted with medicine, will be responsible for his actions."

In another hadith the prophet (pbuh) said:

"O servants of Allah, seek treatment, for Allah has not sent down any illness without sending down its treatment."

Hadith also made treatment mandatory or obligatory when a treatment was definitely available, and also if holding off this treatment would be harmful. But if one is unsure of any benefit from a treatment and any harm is feared, then it is discouraged. These principles were designed to discourage quackery and protect the patients.

One of the most extensive works dealing with ethics was written by Ishaq ibn Ali al- luuhawi, a Christian who embraced Islam. He also wrote extensively on Galen. It is not possible to cover here all aspects of his writings. His book, Adab al-Tabib (Ethics ofa Physician) is an extensive work. It consisted of 112 folios with 17 lines per page. This was found in Suleymaniye Kitabhane. Its English translation appears in the The Transactions of the American Philosophical Society, Vol. 57, part 3, 1967, Philadelphia. The Islamic philosophy served as a basis for defining and solutions to the ethical and moral problems facing physicians. The translator of this work, Martin Levy, in his preface says, and 1 quote:

"in addition. the contents of this world are remarkable in their delineation of the manner in which Muslim (and to lesser extent, Christian) religious ideas were made to hannonize with the older science and ethics of the Grecks in particular."

The Islamic philosophy and the Muslim code was so realislic and practical that al-Ruhawi was at case in dealing with this difficult subject. The society was changing from a tribal primitive society to a more orderly society with emphasis on human values and strong religious feelings. These were times of great changes. Therefore, the setting for this work was not any different from the one prevailing at present. It may be worthwhile just to glance at the titles of the 20 chapters of Adab al-Tabib.

1.The loyalty and the faith of the Physician, and Ethics He Must
Follow to improve His Soul and Morals.
2. Care of the Physician's Body
3. What the Physician Must Avoid and Beware of
4. Directions of the Physician to the Patient and Servant
5. Manners of the Visitors
6. Care of Remedies by the Physician
7. What the Physician Asks the Patient and the Nurse
8. What the Patient May Conceal
from the Physician
9. How the Healthy and III Must Take Orders of the Physician
10. Training of Servants by the Patient before Illness
II. Patient and Visitors
12. Dignity of the Medical Profession
13. Respect for the Physician
14. Physicians and Peculiar Incidents to Aid Treatment
15. Medical Art for Moral People
16. Examination of Physicians
17. Removal of Corruption of Physicians
18. Warning against Quacks
19. Harmful Habits
20. Care of the Physician Himself

Adab al-Tabib is a beautiful illustration of the fact that problems of responsibility, ethical dilemmas, and needs of the society are nothing new to medicine. A review of this work brings home the realization that the present day physician may have been derelict in his responsiblity towards the current ethical needs. In the past, it was the physician who was the advocate of morality, who defended ethics, and who was in the forefront in delineating these areas. During the recent years, due to a variety of reasons, a narrow approach or lack of emphasis on ethics in medical training was noticeable. As a result the physician is no longer seen as a stalwart defender of ethics and morality.

The definition of ethics and morality in medicine has lately become a favorite topic for politicians and non-physician bureaucrats who lack the insight into the whole garnet of patient- physician relationship. It is time that the physician stood his ground. He is still regarded very highly and trusted by the people as shown by polls. Unless the physician takes proper steps, the public trust is likely to wither away. Every teaching physician needs to realize his duty - to train the budding physicians, not only in the art of medicine, but also in handling the ethical dilemmas of medical practice.

In the present day controversies of medical ethics, certain other aspects of the responsibilities of the other parties involved, which have been well delineated by Ruhawi, have been completely ignored in the recent years, for example, the responsibilities of the patient and the society towards a physician. The patient has equal responsibility in the relationship between the physician and the patient. Similarly, the society has to realize the nature of demands placed on a physician and afford him the support that he may need at times.
UP | Islamic Medicine | Digital Radiology Teaching File | Next | Radiology Home |