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<Home> <Ethics> <Health Policy, Ethics and Human Values> <Preface> Health Policy, Ethics and Human Values - An Islamic Perspective PREFACE This meeting
should have been held much earlier. The cardinal ethical principles of
the medical and health professions form part of the cardinal principles
of Islam, as a way of life. These principles are: respect for human dignity,
Justice and beneficence. By respect for human dignity we mean that a human being should be treated as a person, that is to say as an individual who has rights to claim and duties to perform. This entails independent decision-making and continuous protection of such independence. This principle, which is one of the most important Islamic principles, is at the same time one of the most important principles dealing with a patient. It imp1ies recognition of a patient's fundamental right as a person entitled to rights and committed to duties. Patients have the right to know all the detail relating to their illnesses, to receive the proper treatment. to have their medical secrets safeguarded, and to obtain adequate care. However, their enjoyment of these rights should never be at the expense of the community in which they live. Islam stresses also the principles of justice and beneficence. They are mentioned together in the Holy Quran and are highly regarded in contemporary medical ethics. By justice we mean equity in meeting needs and in delivering care. In the area of health, justice is reflected in maintaining, as much as possible, equality in the distribution of health resources and the provision of preventive and curative opportunities, without discrimination with regard to sex, race, belief, political affiliation, social or intellectual level, age, or other considerations. All people, irrespective of any such factor, should have equal access to primary health care preventive and curative services. This is precisely the essence of health for all, the slogan and concept advocated by WHO. Beneficence involves an additional value, namely the conviction that one should at all costs fulfil one's duty towards one's brothers and sisters in humanity and care for them, particularly those who are weak or helpless, in the same way that one would care for oneself. One feels that it is one's duty to strive to obtain for them the rights they are denied. Closely related to this is the duty of health care providers to inform their patients of their rights and of the ways in which they can promote their health and care for themselves before they seek the help of others. Beneficence also entails perfection, as far as possible, both in performance and in kindliness. Indeed, there is an obviously growing need to put such ethical principles into practice, particularly nowadays when the protection of people's health and providing patients with the best possible medical care, as well as the best possible material and moral support, form a fun- damental part of the duties of human society. During the last two centuries the world has witnessed spectacular progress in making the achievements of modern technology accessible to all of us, at least in theory. Regrettably, however, this has been accompanied by a negative change in the attitudes and behavioural patterns of the medical community. The human touch which had always distinguished medicine has waned. A physician may treat a patient just as a case number, or in much the same way as a mechanic would deal with a machine. We may have gained from the progress of science but we have lost, to a considerable extent, from erosion of the respect which a human being owes to a fellow human, the heart-to-heart dialogue between the health provider and the patient, and those tender touches that have often proven more efficacious than medicine. Nevertheless, the international community has witnessed serious attempts to revitalize the humanization of the health professions. One such outstanding attempt has been the resolution adopted by the World Health Assembly on the spiritual dimension of health. In following up this resolution, CIOMS, in the framework of its programme on Health Policy, Ethics and Human Values, has organized jointly with WHO a series of meetings in order to apply this spiritual dimension in health promotion. The Seminar held in Cairo, which was organized by the Islamic Organization for Medical Sciences, and co-sponsored by CIOMS and WHO, constitutes, in our view, a significant landmark on this path. The health profession is undoubtedly one of the noblest professions, as it seeks to care for life itself. This emphatic care for life, or "quickening", to use Quranic terminology, even if it involves one person only, is regarded in Islam as giving life to all humanity. Hence, medicine should be treated as a vocation or mission rather than an occupation. The human touch should mark each of its components Though technology has its undeniable place, the time always comes when a patient prefers to find at the bedside a caring human, rather than a lifeless instrument that traces electric potentials or arteries. As Clements maintains, it is time for us to stop focusing on our differences and to remind ourselves of our points of similarity. There is a common denominator that should unite all believers, namely the set of human values that seeks to preserve human life and dignity, and achieve the highest possible level of justice and beneficence, particularly since the basis for successful cooperation is inherent in every culture; and it is also time for us to recognize and utilize this basis. WHO has, hence, welcomed the holding of this meeting, as an important step towards the attainment of its goal of achieving the best possible standard of health, which is a state of complete physical, mental, social (and spiritual) well-being. It is the achievement of this state of complete well-being that should be seriously sought, for this is what real health truly is. We should by no means allow one aspect to overshadow the others. It is now time for us to turn our backs upon the modern narrow- minded specialist whose attention is totally focused on body organs, and go back to the old broad-minded understanding physician who focused attention on the human being. It is time for the surgeon to actually remove the operating mask and garments outside the operating room so as to be able to have effective communication with the patient who lies covered with a dense sheet of barriers. It is time for the doctor to occasionally stop looking through the microscope and to look from time to time through the window. It is also time for the nurse to revive the "guardian angel" qualities of nursing. It is utterly
meaningless to seek to prolong life in the absence of a value system that
gives meaning to such life, or to establish a system of primary health
care that does not cover, with complete equity, all those who need it. |