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Maqasid al-shariah as a complementary framework to conventional bioethics

Saifuddeen SM, Rahman NN, Isa NM, Baharuddin A

Sci Eng Ethics, 2014 Jun;20(2):317-27.
PMID: 23836155 DOI: 10.1007/s11948-013-9457-0

With the rapid advancements made in biotechnology, bioethical discourse has become increasingly important. Bioethics is a multidisciplinary and interdisciplinary field that goes beyond the realm of natural sciences, and has involved fields in the domain of the social sciences. One of the important areas in bioethical discourse is religion. In a country like Malaysia, where Muslims make up the majority of the population, Islam plays a crucial role in providing the essential guidelines on the permissibility and acceptability of biotechnological applications in various fields such as medicine, agriculture, and food processing. This article looks at the framework of a complementary model of bioethics derived from the perspective of Islam. The framework is based on 'maqasid al-shariah' (purposes or objectives of Islamic law) which aims to protect and preserve mankind's faith, life, intellect, progeny, and property. It is proposed that 'maqasid al-shariah' be used as a pragmatic checklist that can be utilized in tackling bioethical issues and dilemmas.

Matched MeSH terms: Bioethics*
Fulltext The moral responsibility of governments and individuals in the context of the coronavirus pandemic

Nihlén Fahlquist J

Scand J Public Health, 2021 Nov;49(7):815-820.
PMID: 33550931 DOI: 10.1177/1403494821990250

AIM: Not only is the coronavirus pandemic about science and facts, it also raises a number of ethical questions. Some of the most important questions in this context are related to responsibility. First, what is a government's primary responsibility? Second, how should both the government and individuals consider personal moral responsibility in this context?
METHOD: This paper uses conceptual and normative analysis to address responsibility in the context of the pandemic. The paper also refers to reports published by the German Ethics Council, the Malaysian Bioethics Community and the Swedish National Council on Medical Ethics.
RESULTS: The primary responsibility of governments is to create a balance between individual values and rights, one hand, and the health of the population, on the other. There are good reasons to conceive of individual responsibility as a virtue, having to do with the development of crucial character traits and habits. The responsibility of governments is connected to individual responsibility through the values of trust and solidarity.
CONCLUSIONS: Governments need to communicate clearly (a) how they balance conflicts between collective health and individual rights and values and (b) what the chosen strategy entails in terms of collective and individual responsibility. Success requires attention to ethical values from all involved. Individuals will need to develop new character traits to help manage this pandemic and to prevent new ones. Governments must facilitate the development of such character traits by building trust and solidarity with and among citizens.

Matched MeSH terms: Bioethics*
Moral injury and the four pillars of bioethics

Heston TF, Pahang JA

F1000Res, 2019;8:1193.
PMID: 38435121 DOI: 10.12688/f1000research.19754.4

Healthcare providers experience moral injury when their internal ethics are violated. The routine and direct exposure to ethical violations makes clinicians vulnerable to harm. The fundamental ethics in health care typically fall into the four broad categories of patient autonomy, beneficence, nonmaleficence, and social justice. Patients have a moral right to determine their own goals of medical care, that is, they have autonomy. When this principle is violated, moral injury occurs. Beneficence is the desire to help people, so when the delivery of proper medical care is obstructed for any reason, moral injury is the result. Nonmaleficence, meaning do no harm, has been a primary principle of medical ethics throughout recorded history. Yet today, even the most advanced and safest medical treatments are associated with unavoidable, harmful side effects. When an inevitable side effect occurs, the patient is harmed, and the clinician is also at risk of moral injury. Social injustice results when patients experience suboptimal treatment due to their race, gender, religion, or other demographic variables. While minor ethical dilemmas and violations routinely occur in medical care and cannot be eliminated, clinicians can decrease the prevalence of a significant moral injury by advocating for the ethical treatment of patients, not only at the bedside but also by addressing the ethics of political influence, governmental mandates, and administrative burdens on the delivery of optimal medical care. Although clinicians can strengthen their resistance to moral injury by deepening their own spiritual foundation, that is not enough. Improvements in the ethics of the entire healthcare system are necessary to improve medical care and decrease moral injury.

Matched MeSH terms: Bioethics*
Fulltext Regulating advance decision-making: potential and challenges for Malaysia

Chan HY

Asian Bioeth Rev, 2019 Mar;11(1):111-122.
PMID: 33717304 DOI: 10.1007/s41649-019-00078-2

The right to refuse treatment is generally accepted in the legal and bioethics discourses; however, the use of advance directives remains contentious. Some jurisdictions have introduced statutory frameworks to govern the creation and implementation of advance directives, underpinned primarily by the recognition of respect for personal autonomy. Although there are no legislation and judicial decisions on advance decision-making in Malaysia, the considered view is that healthcare practitioners perceived its utility in managing patient care. This paper examines the potential and challenges of applying a statutory framework in Malaysia, drawing from relevant regulatory examples. It argues for greater public awareness within the healthcare discourse and knowledge dissemination regarding the availability, usage and clinical guidance on advance decision-making. The main conclusion drawn from this exploratory analysis is that further understanding of and education about advance decision-making within the population and healthcare practitioners should precede the implementation of a statutory regime in Malaysia.

Matched MeSH terms: Bioethics
Fulltext What Does It Mean for a Case to be 'Local'?: the Importance of Local Relevance and Resonance for Bioethics Education in the Asia-Pacific Region

Bergstresser SM, Ghias K, Lane S, Lau WM, Hwang ISS, Ngan OMY, et al.

Asian Bioeth Rev, 2020 Jun;12(2):173-194.
PMID: 33717336 DOI: 10.1007/s41649-020-00120-8

Contemporary bioethics education has been developed predominately within Euro-American contexts, and now, other global regions are increasingly joining the field, leading to a richer global understanding. Nevertheless, many standard bioethics curriculum materials retain a narrow geographic focus. The purpose of this article is to use local cases from the Asia-Pacific region as examples for exploring questions such as 'what makes a case or example truly local, and why?', 'what topics have we found to be best explained through local cases or examples?', and 'how does one identify a relevant local case?' Furthermore, we consider the global application of local cases to help extend the possible scope of the discussion, opening new avenues for the development of practical bioethics educational materials. We begin with a background description and discussion of why local cases enhance bioethics education, move to an overview of what is currently available and what is not for the region, and then outline a discussion of what it means to be local using example cases drawn from Hong Kong, Australia, Pakistan, and Malaysia. We are not creating a casebook but rather constructing by example a toolbox for designing active and dynamic learning cases using regional diversity as contextualised cases with generalised principles.

Matched MeSH terms: Bioethics
Tri-parent Baby Technology and Preservation of Lineage: An Analysis from the Perspective of Maqasid al-Shari'ah Based Islamic Bioethics

Ibrahim AH, Rahman NNA, Saifuddeen SM, Baharuddin M

Sci Eng Ethics, 2019 02;25(1):129-142.
PMID: 29071572 DOI: 10.1007/s11948-017-9980-5

Tri-parent baby technology is an assisted reproductive treatment which aims to minimize or eliminate maternal inheritance of mutated mitochondrial DNA (mtDNA). The technology became popular following the move by the United Kingdom in granting license to a group of researchers from the Newcastle Fertility Centre, Newcastle University to conduct research on the symptoms of defective mtDNA. This technology differs from other assisted reproductive technology because it involves the use of gamete components retrieved from three different individuals. Indirectly, it affects the preservation of lineage which is important from an Islamic point of view. This paper aims to analyze and discuss the implications of the tri-parent technology on preservation of lineage from the perspective of Maqasid al-Shari'ah based the Islamic bioethics. The analysis shows that there are a few violations of the preservation of lineage, hence the tri-parent baby technology should not be permitted.

Matched MeSH terms: Bioethics*
Maqasid al-Shariah Based Islamic Bioethics: A Comprehensive Approach

Ibrahim AH, Rahman NNA, Saifuddeen SM, Baharuddin M

J Bioeth Inq, 2019 Sep;16(3):333-345.
PMID: 30715660 DOI: 10.1007/s11673-019-09902-8

Maqasid al-Shariah based Islamic bioethics is an Islamic bioethics concept which uses the objectives of the Shariah (maqasid al-Shariah) as its approach in analysing and assessing bioethical issues. Analysis based on maqasid al-Shariah based Islamic bioethics will examine any bioethical issues from three main aspects namely intention, method, and output or final goal of the studied issues. Then, the evaluation will be analysed from human interest hierarchy, inclusivity, and degree of certainty. The Islamic bioethics concept is a manifestation of dynamic Islamic jurisprudence which can overcome new complex and complicated bioethical issues such as tri-parent baby technology issues. Therefore, this article will introduce and explain the concept of maqasid al-Shariah based Islamic bioethics and outline a general guidance of maqasid al-Shariah based Islamic bioethics to determine a maqṣad (objective) based on standards of human good or well-being (maslahah) and harm (mafsadah).

Matched MeSH terms: Bioethics*; Bioethical Issues/legislation & jurisprudence*
Fulltext Principlism and neonatology: utilising the principles of medical ethics in decision-making for neonates

Tan, Mark Kiak Min

Journal of Clinical and Health Sciences, 2018;3(2):5-12.
MyJurnal

Prematurity is the leading cause of infant mortality and one of the main reasons for newborn infants to be admitted to the Neonatal Intensive Care Unit (NICU). Advancements in medicine has made the NICU a maze of sophisticated modern technology and expensive to run. These advances in technology have also resulted in an added layer of complexity to many ethical dilemmas that are encountered in the NICU. In 1977, Beauchamp and Childress introduced the principles of biomedical ethics. These four principles of (1)respect for autonomy, (2)nonmaleficence, (3)beneficence and (4)justice, form a suitable starting point for the analysis of the moral challenges of medical innovation. This article explores how the four ethical principles relate to decision-making in the NICU, and how they can be applied to the treatment of sick newborn infants in clinical practice. It also highlights the reasons why healthcare personnel need to equip themselves with good communication skills and up to date knowledge of ethical considerations in the NICU in order to make quality decisions about care for their patients. This article also suggests that a Clinical Ethics Committee can play a vital role in ensuring that the best decisions are achieved for these patients.

Matched MeSH terms: Bioethics
Islamic bioethical deliberation on the issue of newborns with disorders of sex development

Mohamed MS, Noor SN

Sci Eng Ethics, 2015 Apr;21(2):429-40.
PMID: 24664170 DOI: 10.1007/s11948-014-9534-z

This article presents the Islamic bioethical deliberation on the issue of sex assignment surgery (SAS) for infants with disorders of sex development (DSD) or intersexed as a case study. The main objective of this study is to present a different approach in assessing a biomedical issue within the medium of the Maqasid al-Shari'ah. Within the framework of the maqasidic scheme of benefits and harms, any practice where benefits are substantial is considered permissible, while those promoting harms are prohibited. The concept of Maqasid al-Shari'ah which is the mechanistic interpretation of Qur'an and Hadith presents the holistic attention of Islam on many life activities, including healthcare. Indeed, this concept encompasses many aspects of worldly life, both for the human individual and collectively for the whole society. In healthcare, the practice of SAS on DSD newborns has presented an assortment of implications on the future livelihood of the affected individual. The process of decision-making seems to be very multifaceted since every element such as the determination of the 'correct' sex and the urgency of early surgery must consider the benefits and harms, as well as the child's rights and best interest. The application of the concept of Maqasid al-Shari'ah, would convey a pragmatic approach that is often disregarded in Western medicine. This approach considers the right of the individual to live life optimally, individually and socially and practice his faith, precisely, in accordance with the assigned gender.

Matched MeSH terms: Bioethics
Ethical aspects in the use of radiation in medicine: update from ICRP Task Group 109

Bochud F, Cantone MC, Applegate K, Coffey M, Damilakis J, Del Rosario Perez M, et al.

Ann ICRP, 2020 Dec;49(1_suppl):143-153.
PMID: 32777956 DOI: 10.1177/0146645320929630

Whereas scientific evidence is the basis for recommendations and guidance on radiological protection, professional ethics is critically important and should always guide professional behaviour. The International Commission on Radiological Protection (ICRP) established Task Group 109 to advise medical professionals, patients, families, carers, the public, and authorities about the ethical aspects of radiological protection of patients in the diagnostic and therapeutic use of radiation in medicine. Occupational exposures and research-related exposures are not within the scope of this task group. Task Group 109 will produce a report that will be available to the different interested parties for consultation before publication. Presently, the report is at the stage of a working document that has benefitted from an international workshop organised on the topic by the World Health Organization. It presents the history of ethics in medicine in ICRP, and explains why this subject is important, and the benefits it can bring to the standard biomedical ethics. As risk is an essential part in decision-making and communication, a summary is included on what is known about the dose-effect relationship, with emphasis on the associated uncertainties. Once this theoretical framework has been presented, the report becomes resolutely more practical. First, it proposes an evaluation method to analyse specific situations from an ethical point of view. This method allows stakeholders to review a set of six ethical values and provides hints on how they could be balanced. Next, various situations (e.g. pregnancy, elderly, paediatric, end of life) are considered in two steps: first within a realistic, ethically challenging scenario on which the evaluation method is applied; and second within a more general context. Scenarios are presented and discussed with attention to specific patient circumstances, and on how and which reflections on ethical values can be of help in the decision-making process. Finally, two important related aspects are considered: how should we communicate with patients, family, and other stakeholders; and how should we incorporate ethics into the education and training of medical professionals?

Matched MeSH terms: Bioethics