The Muslim Doctor PDF

See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/328696123 THE MUSLIM DOCTOR Book · November 2018 CITATIONS READS 0...

See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/328696123 THE MUSLIM DOCTOR Book · November 2018 CITATIONS READS 0 2,062 1 author: Idrees Anwar Rawalpindi Medical University, Rawalpindi, Pakistan 48 PUBLICATIONS 635 CITATIONS SEE PROFILE Some of the authors of this publication are also working on these related projects: Diabetic foot View project Apprenticeship model View project All content following this page was uploaded by Idrees Anwar on 02 January 2020. The user has requested enhancement of the downloaded file. THE MUSLIM DOCTOR 2 THE MUSLIM DOCTOR Preface My extensive career spanning over to almost two decades has motivated me to share my fervent convictions regarding my profession. I do not intend to indulge in a long pedantic debate orbiting around vague criticism rather I would like to jot down a few purposeful lines regarding the appropriate conduct of a doctor and a medical student in Hospital and College respectively. This is an earnest effort to transmute these practices to paper in a format that can be further transmitted to our upcoming generations with a prayer that our future doctors would uphold the highest of ethical and professional values. Although most of these precepts are already engraved in the minds of our students by their parents and the veteran college authorities, still there remains room for embracing many more constructive facets of a doctor’s career. We must be able to fathom the profound meaning of being a doctor and his prime responsibilities towards the afflicted humanity beseeching him with wistful eyes. We must aspire to maintain the dignified image that a doctor needs to project in both his personal and professional life. We must ram home in our students minds never to let this extended image get tarnished by any superficial ulterior motive as we the doctors undoubtedly savor the highest of prestige among all the prevailing professions. Here I feel inclined to confess that I learned a lot in writing a book as it rendered me able to discern numerous loopholes in my own practice that were hitherto lying in sheer oblivion. I wholeheartedly venture to become a true Muslim doctor who is considerate and solicitous towards his yearning fellow beings. I firmly believe that all the young rising doctors must elevate their professional aspirations to a much loftier plane so as to build up a genuine philanthropist approach that is paramount for any doctor’s real success. Jazak Allah khayran ‫خيرا‬ ً ُ ‫)جزاك هللا‬ Prof Muhammad Idrees Anwar MBBS, FRCS(Glas), DCPS, HPE(CPSP), MHPE(KMU). 3 THE MUSLIM DOCTOR 4 THE MUSLIM DOCTOR ACKNOWLEDGEMENT First, I would like to thank Almighty Allah for his countless blessings and guidance. This work is gift from Allah Al Rehman and I cannot thank him enough for his mercy and graciousness. I am very lucky to receive the countless and most precious prayers of my mother. She is always there for me whenever I need. Thank you Ami. I must convey my sincere thanks to my sister Birjees Iqbal. She found time in spite of her busy schedule, to grammatically check and correct the manuscript. This achievement would not have been possible without the support, patronage, patience and guidance of my Wife Aisha and my two lovely butterflies Saba and Asma. Thank you all, may Allah bless you. Prof Idrees DEDICATION I am dedicating this book to Recep Tayyip Erdoğan President of Turkey Who has greatly inspired me as a leader for Muslim World. 5 THE MUSLIM DOCTOR CHAPTER 1; ETHICS AND PROFESSIONALISM Objectives We pray to Almighty Allah that the doctor fraternity after reflecting on this chapter will Insha’Allah; Apprehend the true significance of the terms, ‚Ethics and Professionalism‛. Summary This chapter aims to explicate the meaning of terms ethics and professionalism in retrospect to traditional and western teachings. Ethics is the way we interact and behave with our patients based on cultural and moral values. Professionalism however looks at those behaviors, which we adopt due to our particular profession. The chapter also highlights the key domains in UK model of professionalism. What is ethics? Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine.i Medical ethics delves at our everyday behavior in patient care, research and evaluates whether these behaviors are in accordance with moral and ethical principles. We assess our actions in terms of being morally and ethically correct or incorrect, fair or unfair. These principles are formulated by our social, cultural and religious values. Since values vary from place to place and at times, from person to person thus it is crucial to make exact judgment therefore we have to rely on our own conscience. When any of the ethical principle is compromised, it is called ‚a conflict‛. When two values conflict each other it is called ethical dilemma‛ or ‘crises’. Various conflicts can arise during clinical practice, with difficult and ambiguous solutions. The values of patients, health care providers might conflict with values of relatives or attendants. Thorough understandings of such situations are required to reach a mutually acceptable and ethically correct decision. A principle merely facilitates in order to reach an ethically correct solution to a perplexing situation. 6 THE MUSLIM DOCTOR Medical ethics dealing with clinical practice in patient care and research is sometimes referred to as Bioethics. Traditionally the key principles of ethics are; 1. Autonomy -. (Voluntas aegroti suprema lex.) 2. Beneficence - (Salus aegroti suprema lex.) 3. Non-maleficence - "first, do no harm" (primum non nocere). 4. Justice (fairness and equality). 5. Dignity (Respect for person)- 6. Truthfulness and honesty – (the concept of informed consent) During every day clinical practice, we deal with variegated ethical issues. Like disclosure of information, especially in a terminally ill patient in which informing him might hasten his death. Disclosure might scare a patient to extent to refuse all treatment. Similarly, dealing with the patient whose relatives are refusing treatment because of other motives and patient might benefit from treatment. Situation becomes more complicated when the person is either a minor, or mentally incompetent to give consent. We can only tackle with these complicated situations if we are properly trained. Study of ethics is essential for all doctors in order to effectively combat such intricate situations. What is professionalism? What makes us good doctors? When we say, ‚this is the way a doctor should behave‛, we are actually referring to professionalism. These are the demands of our profession that we aspire to accomplish. By definition, Medical Professionalism signifies a set of values, behaviors and relationships that underpins the trust the public has in doctors. The words "profession" and "professional" come from the Latin word "professio," which means a public declaration with the force of a promise. Professions are groups that declare in a public way that their members promise to act or behave in certain way and that the group and the society may discipline those who fail to do so. When we are being trained in profession of medicine we must incorporate certain professional values and behaviors which are worthy of our profession. We exhibit these values and behaviors daily in our clinical practice and at our work place. These values and behaviors are governed by expectations of patients, medical community and society. There are no strict principles, just guidelines that the young doctors should adopt to exhibit a thorough professional behavior. ‚A professional is someone you can trust to do the right thing when no one is looking‛; 7 THE MUSLIM DOCTOR Maxine A. Papadakis, M.D. Professor of Medicine; University of California, San Francisco. Key elements In UK model the three key elements of this domain are; 1. Professional governance 2. Professional practice 3. Personal professional development. Fig 6, UK model of professionalism Professional governance; Doctors have to work in a very complex environment. While contributing in a broad framework of health care system in which many composite governing organizations are simultaneously collaborating, they have to pursue their career goals as well. For example, in our current hospital set up, we have medical college organization, management of hospital and so forth. They have to supervise their junior doctors and concurrently work under the mentorship of their seniors. Thus effecting as a team leader on certain occasions and followers at other. Moreover, they also have to pursue their careers and should fathom how to accomplish their personal goals within this framework. All these are integral components of professional governance. Professional practice In a clinical set up, patient management requires a team effort with close communion with variegated departments and other health care team members. Doctors are a part of a team that manages patients and provide them speedy service and tender care. They should be cognizant of their role in team in order to administer conditions professionally, 8 THE MUSLIM DOCTOR especially in crucial and challenging circumstances. They should be able to take difficult decisions and effectively communicate with them and to other organizations and members. They should be able to advice, develop professional relationship and solve broader management issues in all bearings. These elements in fact represent the professional practice. Personal professional development Diverse issues emerge during the doctor’s clinical training years, some within the workplace and some outside. One must bear in mind that doctor’s personal problems also interfere with clinical practice. Major problems not only hamper their performance but also create friction with others. Thus, doctors require support and encouragement for working through these issues and this substantial reinforcement will pave the way for setting the strong foundation for their evolving professional development. A doctor, being a representative of medical community is also granted great reverence by the society in general and public in particular. Therefore, the doctor has to incorporate his professionalism in his personal disposition even outside his working environment. This is initially quiet difficult to grasp but eventually the doctor realizes, adopts, and it is in fact progression of his personal professional development. Teaching and learning ethics and professionalism We assume that doctors will automatically learn ethics and professionalism in their years of clinical training. Nevertheless, this assumption may not be true, and the students if not taught properly may exhibit totally unethical or unprofessional behavior. As medical educators, we must incorporate teaching and learning ethics and professionalism as part of core curriculum that has to be formally taught and learned. Doctors encounter divergent issues in everyday life and may be able to handle simple situations, but without formal education, tackling intricate and complex situations will not be possible. Prayer May Allah grant us strength to be ethical and honest professionals. 9 THE MUSLIM DOCTOR CHAPTER 2; DISEASE AND TREATMENT Objectives We pray to Almighty Allah that our doctors after reviewing this chapter will Insha’Allah; Discuss the basis of disease and treatment according to Islamic teachings and Sunnah of Prophet ‫ﷺ‬. Summary This chapter elucidates about sickness and health as depicted in Islamic teachings. Sickness occurs by the will of Allah and should never be regarded as punishment and patients as sinners. When stricken one should exhibit endurance and seek treatment by medicine and importantly by Dua. Allah has graciously awarded cure for all diseases and the patient gets better with the benediction of Almighty Allah. Islamic concept of disease and treatment As a Muslim doctor we must perceive that sickness and health all are ordained by Almighty Allah. Health is a great gift of Almighty Allah but Sickness is also determined by Allah and has its own reasons, which we are unable to comprehend. We should not regard sickness as punishment or wrath of Almighty Allah‛ as it may occur to alleviate the spiritual caliber of a person and may be a blessing in disguise. In a Hadith of Prophet ‫ ﷺ‬Allah’s Apostle said; "Expect good, because Allah (s.w.t.) makes a believer's sickness an expiation (for his sins) and a period of repose. As for a disbeliever falling sick, he is like a camel whose owner ties it and then lets it loose --it does not understand why it was tied, nor why it was freed." Bukhari in al-Adab ul-Mufrad (no. 493), verified authentic by al-Albani Whenever a person feels ill he/she is much closer to Almighty Allah as stated in hadith. Aa'isha (Radiyalaahu anha) says, 'I have never seen anybody suffering from sickness as much as Allah's Messenger (‫)ﷺ‬.' (Sahih Bukhari). 10 THE MUSLIM DOCTOR All diseases have cures Allah has accorded treatment for every disease as narrated in this’ Hadith Allah's Messenger said: There is a remedy for every malady, and when the remedy is applied to the disease it is cured with the permission of Allah, the Exalted and Glorious. (Sahih Bukhari, Book 25, Number 5466, Narrated Jabir ibn Abdullah) The treatment might be hidden by Allah and is revealed to man once the right time affirmed by Allah occurs. Allah requires Muslim doctors to strive and search for cure, and it may be revealed only after certain efforts have put into its discovery. Only Allah has the knowledge as when the treatment for a particular sickness will be revealed. Muslim Doctors should strive to perform research and find the cure for every illness. This concept is further discussed in chapter of ‚Ahsan; Allah cures We must also perceive that it is not the medicine or treatment but Almighty Allah that bestows cures. Even the best of treatment will be futile without the will and mercy of Almighty Allah. The concept is clarified in Sura Shuraa (Sura 42 ayat 80) as; And He feeds me and quenches my thirst and when I fall sick then He (Allah) cures me. The task of doctor is to do the best possible effort and leave the rest for Almighty Allah. It should not be a halfhearted effort without any scientific basis or reason but a complete and perfect effort based on modern scientific principals and evidence available. One you have done that then have Faith and tawaqal of Allah. Tawaqal Once the doctor has put his best efforts for treatment and cure, he should put his faith in Almighty Allah to heal the sick. This is called ‘tawaqal’ , which translates itself as ‘trust and reliance’. Both are interlinked having similar meanings and emerge from faith on Almighty Allah and his supremacy over everything. The Quran has highlighted the concept in Sura At talaq (Sura 65 ayat 3) ‘And He will provide him from *sources+ he could never imagine. And whoever puts their trust in Allāh, then He will suffice him. Verily, Allāh will accomplish His purpose. Indeed, Allāh has set a measure for all things.’ Tawaqal emerges as ‘reliance’ or ‘dependence’ on Almighty Allah and we depend on Allāh (subḥānahu wa taʿālā) for everything. These include in terms of our worldly affairs, sickness and health, life and death, as well as our Dīn. 11 THE MUSLIM DOCTOR Rewards for sickness Physicians should not regard sick as outcaste or being punished by almighty Allah and treat patients insultingly. Only Allah knows the true ‘hikmat’or reason for sickness. It may be a reward or means to improve his level in eyes of beholder. It could be a blessing in disguise and a source of bringing a person close to his creator. It has its own rewards in Akhera as well as in this world as narrated by many Hadith. Scholars Jabir ibn Abdullah narrated that Allah’s Messenger ‫ ﷺ‬said, ‚On the Day of Resurrection, when people who have suffered affliction are given their reward, those who are healthy will wish their skins had been cut to pieces with scissors when they were in the world.‛ (Al-Tirmidhi, 1570) As Muslims we have a staunch belief on the benevolence of Allah thus we should regard disease as an opportunity to humbly bow before the will of the creator. The lives of Sahabas (the companions)of Prophet ‫ ﷺ‬are replete with the incidences when they desired for the rewards achieved only by falling sick. Aisha (may Allah be pleased be with her) reported that the Messenger of Allah ‫ﷺ‬said, ‚For any adversity a Muslim suffers, Allah erases some of his sins, even though it may be no more than a thorn pricking him.‛ (Related by Al-Bukhari). Abu Saeed Al-Khudri and Abu Hurairah who quote Prophet ‫ ﷺ‬as saying: ‚Whatever befalls a Muslim of exhaustion, illness, worry, grief, nuisance or trouble, even though it may be no more than a prick of a thorn, earns him forgiveness by Allah of some of his sins.‛ (Related by Al-Bukhari) Once Rasulullah (‫ )ﷺ‬went to the home of Umm Saa-ib (Radiyallaaha anha) and asked her, ‘What is the matter? Why are you shivering?’ She replied, ‘I have a fever. May Allah not bless it! ‘ Rasulullah(‫ )ﷺ‬said, ‘Do not curse fever since it wipes out the sins of the Children of Aadam just as a furnace removes dirt from iron.’ (Sahih Muslim) When a person is sick and cannot perform Ibadat as before, Allah with his graciousness rewards him just as much. Hadrat Abu Moosa(R.A.) reports that Rasulullah ‫ ﷺ‬said, ‘When a person becomes sick or goes on a journey, then those (good) deeds are written down in his favour which he used to perform when he was at home and in good health.’ (Sahih Bukhari) Dua in sickness The other favorable remedy in sickness is residing to Zikar and Dua. It does not mean that we withdraw ourselves from all the natural means that lie at our disposal and instead, raise our hands and set about praying without doing any effort. Rather, it means that after utilizing all the means available before us to the best of our abilities and if we 12 THE MUSLIM DOCTOR fall short, we resort to Dua and, by turning towards and leaning on Allah (s.w.t.), we invigorate within ourselves the spirit of hope, seeking succor from the unfailing assistance of the Allah Ar Rehmaan. Allah says in the Quran, Sura Ghafir (Sura 40)Ayat 60; ‚And your lord said pray to me, I will respond to your invocations.‛ In Hadith narrated by Aisha bint Abu Bakr (Wife of Prophet Muhammad)‫ﷺ‬ Ask Allah for everything, even if it is only a shoelace, because if Allah does not make it easy, then it will not be possible..( al-Tirmidhi.) In Another Hadith Prophet ‫ ﷺ‬is reported to have said, ‚Du‘a is a weapon of a Muslim, a Pillar of Deen and the light of the skies and earth.‛ [Narrated by Hakim from Sayyiduna Abu Hurayrah and Abu Ya’la from Sayyiduna ‘Ali al-Murtudah, Hadith 6163] Thus we should always keep prayers along with providing best care to our patients. Dua of sick person Dua of a sick person is readily accepted as confirmed by this Hadith from Ibn Maajah. Rasulullah(‫ )ﷺ‬has said, 'When you visit a sick person, then tell him to make dua for you, because his duas are (accepted readily) like the duas of the Angels.' (Ibn Maajah). Rasulullah(‫ )ﷺ‬has also said, 'The dua of a sick person is not rejected until he recovers from his sickness.' (Ibn Abiddunyaa) We should therefore not mislay the opportunity to visit the sick and request them to make dua for self and on our behalf. Complaining in sickness Islam teaches us to accede before the decree of Almighty Allah in all His manifestations. We as worshippers have to yield with more submissiveness to the omnipotence of our Lord no matter what befalls us. Henceforth during sickness, the Muslim should exhibit nothing but gratitude and humbleness. That’s why the Messenger of Allah ‫ )ﷺ‬said, ‚How amazing is the case of the believer; there is good for him in everything, and this is only so for the believer. If he experiences something pleasant, he is thankful, and that is good for him; and if he comes across adversity, he is patient, and that is good for him.‛ [Muslim] Hazrat Abu Moosa(R.A.) reports that Rasulullah (‫ )ﷺ‬said, 'When a person becomes sick or goes on a journey, then those (good) deeds are written down in his favour which he used to perform when he was at home and in good health.' (Sahih Bukhari) 13 THE MUSLIM DOCTOR We should also teach our students, patients and relatives of patients to display positive and high self-esteem and high emotional intelligence in such difficult times instead of complaining and quarrelsome attitude. The patients and doctors should demomstrate high degree of endurance and sabar. This will be further discussed in later chapters. The duteousness and servility demonstrated by the believer during sickness enhances his spiritual vitality. Prophet ‫ ﷺ‬is quoted as saying- The Prophet stated that Allah, who is Blessed and Exalted, said "Son of Adam, if you show endurance and seek your reward from me in the first affliction, I shall be pleased with no lesser reward than Paradise for you." (Al-Tirmidhi, Narrated AbuUmamah (Ibn Majah transmitted it.) In another Hadith The Prophet of Allah, ‫ﷺ‬, said, "Do not say, 'I feel rotten.' Instead, say, 'I do not feel well." (Sahih Bukhari, Muslim, and Nasa'i, as Narrated by Hazrat 'A'ishah) Sunnah of Prophet ‫ ﷺ‬is to resort to prayers in sickness and in health. Whenever there is some problem one must display endurance ‚Sabar‛ This will be discussed in later chapters. Show kindness to the sick Islam has put great emphasis on Empathy and sympathy for those who are in agony as narrated in these two Hadiths of Prophet ‫ﷺ‬. ‚Kindness is a mark of faith, and whoever is not kind has no faith.‛ (Muslim) ‚You have two characters which Allah likes; gentleness and deliberation.‛(Muslim) In another hadith Prophet ‫ﷺ‬said ‚Whoever is kind, Allah will be kind to him; therefore be kind to man on the earth. He who is in heaven will show mercy on you.‛(Abu Dawud and Tirmidhi) These hadith dictate us the importance of kindness to all human beings. Patients when they are sick. and in agony, are most deservent of our sympathies and kindness. Even a small act of kind behavior and politeness shown greatly pacify their miseries and alleviate sufferings. Allah's Messenger ‫ ﷺ‬said, "When you go in to visit an invalid, express a hope that he will live long. That will not avert anything, but it will comfort him." Hadith- Sahih Bukhari, Volume 8, Book 73, Number 40, Narrated An-Nu'man bin Bashir This hadith clearly highlights the importance of sympathy for sick and invalid along with empathy. 14 THE MUSLIM DOCTOR Allah's Apostle said, "You see the believers as regards their being merciful among themselves and showing love among themselves and being kind, resembling one body, so that, if any part of the body is not well then the whole body shares the sleeplessness (insomnia) and fever with it." Hadith –( tirmidhi and Ibn Majah) Hence Islam believes in demonstrating a sympathetic, helpful and kind attitude. The Muslim doctor should provide support , hope and prayers to his/her patients. Prayers for sick It was Sunnah of Prophet ‫ ﷺ‬that whenever he visited sick, he always prayed for them. Small prayer is narrated in Hadiths of Prophet ‫ﷺ‬. Many prayers can be recited for and by the sick. Here are few; I ask Almighty Allah , Lord of the Magnificent Throne, to make you well. Reference: At-Tirmithi, Abu Dawud. See also Al-Albani, Sahih At-Tirmithi 2/210 and Sahihul-Jami' As-Saghir 5/180. Sura Fatihah, can also be recited and is considered as powerful dua for sickness As narrated in Hadith Narrated from Abu Sa eed al-Khudri (may Allah be pleased with him) that the Prophet ‫ ﷺ‬described Soorat al-Faatihah as a ruqyah, and he approved of the Sahaabi who recited it as a ruqyah for the one who had been stung by a scorpion.- Al-Bukhaari (2156) and Muslim (2201). Another Dua from Quran is prayer from Hazrat Ayub in Sura Anbiya Sura21 ayat 83 ِ ‫سنِ َي الضُّ رُّ َوأَنتَ أَرْ َح ُم الر‬ َ‫َّاح ِمين‬ َّ ‫َربَّهُ أَنِّي َم‬ O my Rubb, Surely, distress has touched me, and You are the most Merciful of the merciful ones. All these and many more prayers can be recited for sick patients and can be searched from internet. Prayer May Allah guide us to treat patients well and be a source of relieving pain and misery from their lives. Ameen. 15 THE MUSLIM DOCTOR CHAPTER 3; WHAT DOCTOR MEANS Objectives We pray to almighty Allah that our doctors after skimming through this chapter will Insha’Allah; Discuss what it means to be a doctor and what are his key roles and responsibilities. Summary This chapter rationalizes the fact as what it means to be a doctor and what are his or her cardinal obligations towards his patients. He should be perceptive about ‘self’ and become a lifelong learner. He/she has to acquire certain qualities like communicator, leader, collaborator apart from possessing basic knowledge and skills. One must conceive and comply with the expectations of the society and more particularly with his liability and commitment towards his patients. Introduction Ethics and professionalism is a cultural phenomenon and values are specific to geographical and religious boundaries. What may be ethical in Pakistani Islamic society may be unethical to another society and vice versa. We must understand the ethics and professionalism in perspective to our own societal needs, and learn values which we have developed in years of practice of our predecessors. Surely, there must be some perverse practices, which are contradictory to our religion or moral values and these must be challenged and corrected. A doctor Doctor, as this title, originates from the Latin word primarily an agentive noun of the Latin verb docēre *dɔˈkeːrɛ] means 'to teach'. 1 It started as an honored academic title in Europe and later adopted in America, former European colonies, and is now prevalent in most parts of the world. Contracted "Dr" or "Dr.", is used as a designation for a person 16 THE MUSLIM DOCTOR who has obtained a doctorate-level degree. Doctorate may be research doctorate or professional doctorate. Doctor literally means a learned person, a ‘teacher’ or one who has received a highest degree or award from a College or University. Followings are synonyms of a term doctor; - 1. A scholarly and sapient. 2. An educator or guide. 3. Knowledgeable possessing highest academic degree , 4. A healer who can treat or cure people. It is a great benediction of Almighty Allah that we have been granted a status of a doctor. Wisdom will come subsequently as a peculiar benefaction from Allah SubhanotayAllah. He grants wisdom to whom He pleases and whoever has been granted wisdom has been granted abundant good. And none would take Heed except those endowed with understandings. Sura Al BaqarahSura 2 Ayat 270 What society expects from a doctor? The society traditionally regards doctor as a divine, sanctified and mystical who upholds the best of moral and ethical scruples and conclusively repose their trust and faith on him. He is regarded as a learned, sagacious and wise person therefore is consulted for help and guidance in all situations even beyond his medical scope of work. Unfortunately, in spite of excellent work by most, this image is being tarnished because of few incidences of unethical and unprofessional behavior. Whenever there is some such mishap, the society castigates the whole profession rather than considering it an individual negligence. Thus, to be a doctor is a prodigious responsibility and a single laxity can fetch an ignoble name to the whole community. Responsibilities of a doctor Being a doctor is a fulltime commitment to self, family, patients, students and by large to whole society. Over the recent years, the duties of doctors have changes considerably 17 THE MUSLIM DOCTOR with emerging newer skills and attitudes. The future doctor has massive responsibilities that demand added commitment and dedication. These responsibilities are; Responsibilities to self A doctor must be committed to medicine and should strive to obtain highest degree of professional excellence in subject he or she wishes to pursue. Medicine is a highly dynamic science with continuous rapid advances in every sphere. Thus, the primary concern of the doctor should be optimal patient care. It is only possible if he or she is a lifelong learner, only then he can be safe for the patients as well as community. A modern doctor must be equipped with the ability to acquire knowledge skills and attitude to keep abreast with recent developments in respected specialty. Lifelong learner I feel that the doctor should acquire and practice the art of being a lifelong learner persistently aspiring to enhance his professional skills. This is attainable when he should  Attend conferences, and seminars,  Attend other Continuous professional development activities like workshops etc.,  Read recent articles from Journals and internet and perform literature search,  Learn and teach from colleagues, seniors and juniors alike.  Conduct and publish research. Whenever he has some difficulty and problem in clinical practice he or she should not hesitate from consulting other colleagues. A second opinion in a difficult case is always productive and helps in reaching out to a correct decision. The ego and selfdom of a doctor must not be that much elated that it should jeopardize and restrain him from consulting others and from farther learning. Self-recognition No one is perfect and everyone is liable to make errors and mistakes. One must identify his or her own limitations and practice within these boundaries. Too much self- confidence is extremely harmful for professional and personal growth. This exalted audacity persuades the physician to take unnecessary risks and increases complication rate. One should try to identify and ameliorate his personal mistakes. Similarly, too little faith and lack of self-confidence can also make practice difficult and one would always 18 THE MUSLIM DOCTOR be hesitant to make decisions. On certain emergency or life threatening situations, a practicing doctor has to make a quick and urgent decision that can only be possible when he has complete confidence on his skills and expertise. Thus recognizing self and personal limits, personal biases, errors, mistakes, and a self-directed effort to control them is a prime responsibility of a physician. Responsibilities to patients The ultimate responsibility of a doctor is a provision of patient care and best medical aid available. Besides this as we are living in a materialistic society where being a doctor means a superior social status, economic stability, fame, position and power. Very soon, we tend to buckle to external pressures and become concerned about gaining personal benefits. These factors always compromise our prime responsibility of striving for the wellbeing of the patient. These material comforts are no doubt essential for surviving in a society but they should not be our optimal goal. In addition, at times we have to face pressures from home, colleagues, seniors, juniors and from other social and political elements. These pressures are usually for wrong cause and untruthful demeanor. The ethics and professional values compel us to uphold our prime responsibility and sustain these pressures. We must have staunch faith in Almighty Allah who always paves a smooth path for those who strive for truth. As physicians, these are our responsibilities for the patients; 1. Provide optimal and best possible care, 2. Treat patients as individuals and respect their dignity, 3. Communicate and alleviate their concerns about disease, 4. Demonstrate concern and empathy towards patients, 5. Respects their rights to confidentiality, 6. Involve them in treatment decision, and honor their decisions, 7. Help them in maintaining optimal health, 8. Treat patients with justice and equality, Only when the doctor demonstrates these behaviors will he or she can gain the unflinching trust and faith of his/her patients. Allah says, in Sura Maida (Sura 5 Ayat 32) ‚Whosoever killed a soul not to retaliate for a soul, nor for creating disorder in the land, then it is as if he had killed all mankind. And whoso gave life to one soul, then it is as if he had given life to all mankind.‛ This lays a heavy responsibility on a Muslim doctor, he would also be held responsible if a patient dies because of his negligence, or incompetency. 19 THE MUSLIM DOCTOR Concept of social and public responsibility The role of the physician as more than a commitment to the individual patient but in fact, a social contract with humanity, to the interconnectedness of all people. These include commitments to work freely with colleagues to discover, develop, and promote advances in medicine and public health that ameliorate suffering and contribute to human well- being. To educate the public and polity about present and future threats to the health of humanity and to advocate for social, economic, educational, and political changes that ameliorate suffering and contribute to human well-being.‛ In short, he has now a wider social canvass to work for betterment of society and humanity at large. A communicator A doctor has not only to satisfy the concerns of patients abut also to communicate it to the attendants and to the public (at times) about the disease and other issues. Good communication skills, politeness and decent manners are essential for the practicing doctors. A colleague A doctor interacts decently and amiably with all his peers and colleagues, supports them and facilitates them in their learning and provides cover when they have to go on leave. He demonstrates a pleasant disposition, a genteel attitude and is benefactor in need. A teacher A doctor has to be an intellectually accomplished academician to teach in classroom, to his colleagues and at times to community comprising of public. Teaching is a great art that a doctor has to acquire in order to transfer his/her knowledge and skills to next generation. A leader Doctor enjoys a very conspicuous position in a society. Not only he or she is a health advocate but also a leader and advisor in all situations. In a society, people tend to consult a doctor for advice in all matters. This is indeed a great social responsibility, 20 THE MUSLIM DOCTOR which a doctor carries on his shoulder. This includes giving a sincere and honest advice, opinion to people, to guide them is crises, and to lead them when needed. A responsible citizen As the doctor, he/she is a responsible and a cultured citizen with deep concerns towards the society. Whenever he identifies some wrongdoing in his work place, or society he immediately informs the concerned authorities and endeavors to prevent the damage and loss. He abides by the rules of workplace and land and like a conscientious citizen pays his taxes regularly. Prayer May Allah grant us with wisdom and make us good doctors. Ameen. 21 THE MUSLIM DOCTOR CHAPTER 4; ISLAMIC PRINCIPALS OF ETHICS Objectives We pray to almighty Allah that our doctors after skimming through this chapter will Insha’Allah ; Discuss the principals of ethics compatible with Islamic teachings and Sunnah of Prophet ‫ﷺ‬. Summary This chapter aims to annotate about principals of ethics in the light of Islamic teachings. These principals are based on taqwa i.e. fear of Allah Almighty. Like every devoted practicing muslim a doctor has to follow the enunciated paradigms and bench marks affixed by Allah Almighty which includes to attain excellence in workplace and profession, demonstrate mercy, communicate with good manners to patients and above all to fulfill the rights of the people. A doctor has to perform his core duties with integrity and justice. It is also mandatory to visit the sick and invalid. What is Islamic perspective of ethics Islam is an embodiment of ethics and righteousness. It is a set of demeanor that safeguards the welfare of not only individuals but also of whole society. These principles of Islamic ethics have been derived from extensive literature search from Quran and Hadith. Islamic ethics defined as "good character," started with Prophet hood of Muhammad ‫ﷺ‬. It is based on Qur'anic teachings, the teachings of the Sunnah of Muhammad, the precedents of Islamic jurists (see Sharia and Fiqh). These principals have not been transcribed from any source but are the result of my untiring efforts as a novice of ethics and professionalism. The principals of Islamic ethics are; 1. Taqwa ( fear of Allah) 2. Hadood Allah ( limits of Allah) 3. Haqooq ul ebad ( rights of people) 4. Ahsan (Perfection or excellence) 22 THE MUSLIM DOCTOR 5. Adal ( justice) 6. Ikhaq e husna (nice manners) 7. Ikhlas ( sincerety) 8. Ayadat (visit the Sick) 1.Taqwa Taqwa is interpreted as fear of Almighty Allah. As a doctor, we should practice with the conviction of Allah’s Omnipresence and with the firm fidelity, that Almighty Allah is all- knowing. Allah is Samme o Baseer. i.e. can see and hear us. All Muslims and especially Doctors when have a bearing that all their actions are being monitored, they would automatically refrain from performing any wrong doings. More over a doctor should be Allah fearing and should make his actions, conduct subservient to the will of Allah and should aspires to a competent doctor and a finer person resultantly he will become an exemplary soul. This principle formulates an ideological basis of all other principles. For example, once Ikhaq e husna has been incorporated he would be nice just because of his Taqwa..Above all an Allah fearing doctor would become most learned of all men as narrated in Hadith. A companion of the Prophet ‫ ﷺ‬Khalid bin Waleed narrated the following Hadith; A Bedouin came one day to the Prophet and said to him, ‚O, Messenger of Allah! I’ve come to ask you a few questions about the affairs of this life and the Hereafter.‛ The Prophet responded ‚Ask what you wish!‛The Bedouin said, ‚I’d like to be the most learned of men.‛The Prophet replied, ‚Fear Allah, and you will be the most learned of men.‛(Related by Imam Ibn Hambal) In Sura Fatir (Sura 35Ayat 28‛) Allah only those of his servants with wisdom have fear of Allah. Allah is Almighty, Ever- Forgiving." The wisdom and fear of Allah are interwoven. If one fears Allah he will be granted wisdom and fear of Allah will only come if one is wise. This is mostly awarded and to certain extent acquired by developing deeper perception of religion. Faith in Allah A Muslim doctor has full faith in Allah and he believes that cure will only be bestowed by Almighty Allah. A doctor’s job is only to put maximum and sincere effort with full faith. Allah said that his Prophet Ibrahim (‫ )ﷺ‬said, 23 THE MUSLIM DOCTOR And He feeds me and quenches my thirst and when I fall sick then He (Allaah) cures me. [Soorah Shu'araa: ayat 80]. Muslim doctor must understand that the medicine, surgery and all sort of treatment can only cure the disease with the benefaction of Allah Rehmaan. The experienced physicians are usually quiet aware of the fact that they can never predict the outcomes and see strange results even with their best and sincere efforts. They also must assimilate that there is cure for every disease. Allah's Messenger‫ ﷺ‬quoted as saying in hadith: There is a remedy for every malady, and when the remedy is applied to the disease it is cured with the permission of Allah, the Exalted and Glorious. (Sahih Bukhari, Book 25, Number 5466, Narrated Jabir ibn Abdullah) Thus the Muslim doctors as a scientist explore and try to find cure for every disease and not give up hope. In Sura Yusuf (Sura12) Ayat 87 Allah Almighty says ‚Despair not of Allah's mercy. No doubt, none despairs of the mercy of Allah but a people disbelieving. Furqaan A person who has taqwa is gifted with a special blessing which is called ‘ Furqaan.‛ A blessing from Allah almighty to guide towards the right path and way out from difficulty. In Holy quarn Allah promises furqaan ( Sura Anfaal Sura25 Ayat 29 ) ‚O those who believe, if you fear Allah He will grant you furqaan Furqaan means to judge between right and wrong, and to make right and logical decisions. In Holy Quran Allah Almighty discusses this in Sura Al Hadid Sura57Ayat 28 O believes! Fear Allah and believe in His Messenger He will give you a two-fold portion of His mercy and will provide for you a light wherein you will walk, and will grant you forgiveness. And Allah is Forgiving, Merciful. In Sura Furqan Sura25 Ayat 1 Allah Almighty says‛ Immensely Blessed is He Who has sent down the furqaan to His Bondman( Prophet Muhammad)‫ ﷺ‬that he may be a warner to the entire world. Furqaan is a light that will guide you in all difficult and problematic situations. To me it means critical thinking. Our Prophet ‫ ﷺ‬was blessed with perfect Furqaan. For Muslim doctors Ethics involves developing an understanding of Islamic principles and applying those for amelioration of human progress and treatment. These are possible with blessing and Furqaan from Almighty Allah 24 THE MUSLIM DOCTOR 2. Hadood Allah Once we have homogenized this principle and developed a reasonable critical thinking or Furqaan we are apt to follow the Hadood or Confines of Allah. These are perimeters laid down by Almighty Allah and his Prophet. ‫ﷺ‬. Islam is perfect religion and has its own obligations and limits that a Muslim has to follow on all accounts. These limits are called ‘Hadood Allah‛.These have to be followed in letter and spirit in all work and teaching places of doctors. Some of these principals are as follows. Privacy, Patients should only be interviewed and examined in private and with blinds so as not to hurt their dignity. Their personal information should not be disclosed to any other person without their prior permission. As the patient discloses information by putting a faith and a trust in a doctor and doctors on the other hand casually discuss their patients in tearooms and other meeting places, and at times crack jokes and ridicule them. This is un-Islamic and very unethical practice and should be condemned. Purdah Islam has clearly laid down rules of purdah and sattar. Patients should not be examined and undressed without sheets in OPDS and in work places unless necessary. In all places, one must follow principles of purdah and Sattar mandatory for male and female patients equally. Male doctor should examine male patients and vice versa unless necessary. In operating rooms, often the principles are neglected and patients are exposed unnecessarily. Patients can be draped and disrobe in privacy before the operating physicians come to table. A sign on operating room ‚do not enter‛ is imperative when female patient is being operated or unveiled. All unnecessary personnel not directly involved with the patient’s treatment should not be allowed to enter. Hallal Muslim physician must prescribe only those medicines that are Hallal and should avoid medicines containing Haram elements. So the Messenger of Allah ‫ﷺ‬said: ‚Indeed Allah Most High has not put cure for you in the unlawful.‛ (Sahih Ibn Hibban Sayyida Umm Salamah (Allah be pleased with her) narrates