The field of bioethics continues to struggle with the problem of cultural diversity: can universal principles guide ethical decision making, regardless of the culture in which those decisions take place? Or should bioethical principles be derived from the moral traditions of local cultures? Ten Have and Gordijn and Bracanovic defend the universalist position, arguing that respect for cultural diversity in matters ethical will lead to a dangerous cultural relativity where vulnerable patients and research subjects will be harmed. We challenge the (...) premises of moral universalism, showing how this approach imports and imposes moral notions of Western society and leads to harm in non-western cultures. (shrink)

This paper explores the evolution of the Universal Declaration on Bioethics and Human Rights , which was adopted by the United Nations Educational, Scientific and Cultural Organization in 2005. While the draft UDBHR generated controversy among bioethicists, the process through which it evolved excluded mainstream bioethicists. The absence of peer review affects the declaration’s content and significance. This paper critically analyses its content, commenting on the failure to acknowledge socioeconomic and other factors that impede its implementation. The UDBHR outlines ideal (...) standards but fails to provide guidance that can be readily applied in different settings. It strives for universality but does not contribute to understanding of universal or global bioethics.The Universal Declaration on Bioethics and Human Rights was developed through multinational consultation over several years. It was officially adopted by the United Nations Educational, Scientific and Cultural Organization in October 2005.1 This paper explores the process of drafting the UDBHR, critically analyses its content and considers its status in the context of global bioethics. It comments on the UDBHR’s failure to acknowledge or respond to socioeconomic and other factors that impede attempts to implement it. The paper concludes that the process of drafting the declaration excluded a necessary group of stakeholders and that the UDBHR therefore fails to provide the guidance it aims to offer.Identifying a need to develop universally applicable ethical guidelines within a context of cultural pluralism, Unesco began developing a draft Declaration on Universal Norms on Bioethics. A near final draft was posted on Unesco’s website in February 2005 and replaced in June 2005 with the version subsequently adopted as the UDBHR. Stakeholder consultation on the draft involved hundreds of people in many diverse nations. These were seemingly limited to consultations with Unesco affiliates, however, and public comment was not solicited. …. (shrink)

In contemporary debates about the nature of bioethics there is a widespread view that bioethical decision making should involve certain knowledge of and respect for cultural diversity of persons to be affected. The aim of this article is to show that this view is untenable and misleading. It is argued that introducing the idea of respect for cultural diversity into bioethics encounters a series of conceptual and empirical constraints. While acknowledging that cultural diversity is something that decision makers in bioethical (...) contexts should try to understand and, when possible, respect, it is argued that this cultural turn ignores the typically normative role of bioethics and thus threatens to undermine its very foundations. (shrink)

Aim To study the views of people in a largely Muslim country, Kuwait, of the acceptability of a life-ending action such as physician-assisted suicide (PAS). Method 330 Kuwaiti university students judged the acceptability of PAS in 36 scenarios composed of all combinations of four factors: the patient's age (35, 60 or 85 years); the level of incurability of the illness (completely incurable vs extremely difficult to cure); the type of suffering (extreme physical pain or complete dependence) and the extent to (...) which the patient requests a life-ending procedure, euthanasia or PAS (no request, some form of request, repeated requests). In all scenarios, the patients were women who were receiving the best possible care. The ratings were subjected to cluster analysis and analyses of variance. Results Five clusters were found. For 44%, PAS was always very unacceptable, no matter what the circumstances. For 23%, it was unacceptable, but less so if the patient was older or requested it repeatedly. For 16%, it was unacceptable if the patient was young but was acceptable if the patient was elderly. For 5%, it was unacceptable if the patient had extreme pain but was acceptable if completely dependent. For 11%, it was unacceptable if the patient did not request it but acceptable if she did. Conclusion The majority of the Kuwaiti university students opposed PAS either categorically or with a slight variation according to circumstances. Nonetheless, a minority approved of PAS in some cases, particularly when the patient was elderly. (shrink)

This paper suggests that many of the pressing dilemmas of bioethics are global and structural in nature. Accordingly, global ethical frameworks are required which recognize the ethically significant factors of all global actors. To this end, ethical frameworks must recognize the rights and interests of both individuals and groups (and the interrelation of these). The paper suggests that the current dominant bioethical framework is inadequate to this task as it is over-individualist and therefore unable to give significant weight to the (...) ethical demands of groups (and by extension communal and public goods). It will explore this theme by considering the inadequacy of informed consent (the ‘global standard’ of bioethics) to address two pressing global bioethical issues: medical tourism and population genetics.Using these examples it will show why consent is inadequate to address all the significant features of these ethical dilemmas. Four key failures will be explored, namely,• That the rights and interests of those related (and therefore affected) are neglected;• That consent fails to take account of the context and commitments of individuals which may constitute inducement and coercion;• That consent alone does not have the ethical weight to negate exploitation or make an unjust action just (‘the fallacy of sufficiency’);• That consent is a single one-off act which is inappropriate for the types of decision being made.It will conclude by suggesting that more appropriate models are emerging, particularly in population genetics, which can supplement consent. (shrink)

In 1970 Van Rensselaer Potter was the first to use the term "bioethics" in a publication to advocate the development of a new discipline to address the basic problems of human flourishing. This article analyzes Potter's notion of bioethics in order to understand its origins, sources, and substance. In early publications, Potter conceptualized bioethics as a bridge: between present and future, nature and culture, science and values, and finally between humankind and nature. In later publications, disappointed by a predominant focus (...) on individual and medical issues, and with a wish to underscore the need for a broader perspective, Potter introduced the new term "global bioethics," meant to transcend ethics specialties and integrate them into a new interdisciplinary endeavor to address global problems. A growing interest in global bioethics today means that Potter's original insights are more timely than ever. (shrink)

Background: Empirical studies in Muslim communities on organ donation and blood transfusion show that Muslim counsellors play an important role in the decision process. Despite the emerging importance of online English Sunni fatwas, these fatwas on organ donation and blood transfusion have hardly been studied, thus creating a gap in our knowledge of contemporary Islamic views on the subject.Method: We analysed 70 English Sunni e-fatwas and subjected them to an in-depth text analysis in order to reveal the key concepts in (...) the Islamic ethical framework regarding organ donation and blood transfusion.Results: All 70 fatwas allow for organ donation and blood transfusion. Autotransplantation is no problem at all if done for medical reasons. Allotransplantation, both from a living and a dead donor, appears to be possible though only in quite restricted ways. Xenotransplantation is less often mentioned but can be allowed in case of necessity. Transplantation in general is seen as an ongoing form of charity. Nearly half of the fatwas allowing blood transfusion do so without mentioning any restriction or problem whatsoever. The other half of the fatwas on transfusion contain the same conditional approval as found in the arguments pro organ transplantation.Conclusion: Our findings are very much in line with the international literature on the subject. We found two new elements: debates on the definition of the moment of death are hardly mentioned in the English Sunni fatwas and organ donation and blood transfusion are presented as an ongoing form of charity. (shrink)

I reflect on the past, present, and future of the field of bioethics. In so doing, I offer a very situated overview of where bioethics has been, where it now is, where it seems to be going, where I think we could do better, and where I dearly hope the field will be heading. I also propose three ways of re‐orienting our theoretic tools to guide us in a new direction: (1) adopt an ethics of responsibility; (2) explore the responsibilities (...) of various kinds of actors and relationships among them; (3) expand the types of participants engaged in bioethics. (shrink)

While the practice of Western medicine is known today to doctors of all ethnic and religious groups, its standards are subject to the availability of resources. The medical ethics guiding each doctor is influenced by his/her religious or cultural background or affiliation, and that is where diversity exists. Much has been written about Jewish and Christian medical ethics. Islamic medical ethics has never been discussed as an independent field of ethics, although several selected topics, especially those concerning sexuality, birth control (...) and abortions, have been more discussed than others. Islamic medical ethics in the 20th century will be characterised on the basis of Egyptian fatawa (legal opinions) issued by famous Muslim scholars and several doctors. Some of the issues discussed by Islamic medical ethics are universal: abortions, organ transplants, artificial insemination, cosmetic surgery, doctor-patient relations, etc. Other issues are typically Islamic, such as impediments to fasting in Ramadan, diseases and physical conditions that cause infringement of the state of purity, medicines containing alcohol, etc. Muslims' attitudes to both types of ethical issues often prove that pragmatism prevails and the aim is to seek a compromise between Islamic heritage and the achievements of modern medicine, as long as basic Islamic dogma is not violated. (shrink)

Background: Islam and Muslims are underrepresented in the medical literature and the influence of physician’s cultural beliefs and religious values upon the clinical encounter has been understudied. Objective: To elicit the perceived influence of Islam upon the practice patterns of immigrant Muslim physicians in the USA. Design: Ten face-to-face, in-depth, semistructured interviews with Muslim physicians from various backgrounds and specialties trained outside the USA and practising within the the country. Data were analysed according to the conventions of qualitative research using (...) a modified grounded-theory approach. Results: There were a variety of views on the role of Islam in medical practice. Several themes emerged from our interviews: (1) a trend to view Islam as enhancing virtuous professional behaviour; (2) the perception of Islam as influencing the scope of medical practice through setting boundaries on career choices, defining acceptable medical procedures and shaping social interactions with physician peers; (3) a perceived need for Islamic religious experts within Islamic medical ethical deliberation. Limitations: This is a pilot study intended to yield themes and hypotheses for further investigation and is not meant to fully characterise Muslim physicians at large. Conclusions: Immigrant Muslim physicians practising within the USA perceive Islam to play a variable role within their clinical practice, from influencing interpersonal relations and character development to affecting specialty choice and procedures performed. Areas of ethical challenges identified include catering to populations with lifestyles at odds with Islamic teachings, end-of-life care and maintaining a faith identity within the culture of medicine. Further study of the interplay between Islam and Muslim medical practice and the manner and degree to which Islamic values and law inform ethical decision-making is needed. (shrink)

Some commentators have criticized bioethics as failing to engage religion both as a matter of theory and practice. Bioethics should work toward understanding the influence of religion as it represents people's beliefs and practices, but bioethics should nevertheless observe limits in regard to religion as it does its normative work. Irreligious skepticism toward religious views about health, healthcare practices and institutions, and responses to biomedical innovations can yield important benefits to the field. Irreligious skepticism makes it possible to raise questions (...) that otherwise go unasked and to protect against the overreach of religion. In this sense, bioethics needs a vigorous irreligious outlook every bit as much as it needs descriptive understandings of religion. (shrink)

ABSTRACT Fast forward 50 years into the future. A look back at what occurred in the field of bioethics since 2010 reveals that a conference in 2050 commemorated the death of bioethics. In a steady progression over the years, the field became increasingly fragmented and bureaucratized. Disagreement and dissension were rife, and this once flourishing, multidisciplinary field began to splinter in multiple ways. Prominent journals folded, one by one, and were replaced with specialized publications dealing with genethics, reproethics, nanoethics, and (...) necroethics. Mainstream bioethics organizations also collapsed, giving way to new associations along disciplinary and sub‐disciplinary lines. Physicians established their own journals, and specialty groups broke away from more general associations of medical ethics. Lawyers also split into three separate factions, and philosophers rejected all but the most rigorous, analytic articles into their newly established journal. Matters finally came to a head with global warming, the world‐wide spread of malaria and dengue, and the cost of medical treatments out of reach for almost everyone. The result was the need to develop plans for strict rationing of medical care. At the same time, recognition emerged of the importance of the right to health and the need for global justice in health. By 2060, a spark of hope was ignited, opening the door to the resuscitation of bioethics and involvement of the global community. (shrink)

“Bioethics began in religion, but religion has faded from bioethics.” This interpretation is commonplace among many who have an opinion on bioethics. This chapter examines this.

ABSTRACT This article attempts to show a way in which social science research can contribute in a meaningful and equitable way to philosophical bioethics. It builds on the social science critique of bioethics present in the work of authors such as Renée Fox, Barry Hoffmaster and Charles Bosk, proposing the characteristics of a critical bioethics that would take social science seriously. The social science critique claims that traditional philosophical bioethics gives a dominant role to idealised, rational thought, and tends to (...) exclude social and cultural factors, relegating them to the status of irrelevancies. Another problem is the way in which bioethics assumes social reality divides down the same lines/categories as philosophical theories. Critical bioethics requires bioethicists to root their enquires in empirical research, to challenge theories using evidence, to be reflexive and to be sceptical about the claims of other bioethicists, scientists and clinicians. The aim is to produce a rigorous normative analysis of lived moral experience. (shrink)

This chapter argues that ethics plays an extremely important role in decision making and lawmaking in bioethics issues. These decisions are not simple case-by-case judgments; rather, they rest upon deeply considered ethical opinions. It also discusses the implications of this epistemic grounding for bioethics and its use of case law materials as an ethical resource. Finally, since many people base their moral judgments on religious beliefs, the religious implications of this legal-moral relationship are considered.

In The Ethico-Religious Concepts in the Qur'án Toshihiko Izutsu analyses the guiding spirit of the Islamic moral code, the basic ethical relationship of man to God. Izutsu asserts that, according to the Qur'anic conception, God is of an ethical nature and acts upon man in an ethical way. The resulting implications for man are enormous, requiring devotion not merely to God but to living one's life ethically.Izutsu shows that for the Qur'an our ethical response to God's actions is religion itself; (...) it is at the same time both ethics and religion. Izutsu explores these themes by employing ethnolinguistics, a theory of the interrelations between linguistic cultural patterns, to analyse the semantic structure of major concepts in the Quar'an. Islam, which arose in the seventh century, represents one of the most sweeping religious reforms ever to appear in the East.The Quar'an shows in vividly concrete terms how time-honoured tribal norms came into bloody conflict with new ideals of life, and finally yielded to the rising power. This transitional epoch is of particular importance in the whole of Islamic thought, a time during which the key terms of a traditionally fixed system of values were transformed in their connotative structure, modified in their combinations, and finally integrated into an entirely different system.Originally published in 1959 as The Structure of the Ethical Terms in the Koran and revised under the current title in 1966 this 2002 reprint makes this classic work of Islamic studies once again available. (shrink)

Titel oversat: Islamisk, medicinsk etik i det tyvende århundrede.

In search of principles of health care in Islam -- Health and suffering -- Beginning of life -- Terminating early life -- Death and dying -- Organ donation and cosmetic enhancement -- Recent developments -- Epilogue.

What kind of duty do we have to try to stop other people doing wrong? The question is intelligible in just about any culture, but few of them seek to answer it in a rigourous fashion. The most striking exception is found in the Islamic tradition, where 'commanding right' and 'forbidding wrong' is a central moral tenet already mentioned in the Koran. As an historian of Islam whose research has ranged widely over space and time, Michael Cook is well placed (...) to interpret this complex subject. His book represents the first sustained attempt to map the history of Islamic reflection on this obligation. It covers the origins of Muslim thinking about 'forbidding wrong', the relevant doctrinal developments over the centuries, and its significance in Sunni and Shi'ite thought today. In this way the book contributes to the understanding of Islamic thought, its relevance to contemporary Islamic politics and ideology, and raises fundamental questions for the comparative study of ethics. (shrink)

Muslim Medical Ethics draws on the work of historians, health-care professionals, theologians, and social scientists to produce an interdisciplinary view of ...

Qur'an 3:104 speaks of "commanding right and forbidding wrong" as a constitutive feature of the Muslim community. Michael Cook's careful and comprehensive study provides a wealth of information about the ways Muslims in various contexts have understood this notion. Cook also makes a number of comparative observations, and suggests that "commanding" appears to be a uniquely Muslim practice. Scholars of religious ethics should read Cook's study with great appreciation. They will also have a number of questions about his comparative comments. (...) In this article, I suggest that scholars of comparative ethics should think less about the "uniqueness" of the materials examined by Cook, and more about the ways groups of human beings discipline their members, thereby constituting and maintaining themselves as communities of virtue. (shrink)