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“Indigenizing” Bioethics: The First Center for Bioethics in Pakistan

Published online by Cambridge University Press:  28 May 2010

AAMIR M. JAFAREY  and
FARHAT MOAZAM
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Extract

Contemporary bioethics has evolved over the past 40 years predominantly as a “Western” construct drawing fundamental inspiration for its conceptual and methodological frameworks from secular, Anglo-American philosophical traditions. American bioethicists can be credited with playing a defining role in the globalization of this new discipline to the developing countries of the world, but in this process, in the words of LaFleur, “Bioethics has become international without becoming internationalized.” Among the criticisms leveled against the dominant American model of bioethics is that in its focus on universalism it ignores local cultural and religious influences that are vital to the comprehension of the moral life in many societies. Medical sociologist Renée C. Fox and historian Judith P. Swazey have termed this as a form of “cultural myopia.”

Type
Special Section: International Voices 2010
Information
Cambridge Quarterly of Healthcare Ethics , Volume 19 , Issue 3 , July 2010 , pp. 353 - 362
Copyright
Copyright © Cambridge University Press 2010

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References

1. Fox, RC, Swazey, JP. Bioethics circles the globe. In: Fox, RC, Swazey, JP, eds. Observing Bioethics. New York: Oxford University Press; 2008:215–32 at p. 225CrossRefGoogle Scholar.

2. Kleinman, A. Moral experience and ethical reflection: Can ethnography reconcile them? Daedalus 1999;128:69–97Google Scholar. For a perspective from Pakistan, see Moazam, F, Zaman, RM. At the interface of cultures. Journal of Clinical Ethics 2003;14:246–58Google ScholarPubMed.

3. Fox, RC, Swazey, JP. Medical morality is not bioethics: Medical ethics in China and the United States. In: Fox, RC, ed. Essays in Medical Sociology: Journeys into the Field, Rev. ed. New Brunswick, NJ: Transaction; 1988:646–71Google Scholar.

4. Beauchamp, T, Childress, JF. Principles of Biomedical Ethics, 3rd ed. Oxford: Oxford University Press; 2001Google Scholar.

5. American physician Jack Bryant was Chairman of the Department of Community Health Sciences in the Aga Khan University and introduced the first formal bioethics sessions for medical students in that institution. Bryant also helped develop Council for International Organizations of Medical Sciences international guidelines for research subject protection.

6. Moazam, F, Jafarey, AM. Pakistan and biomedical ethics: Report from a Muslim country. Cambridge Quarterly of Healthcare Ethics 2005;14:240–53CrossRefGoogle ScholarPubMed.

7. A copy of the recommendation can be accessed at www.pmdc.org.pk/ethics.htm

8. Moazam, F. Bioethics and Organ Transplantation in a Muslim Society: A Study in Culture, Ethnography, and Religion. Bloomington: Indiana University Press; 2006:77–81Google Scholar. Also see Moazam, F. Families, patients and physicians in medical decisionmaking: A Pakistani perspective. Hastings Center Report 2000;30:28–37CrossRefGoogle ScholarPubMed.

9. Pakistan Islamic Medical Association. Available at http://www.pima.org.pk/eth_board(english).asp (last accessed 19 March 2010).

10. Moazam was completing her doctorate from the Department of Religious Studies at the University of Virginia and Jafarey his fellowship in Research Ethics from the Harvard School of Public Health in Boston.

11. Centre of Biomedical Ethics and Culture, SIUT. Dawn Supplement 2004 Oct 8; CBEC to be inaugurated today. The News 2004 Oct 8. Also see http://www.dawn.com/2004/10/09/local8.htm

12. International speakers and teaching faculty included Dr. Jonathan Moreno, former director of the Center for Bioethics at the University of Virginia (UVA), Dr. Haytham Al-Khayat, Senior Advisor to the Director General of EMRO-WHO, Dr. Abdul Aziz Sachedina, Islamic scholar at UVA. Medical sociologist Dr. Renée C. Fox, Annenberg Professor Emerita, University of Pennsylvania and Dr. Judith Swazey, Consultant, Boston University School of Medicine could not come at the last moment but participated with a video recorded for the occasion. Eminent local speakers included Islamic scholar Mr. Jawaid Ghamadi, president of the Al-Mawrid Institute in Lahore, and Dr. Manzoor Ahmad, philosopher and former chairman of the Department of Philosophy at Karachi University.

13. A detailed listing of the activities of CBEC and its faculty is available at www.siut.org/bioethics/CBEC%20EVENTS.html and www.siut.org/bioethics/INVITED.html (last accessed 19 March 2010).

14. For a list of PGD faculty, please see www.siut.org/bioethics/vfaculty.html. Foreign faculty who have taught or served as examiners include scholars from the United States, Sri Lanka, Turkey, the WHO/EMR office in Egypt, UNESCO, Bangkok, India, Bangladesh, Iran, New Zealand, and China.

15. Materials used in contact sessions include the painting “The Doctor” by Samuel Luke Fildes (1891), Urdu poetry by Allama Iqbal (Pakistan’s national poet), and contemporary poetry by Parveen Shakir, who focuses on social issues, including oppression of women. Videos include “Wit,” “The Constant Gardner,” and “Side Effects.”

16. For difficulties in translating from English to Urdu see note 8, Moazam 2006:222–4. For an analysis in translating from English to Japanese, see LaFleur, WR. Transplanting the transplant: Japanese sensitivity to American medicine as an American mission. In: Messikomer, CM, Swazey, JP, Glickman, A, eds. Society and Medicine: Essays in Honor of Renee C. Fox. New Brunswick, NJ: Transaction; 2003:87–107Google Scholar.

17. Paintings by Robert Pope, The Doctor Stories by Richard Selzer, and William Carlos Williams’ short story “The Use of Force” are examples of some of the materials used.

18. For examples of ethics projects begun by graduates of 2006 and 2007 in their parent institutions see the CBEC web site at www.siut.org/bioethics/projects.html (last accessed 19 March 2010).

19. The data were presented as a paper, “Informed Consent: A Step towards Women Empowerment in a Public Sector Hospital,” at the annual symposium of the Society of Obstetrics and Gynecology, Pakistan, in March 2008.

20. The 25 graduates from the classes of 2006 and 2007 have participated in a total of 70 bioethics-related activities over the past 2 years. The list of alumni activities can be accessed at http://www.siut.org/bioethics/workshops.html. For details of the Karachi Bioethics Group, see Bashir NW. Building networks: The Karachi bioethics group. Bioethics Links 2008;4, available at www.siut.org/bioethics/newsletter.html

21. Hyder, AA, Nadeem, S. Health ethics in Pakistan: A literature review of its present state. Journal of Health Population and Nutrition 2001;19:6–11Google ScholarPubMed.

22. See note 8, Moazam 2000; Zaman, RM. The adaptation of Western psychotherapeutic methods to Muslim societies. World Psychology 1997;3:65–87Google Scholar.

23. The findings from this unpublished study were presented at the National Bioethics Conference in Bangalore, India, in December 2007.

24. Jafarey, AM, Thomas, G, Ahmad, A, Srinivasan, S. Medical professionals and the organ trade: An unholy alliance. Indian Journal of Medical Ethics 2007;IV:52–3Google Scholar; Moazam F. Organ(ised) crime. Dawn Magazine 2006 Aug 27.

25. Editorial: Stealing to get promoted. Dawn 2008 Feb 2; Malik M. HEC chalks out a lesson for plagiarists. Dawn 2008 Sep 26.

26. Preliminary analysis suggests that only 18%–20% of respondents are aware that Internet material must be referenced and only 20% are fully knowledgeable about copyright laws.