Ethical Background

Bioethics is the study of ethical issues arising in health care and the biological sciences. It also includes the study of social, legal, economic and religious issues related to these ethical issues.

The four ethical principles involve the traditional principles of justice, autonomy (respect for persons), beneficence (duty to do good) and nonmaleficence (avoid harm). Justice is the ethical principle served by the public instiution of law, which observed the duty to treat like cases alike through doctrines and practices of following precedents. Justice includes distributive justice and corrective justice. Distributive justice is concerned with the allocation of rights, duties and burdens among community members. Corrective justice is concerned with correcting an imbalance of rights and duties among community members by restoring the position that existed or should have existed before a wrong act was done(9). There are two ethical levels concerned : the microethical and macroethical. The microethical level applies to relations between individuals. The macroethical level applies to relationships among communities themselves and between communities and their members(10).

Any debate on the social, legal and ethical issues surrounding embryo research must consider these new techniques within the general context of reproductive health care. In providing this new technology one must respect the dignity of human beings, security of human genetic material, inviolability of the person, inalienability of the person and necessary quality of services. These principles demand a measure of protection for the human embryo that is consonant with national, cultural, religious and social mores. Ethical discourse is necessary for any society to form its responses to any scientific or medical innovation(11).

Also, there are three moral principles which provide an ethical basis for embryo research. The principle of liberty, which guarantees a right to freedom of action; the principle of utility, which defines moral rightness by the greatest good for the greatest number; and the principle of justice, which requires that everyone have equal access to necessary goods and services. However, one must remember that ethics and morality are only valid when individuals can act freely.

Medical  ethics are based on the moral, religious and philosophical ideals and principles of the society in which they are practiced(12). It is therefore not surprising to find that what is ethical in one society might not be ethical in another society. It is mandatory for practicing doctors and critics of conduct to be aware of such backgrounds before they make their judgement on different medical practice decisions(13). According to each society's condition the ethical attitude of the individual may be coloured by the attitude of the society which reflects the interest of the theologians, legislators, sociologists, economists, doctors, ethicists, demographers, family planning administrators and policy-makers. Responsible policy-makers in the medical profession in each country have to decide on what is ethically acceptable in their own country guided by the international guidelines which should be tailored to suit their own society. Truly ethical conduct consists of personal searching for relevant values that leads to an ethically inspired decision(14).

Those  for  whom  religion  is  important, and it is so for the Muslims, need to distinguish between medical ethics and humanitarian  considerations on the one hand, and religious teachings and national laws on the other hand. The doctor is always concerned about the legal basis of his acts and that they are undertaken on the basis of ethical precepts. He/she should always keep clear the distinctions and potential conflicts between legal and ethical duties. What is legal might not be ethical. Law rarely establishes positive duties such as beneficence. On the contrary professional medical ethics makes beneficence a primary obligation(15).

The Muslim ethics is a systematic refletion from a theological perspective, both on moral actions and practices of those in the Muslim community. It also reflects the character, traits, virtues, dispositions and intentions out of which those actions and practices come(12 & 16). The primary sources of Sharia seem quite congenial to the four standard principles of medical ethics as elucidated by Beauchamp and Childress(17).

The reproductive choice is the right of the person to freely choose his/her reproductive performance including his/her reproductive potentials. Though reproductive choice is basically a personal decision, yet it is not totally so. This is because reproduction itself is a process which does not involve the person who makes the choice alone. It also involves the other partner, the family, the society and the world at large. It is therefore not surprising that reproductive choice is affected by the diverse contexts, mores, culture, religion as well as the official stance of the different societies. The reproductive choice of the person not uncommonly may even conflict with the interest of his or her own society. In reproduction, one cannot always have what he or she chooses to be done within his/her own society or country(18).