MEDICAL EDUCATION: CONTENT and ISSUES
Medicine is closely associated with all the 5 purposes of the Law: religion, diin;
life & health, nafs; progeny, nasl;
intellect, aql; & wealth, maal.
Study of medicine is therefore fardh kifayat. Medical students should learn basic and clinical sciences, the essentials
of Islam, al ma’lum fi al diin bi dharurat, and legal rulings, ahkam fiqhiyyat, relating to medicine, and the social background to disease causation
and prevention. In this lecture we shall discuss the following issues: purpose of medicine and medical education, integration,
balance, and service.
2.0 THE ISSUES OF PURPOSE, INTEGRATION, and BALANCE
Purpose: The aim of medicine
is to maintain or improve the quality of remaining life. Medicine does not have as an aim the prevention of death or prolongation
of life because ajal is in the hands of Allah. The purpose of medical education
is based on the paradigm of tauhid and the purposes of the Law, maqasid al sharia. The aim of medical education should be producing physicians who fulfill that purpose or maqsad within a holistic tauhidi context.
These physicians will have the following characteristics: health and not disease oriented, focused on quality and not quantity
of life because ajal is with Allah, humble to recognize limitations to their curative
abilities, holistic in outlook (physical, spiritual, social, psychological aspects), understand society, scientific capability,
clinical expertise, and leadership. These qualities must be in a context of iman, tauhid
and fulfillment of the general purposes of the shari’at.
Integration: European medicine is characterized by narrow specialization and fragmentation. Fragmentation
is a reflection of an underlying European secular world-view that separates religion from public life and science, and the
body from the soul and the mind. Each disease or organ was isolated and was dealt with in isolation such that the concepts
of ‘total health’, ‘total disease’, and a ‘total human’ were lost. Recent attempts at
integration have not been successful due to lack of a guiding vision. Integration is not just putting two or more disciplines
together. It is a fundamental philosophical attitude based on a vision and a guiding paradigm. There is a need for an integrative
paradigm to replace the European non-tauhid world-view that is atomistic, analytic,
and not synthetic.
Balance: Lack of equilibrium in medicine
is a result of lack of integration. Modern European medicine lacks the concept of equilibrium or balance. It overdoes a good
thing beyond the equilibrium point creating even bigger problems. Human illness is due to lack of balance and equilibrium
and must be managed by a balanced therapeutic approach. The concepts of centrality, wasatiyyat;
balance, mizaan; equilibrium, i’itidaal;
and action-reaction, tadafu’u, provide a conceptual framework for balanced
The tauhidi paradigm, integration and balance: The tauhidi paradigm implies integration and harmony of matter and soul, body and mind, parts and the whole. The physician
should practice medicine as a total holistic approach to the human in the social, psychological, material, & spiritual
dimensions and not an attack on particular diseases or organs. The tauhidi approach
to integration is putting medical knowledge, teaching and practice in a larger context to making sure it is in harmony and
is well coordinated with other related medical or non-medical phenomena. It is therefore possible to envision a very ‘integrated’
doctor who at the same time is very specialized. Such a doctor will approach the patient as a whole human and not just as
organs or tissues.
3.0 THE ISSUE OF SERVICE
The paradigm of service requires that the physician should be trained to understand medicine as a social service. The
human dimension should dominate over the biomedical one. The selection of medical students, their training, and evaluation
should emphasize human service and not material gain for the physician. The medical school cannot be expected alone to effectively
teach the spirit of serving others. The values and attitudes of self-less service for others are taught by the family and
the community and are already well set by the time the student enters medical school. The school can only build on and enhance
basic values that students bring with them from their homes and communities. In such circumstances, the medical school will
do well to select those students who already have the vocation to serve. A medical education or health care delivery system
developed within an Islamic society will have no alternative but to be service-oriented. This is because of the emphasis on
mutual social support, takaful ijtimae. Society should look after the weak and
less privileged: the widows, the poor, and the wayfarer. The social services must have the ability to seek out those in need
even if they do not come to them seeking aid. Zakat is an obligatory payment to the poor and the needy. The obligatory fasting
of Ramadhan is training and inspiration for the rich to remember the poor because they voluntarily taste hunger and fully
understand the plight of the deprived. Many breaches of the law are expiated by kaffarat,
normally feeding the poor.
education should include both materially-deprived and materially-well off communities because social and medical problems
exist in both. Primary health care (PHC) is the first point of contact of a patient with the health care system. PHC can be
simple in a rural area or quite sophisticated. It requires training a physicians who will be able to do the following: respond
to health needs and expressed demands of the community; work with the community so as to stimulate healthy life style and
self-care; educate the community as well as the co-workers; solve, and stimulate the resolve, of both individual and community
health problems; orient their own as well as community efforts to health promotion and to the prevention of diseases, unnecessary
sufferings, disability and death; work in, and with, health teams, and if necessary provide leadership to such teams; continue
learning lifelong so as to keep their competence up-to-date and even improve it as much as possible. We can envisage medical
education in the future taking place in primary care settings in both its simple and sophisticated modes.