Q: Many people outside of the healthcare community may not know what Islamic bioethics means. Could you please define it?
Dr. Mohammed Ghaly: Islamic bioethics is a relatively new, emerging field of study. In its modern form, it goes back to the 70s and 80s. It deals with ethical questions raised by modern biomedical technology from an Islamic perspective, in particular, how to create a well-balanced risk-benefit assessment which keeps in mind one’s own moral values. Of course, this is a recent and newly emerging field but it stems out of a long history in the Islamic tradition of dealing with medicine which we call Islamic medical ethics. This goes back as early as the very beginning of Islamic history and we find relevant references to in the Islamic Scriptures, namely Quran and Sunna.
Q: In your opinion, why is this issue important? Why do we need to study this field?
Dr. Mohammed Ghaly: Because the ethical issues raised by modern biomedical technologies are so deep and intense, the calculations of benefits and harms get mixed up. They are so complicated that they cannot be resolved in a simple mathematical way. So the involvement of one’s culture, or religion or other political, geographical and economic factors becomes necessary. This is what you call in bioethics, one’s moral world. Each one of us, in each country, and each group of people in each community has their own moral world. So when you calculate the pluses and minuses of biomedical technologies and you make the risk- benefit assessment, it’s important to have bioethics related to world religions like Judaism, Christianity and Islam.
Q: Why does your report focus on issues around incidental findings? Why is that topic important?
Dr. Mohammed Ghaly: With the genomic revolution, especially after the successful completion of the Human Genome Project by the beginning of this century, we have a clear revolution in the field of biomedical sciences. One of the clear aspects of this revolution is that the results of the tests that we make, whether they are research projects or clinical tests involving genome sequencing, are no more under the control of the team of researchers or the research subjects. We make a test, with the specific results we want to reach. Most of the time this doesn’t happen. We get much more than what we expected or planned for. This is what we call incidental findings and these findings can in fact be life-saving or life-changing. They are findings we didn’t plan for but we can hardly avoid.
Q: How should ethical incidental findings be ethically managed?
Dr. Mohammed Ghaly: This is a very complicated and sophisticated question. We have hundreds of publications now, especially in Western countries that relate to this subject. I believe WISH is the first academic meeting in the Muslim world which will address the ethical management of incidental findings from an Islamic perspective in an interdisciplinary way. The management of incidental findings calls for a step-by-step approach. The first step is to anticipate as much as possible. When we start the research project or initiate a clinical test, we try to anticipate the amount of incidental findings we might get, as thoroughly as possible. Once we anticipate them, we put them on paper, so we have an expectation of what we will find outside of our original plans. Then we study the research subjects to see how much of this information can or should be communicated. Some of the information has no clinical relevance at all, but socially and culturally, it can be extremely important. Consider the example of misattributed paternity.
So you need to put this huge amount of information in distinct boxes and ask whether the results are clinically relevant or not, and socially relevant or not. Then you have to study the moral world of the people you are dealing with. So this is more or less the process of ethical management.
Q: So what are the main recommendations of your report?
Dr. Mohammed Ghaly: We have two main recommendations: The first is that when it comes to policy making in the Gulf region or Muslim majority countries, in order to have effective policies that can speak to and appeal to the general public, Islamic ethical perspectives must be taken into consideration and must be taken seriously. The second recommendation in this regard is that Islamic bioethics is not exclusively religious. Islamic bioethics necessitates serious and constructive engagement with the global bioethical discourse.
Q: What impact do you hope your report will have?
Dr. Mohammed Ghaly: When we think of the potential impact of this report, we think of different categories of people. Firstly, we hope to help policymakers develop culturally sensitive policies, those that take into consideration the culture, religious and ethical aspects of the people in this region and in Muslim world in general. Secondly, we hope to help physicians and biomedical scientists involved in research and clinicians as well. A huge number of physicians ask how to deal with the issue of incidental findings, and so we hope this report will have a positive impact on their practice. The next group would be academics. We now have concrete plans to use the bulk of this research to produce some high-quality publications in journals that will be read by academics globally. Hopefully our report will provide information from one of the world’s biggest religions, Islam, on a significant topic like the ethical management of incidental findings. I believe the WISH 2016 summit will be a great instrument to reach to these target groups.
Q: So how is WISH important in supporting your research?
Dr. Mohammed Ghaly: The 2016 summit will be the third consecutive year to dedicate a panel on Islam and Healthcare Ethics so it’s now a longstanding collaboration between the Research Center for Islamic Legislation and Ethics and WISH and we hope this will continue. I have to say that WISH has provided us immense support in giving us the freedom to choose the topic that is close to people living in this region and which also have relevance worldwide.