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The Influence of Islamic Philosophy and Ethics on The Development
of
Medicine During the Islamic Renaissance By Dr. Sharif Kaf Al-Ghazal January, 9, 2005 Although Islamic philosophy is of great diversity and richness, it is characterized by certain features that are of special significance for both an understanding of it and for an appraisal of its impact on the world at large. One must remember that this philosophy existed at a time in which strict obedience to the Islamic religion was customary. Islamic philosophy was also concerned with the basic issue of the relation between human reasoning and the revelations provided to the Muslims in the holy Qur'an. As a result, all sorts of sciences were studied in order to determine that relation between the universe and the human being on one hand, and the creator of that universe, Allah Most High, on the other hand. The impact of Islamic philosophy on the Renaissance was enormous. First and foremost, Islamic philosophy originates from a time when Islam had a great influence on everyday life. The mere fact that Islamic philosophy was able to operate in such a fundamentalist environment greatly affected the Renaissance. It served as an example to the thinkers of that time on how to present new, radical ideas without angering religious fundamentalistsâat that time, the Church. Without Islam's example, the Renaissance thinkers may have presented their ideas in a much more provocative form, setting them back hundreds of years due to widespread hate, distrust, and non-acceptance of what people would perceive to be overly radical ideas. Secondly, in general, Islamic philosophy always leads to one main conclusion, that the power of Allah Most High is supreme and that His words are the absolute truth (although through different understandings). Thirdly, many of the ideas of Renaissance philosophy are based on ancient Greek, Persian, and Indian textsâwhich the Muslims translatedâas well as the philosophy of the Muslims themselves. The Muslims were responsible for creating the foundation for the "building" of philosophy that the Renaissance thinkers would later "construct." Finally, Islamic philosophy greatly encouraged science, particularly mathematics and medicine. Without philosophy's constant encouraging of scientific development, the large number of discoveries made by the Muslims may never have taken place. I will take medicine as an example and I will highlight the reasons for the excellent success of those Muslims in the field of medicine. Medical ethics is one of the hottest issues in medicine these days. Ethics can be described as a sub-branch of applied philosophy, where one seeks the right and the wrong (the good and the bad) set of behaviors in any given circumstance. I will try to shed light on the influence of Islamic medical ethics on the advancement of medicine during that Islamic golden era. Therefore, what were the factors behind the success of the Muslim scientists? How did Islamic philosophy encourage them to be leaders in many branches of science, especially in the medical sciences? I. Islam and the Promotion of Science II. The Attitude and Contribution of the State III. Islamic Physicians IV. Medical Ethics in Islam I. Islam and the Promotion of Science As the Muslims challenged the civilized world, they preserved the cultures of the conquered countries. On the other hand, when the Islamic empire became weak, most of the Islamic contributions in art and science were destroyed. This was done by the Mongols, who, out of barbarism, burnt Baghdad (CE 1258), and by the Spaniards, who, out of hatred, demolished most of the Islamic heritage in Spain. The difference between the Arabs and these others were the teachings of Islam. These teachings had played extensive roles by: Stressing the importance and respect of learning. For example, the first word revealed to Prophet Mohammad (peace and blessings be upon him) was "read." In that time, a captured enemy was freed if he paid a ransom or taught ten Muslims reading and writing. In the holy Qur'an, the importance of knowledge has been repeatedly stressed, as it says. Say (unto them, O Muhammad): Are those who know equal with those who do not know?" (Az-Zummar 39:9) Prophet Muhammad (peace and blessings be upon him) stressed learning by saying, "One hour of teaching is better than a night of praying." The general philosophy in Islamic medicine is that the healer is Allah Most High and the doctor is the instrument that Allah uses to heal the people. The doctor-patient relationship is stronger in Islam than it is in modern medicine as he has responsibilities, which Allah on the Day of Judgment will ask about. The relationship now in the West is medico-legal. The emphasis has become one that has slipped into materialism. Because the relationship between doctor and patient has become one that is based more on money, the level of trust has been decimated between the doctor and his or her patients. There is no censorship in Islam on scientific research, be it academic, to reveal the signs of God in His creation, or applied, aiming at the solution of a particular problem. Freedom of scientific research shall not cause harm to any human being or subject anyone to probable harm, or withhold anyone's therapeutic needs, or defraud or exploit anyone. Freedom of scientific research shall not entail cruelty to animals or their torture. Suitable protocols should be laid down for the humane handling of experimental animals during experimentation. Islam provides laws and a basis for the protection and safeguarding of the human body as well as the spirit and seeks to prevent any hindrance to either body or soul. The holy Qur'an says: And whoever saves a life it would be as if he saved the life of all the people. (Al-Ma'idah 5:32) Perhaps there is no better way to implement this concept than in the area of saving lives by transplanting donated organs to replace failing vital ones. In one hadith, the Prophet (peace and blessings be upon him) said, "Whoever helps a brother in difficulty, God will help him through his difficulties on the Day of Judgment." Islam provides rights and protection to all human beings at every stage and area of life. The holy Qur'an states: Do not kill your children on account of want or poverty, We provide them sustenance for you and for them. (Al-An`am 6:151) Islam developed in Muslims the respect for authority and discipline. For example, realizing the scourges and terror of plague, Prophet Muhammad (peace and blessings be upon him) decreed, "No man may enter or leave a town in which plague broke out." And to make this law all the more binding and effective, he promised the blessing of Heaven to those who die of plague by stating that if a man died of plague he would be considered a martyr. Thus, Prophet Muhammad (peace and blessings be upon him) laid down laws governing the Muslims and made them work. Tolerated other religions. The Islamic religion recognizes Christianity and Judaism and considers their followers to be people with holy books like Muslims. Moreover, they treated the Jews honestly, at a time when the latter were persecuted in Europe. Dr. Jacob Minkin, a reputable Rabbi and scholar says, "It was Mohammedan Spain that was the only land of freedom the Jews knew in nearly a thousand years of their dispersion. While during the Crusades, the armored Knights of the Cross spread death and devastation in the Jewish communities of the countries through which they passed, Jews were safe under the sign of the Crescent. They were not only safe in life and possessions, but were given the opportunity to live their own lives and develop a culture. So, there were many Christian and Jewish physicians who contributed in the Islamic renaissance (such as Jibra'il Ibn Bakhtashoo'e, Youhanna Ibn Masawaih, Ishaq Ibn Honain, and Ishaq Ibn Moosa). They were part of that "Golden Age." II. The Attitude and Contribution of the State The Islamic empire in the early eighth century was the inheritor of the scientific tradition of late antiquity. The Muslims preserved it, elaborated on it, and finally, passed it to Europe. At this early date, the Islamic dynasty of the Umayyads showed an interest in science. These were the centuries that were, for Europeans, the Dark Ages, but for Muslim scholars, these were the centuries of philosophical and scientific discovery and development. The Arabs at that time not only assimilated the ancient wisdom of Persia and the classical heritage of Greece, but adapted their own distinctive needs and ways of thinking One of the early Umayyad princes, Khalid Ibn Yazid (end of the 7th century), gave up his treasure for the study of medicine and chemistry. He studied medicine under John the Grammarian of Alexandria, and chemistry under Merrinos the Greek. He also encouraged several Greek and Coptic medical books to be translated into Arabic. During the eighth century, the Abbasi Caliphs encouraged the Persian physicians to translate their medical knowledge into Arabic, to build medical centers in Baghdad, the capital of their empire, and to run newly built hospitals. With further expansion east, the Arabs, through contacts with India and China, brought ideas and methods, not only in medicine, but also in mathematics, chemistry, philosophy, and so on. Characteristic Features of Hospitals in the Islamic Civilization The Muslims planned and developed what would become the world's first hospitals. The Muslims eventually constructed 34 of these hospitals throughout their empire. These hospitals had different wards for the treatment of different diseases, special quarters for the insane, outpatient departments for the treatment of minor injuries, and dispensaries, which provided virtually every kind of remedy then known. These hospitals had specific characteristics: Secular: Hospitals served all people, irrespective of color, religion, or background. The government ran them, as opposed to religious groups, and their directors were usually physicians who were assisted by persons who had no religious color. In hospitals, physicians of all faiths worked together with one aim in commonâthe well-being of patients. Separate wards and nurses: Patients of different sexes occupied separate wards. Also, different diseases, especially infectious ones, were allocated different wards. Male nurses took care of male patients and female nurses took care of the female patients. Proper records of patients: For the first time in history, these hospitals kept records of patients and their medical care. Baths and water supplies: Praying five times a day is an important pillar of Islam. Sick or healthy, it is an Islamic obligation; of course, physical performance depends on one's health, but one can pray even while lying in bed. Therefore, these hospitals had to provide the patients and employees with a plentiful clean water supply and with bathing facilities. Practicing physicians: Only qualified physicians were allowed by law to practice medicine. In CE 931, the Caliph Al-Mugtadir from the Abbasid dynasty, ordered the Chief Court-Physician Sinan Ibn-Thabit to screen the 860 physicians of Baghdad, and only those qualified were granted license to practice. It is also worth mentioning that the physicians of that era gained high prestige. Although almost anyone, irrespective of social status, could study medicine, the route was long and tedious. He had to finish Islamic studies, philosophy, astronomy, art, chemistry, amongst other things, before being accepted as a medical student. Therefore, the physician was an educated person who had wisdom and knowledge. In fact, the Arabic translation of a physician is hakim, which means sage. In the 9th and 10th centuries, the court physician was ahead of the chief justice in the protocol. Many eminent physicians, as we will discuss later, showed enough talent, social knowledge, political capabilities, and wisdom to be appointed by the Caliphs as prime ministers. Owing to the high prestige and connections of physicians, generous funds for hospitals were easily obtained. Medical regulations: Before the Muslims, medicine had been an unregulated profession, where one could easily fall into the hands of an unqualified doctor. However, the Muslims' introduction of regulations ensured that all doctors were qualified. Prophet Muhammad (peace and blessings be upon him) said. "He who practices medicine and is not therein versed is deemed like a guarantor. The regulations also ensured that doctors did not cheat their patients when it came to drug composition. This concept affected the Renaissance's physicians as it set an example for them, leading them to found various medical associations and guilds for regulating their profession too. Hence, one could say that the Muslims' regulation of medicine led to a safer and more professional medical institution during the Renaissance, which undoubtedly saved countless lives, which would have been lost due to medical incompetence. Medical schools: The hospital was not only a place for treating patients, but was also for educating medical students, interchanging medical knowledge, and developing medicine as a whole. Attached to the main hospitals, there were expensive libraries containing the most up-to-date books, auditoria for meetings and lectures, and housing for students and house-staff. Rulers' involvement in building hospitals: The Caliphs of the Islamic empire built magnificent hospitals; partly for religious reasons, as Islam teaches that money spent on charity is a good investment for Judgment Day; and partly for political reasons to show their people that they cared and were interested in them. Whatever the motive of the ruler, the population benefited and good hospitals were established. Adequate financing to run the hospitals: The rulers set aside generous funds to run these hospitals. There was a special system called al-waqf. A person can donate part or all of this wealth to charity. The government takes care of such a donation, and its revenues help to maintain and build mosques, hospitals, and schools. Another source of funds and an important pillar of Islam is obligatory alms or zakah (2.5% of property value). Thus, the main Arabian hospitals were models for medieval hospitals built later in Europe. They were also medical schools to which those seeking advanced medical knowledge, from the East or West, attended. III. Islamic Physicians: Medicine in Islam passed through three stages: The first stage was the stage of translation of foreign sources into Arabic. It extended through the seventh and eighth centuries. The second stage was the stage of excellence and genuine contribution, in which the Islamic physicians were the leaders and the source of new chapters of medicine. This stage extended from the ninth to the thirteenth centuries. The third stage was the stage of decline, where medicine, as well as other branches of science, became stagnant and deteriorated. This stage started mainly after the thirteenth century. During the first stage, Syrian and Persian scholars did a marvelous job by faithfully translating the ancient Greek and Syrian literature into Arabic. They translated different branches of science, including philosophy, astrology, and medicine. The works of Hippocrates, Aristotle, and Galen were among those translated from Arabic; the classic Greek literature was translated into Latin then into Greek because most of the original scripts were lost and the only source was the Arabic translation. If the Arabs only did only thing, namely, preserving ancient literature and handing it honestly to Europe, that would have been a sufficient contribution in itself. The Moslem rulers encouraged translation. Caliph Al-Mamun Al-Abbassi paid the translator the weight of his translation in gold. Among the eminent physicians who took part in the first stage were Jurjis lbn-Bakhtashoo, his grandson Jibrail, Youhanna Ibn-Masawaih, and Honain Ibn-Ishaq; most of them were Christians, yet they were respected and well treated by the Moslem rulers. The impact of some Muslim physicians Al-Razi (Rhazes) was said to have written more than 200 books, with 100 of these books on medicine. Al-Razi's work had a significant impact on the Renaissance. Firstly, Razi's discovery of smallpox was the first differentiation of a specific disease from many eruptive fevers that assailed man. The Renaissance physicians utilized his methods of differentiation when they attempted to do the same with other diseases hundreds of years later. Additionally, his treatise of smallpox was used by physicians to treat cases of this disease throughout the Renaissance, saving countless lives. His works on hygiene set an example that Renaissance physicians followed and attempted to improve on. The result was that medical procedures were much more hygienic, again saving countless lives that would have been lost through infection. Finally, his monumental encyclopedia Al Hawi offered striking insights for its time, and it had a huge impact shaping European medicine during the Renaissance and for years afterwards. Ibn Sina (Avicenna) was honored in the West with the title of "Prince of Physicians." Ibn Sina's works also had a significant impact on the Renaissance. First, his Canon of Medicine was the most widely studied work of medicine in Europe from the 12th to the 17th century. It also served as a chief guide to medical science in European universities. Needless to say, the impact of this book on Renaissance science was enormous, as it was their primary source of medical information. Ibn Sina's discovery that certain diseases could be spread through water and soil affected the research of many Renaissance physicians. If they knew how diseases were transmitted, it made their job of finding cures for the diseases much easier. It also provided a base for their studies into how diseases were spread. Ibn Al-Nafis discovered the pulmonary circulation, which was re-discovered by modern science after a lapse of three centuries. He was the first to describe correctly the constitution of the lungs and gave a description of the bronchi and the interaction between the human body's vessels for air and blood. Also, he elaborated the function of the coronary arteries as feeding the cardiac muscle. Al Zahrawi (Abulcasis) was a Spanish-born Muslim in the 10th century who wrote about the science of surgery. He was able to perform remarkably complex operations for his time, including cranial and vascular surgery, operations for cancer, delicate abdominal surgery, involving the use of drainage tubes, and the amputation of diseased arms and legs. Ibn Juljul of Cordoba became a leading physician in 943 at the age of 24. He compiled a book of special treaties on drugs found in Al-Andalus. Ibn-Masawayh wrote the earliest systematic treaties on ophthalmology. The book, titled Al-Ashr Maqalat Fi Al-'Ayn (the ten treaties of the eye) was the earliest existing text book of ophthalmology. In the curative use of drugs, the Muslims made some amazing advances. They established the first apothecary shops and founded the earliest school of pharmacy. The Muslims were also one of the first people to use anesthetics to render patients unconscious. IV. Medical Ethics in Islam Several works were written by Muslim physicians specifically on the subject of ethics and medicine. The medical profession was a well respected specialty and its leaders kept it this way by laying down proper ethics. Ishaq ibn 'Ali Al-Ruhavi (9th century) wrote a book entitled Adab Al-Tabib or "The Ethics of the Physician." Al-Tabari, the chief physician in 970 CE, described the Islamic code of ethics in his book Fardous Al Hikma, "The paradise of wisdom," stressing on good personal characters of the physician, the physician's obligations towards his patients, community, and colleagues. He stated: The physician should be modest, virtuous and merciful. He should wear clean clothes, be dignified, and have well groomed hair and beard. He should select his company to be persons of good reputation. He should be careful of what he says and should not hesitate to ask forgiveness if he has made an error. He should be forgiving and never seek revenge. He should be friendly and a peacemaker. He should avoid predicting whether a patient will live or die, only Allah knows. He should not lose his temper when his patients keep asking questions, but should answer gently and compassionately. He should treat alike the rich and the poor, the master and the servant. God will reward him if he helps the needy. He should be punctual and reliable. He should not wrangle about his fees. If the patient is very ill or in an emergency, he should be thankful, no matter how much he is paid. He should not give drugs to a pregnant woman for an abortion unless necessary for the mother's health. He should be decent towards women and should not divulge the secrets of his patients. He should speak no evil of reputable men of the community or be critical of any other's religious belief. He should speak well of his colleagues. He should not honor himself by shaming others." Therefore, although Bioethics was born and developed in the Western world, most of the philosophical bases of bioethics are derived from concepts of Eastern philosophies. In last 25 years, the Islamic world has felt the need to introduce courses in Islamic bioethics, in order to study Islamic ethics in the medical field which was established hundreds of years ago and also to appreciate what Shari`ah has to say about the predominant bioethical issuesâinformed consent, abortion, IVF, euthanasia, organ transplantation, and many others. It is essential to introduce the tenets of Islamic legal philosophies and theories. At the end of this article, it is worth mentioning that the first International Conference on Islamic Medicine held in Kuwait in January 1981 published the oath of Muslim doctor, which says I swear by God, the Great, to regard God in carrying out my profession. To protect human life in all stages and under all circumstances, doing my utmost to rescue it from death, malady, pain and anxiety. To keep peoples' dignity, cover their privacies, and lock up their secrets. To be, all the way, an instrument of God's mercy, extending my medical care to near and far, virtuous and sinner, friend and enemy. To strive in the pursuit of knowledge and harness it for the benefit, but not the harm, of Mankind. To revere my teacher, teach my junior, and be brother to members of the medical profession. To join in piety and charity. To live my faith in private and in public, avoiding whatever blemishes me in the eyes of God, His apostle and my fellow faithful. And may God be witness to this oath." References: Hamarneh, S. "The Physician and the Health Professions in Medieval Islam" (NY Academy of Medicine. 47.1088-1110, 1971) Kaf Al-Ghazal, Sharif. "The Origin of Bimaristans (Hospitals) in Islamic Medical History" Kaf Al-Ghazal, Sharif. "The Discovery of the Pulmonary Circulation: Who Should Get the Credit, Ibn Al-Nefis or William Harvey?" Kaf Al-Ghazal, Sharif, "Al-Zahrawi (Albycasis): A Light in the Dark Middle Ages in Europe" Kaf Al-Ghazal, Sharif, "The Valuable Contributions of Al-Razi (Rhazes) in the History of Pharmacy During the Middle Ages" Kaf Al-Ghazal, Sharif, Do medical ethics need an Islamic renovation? Interview with IslamOnline Kaf Al-Ghazal, Sharif, Islamic Medicine Online Martin, M.A. The Genius of Arab Civilisation, 2nd ed, (London, J.R. Hayes, 1983). "The Oath of Muslim Physician", Published in the Islamic Organization for Medical Science Web site Butt,N, Science and Muslim Societies (London: Grey Seal, 1991) Sheikh, A., A R Gatrad, S Dhami, "Culturally Sensitive Care for the Dying is a Basic Human Right" (BMJ 1999;319:1073). Arafa, Hossam, Ethics of the Medical Profession from the Islamic Viewpoint. Al-Sayyad, I (Translated by M Madi) "Islamic approach to Medicine" Ahmad, Aminuddin "Islamic Contributions to Science" Hitti, Philip K. History of the Arabs, 10th ed. ( London : Macmillan,1970 Levy, M, "Medical Ethics of Medieval Islam with Special Reference to Al-Ruhawis' 'Practical Ethics of the Physician'" (American Philosophical Society, Vol. 57, Part 3, 1967) * External links last accessed on December 29, 2004. Dr. Sherif Kaf Al Al-Ghazal is a plastic surgeon, residing in England. He is founder and an executive member of the International Society for History of Islamic Medicine (ISHIM), editor of the ISHIM Journal and a member of the official journal of the Arab Physicians Union in Europe. -------------------------------------------------------------------------- All views expressed herein belong to the individuals concerned and do not in any way reflect the official views of Hidayahnet unless sanctioned or approved otherwise. 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