Lecture on Public Health Ethics given by Prof. Omar H. Kasule to 4th year medical students at King Fahd Medical City on May 07, 2012

1. PUBLIC HEALTH ETHICS: 120507
INTRODUCTION
Lecture for 4th year medical students by Prof
.Omar Hasan Kasule Sr

2. CONCEPT OF GOOD HEALTH 1.0
 Health is a positive state of being and not just absence of
disease. Individuals who are disease-free may not be
healthy.
 The components of good health are spiritual health,
physical health, psychological and mental health, and social
health.
 Islam looks at health in a holistic sense.
 If any part of the body is sick the whole body is sick
 If a member of a family is sick the rest of the family are
affected emotionally and psychologically.
 Any sickness in the community will sooner or later have
some negative impact on all the members.
 The holistic outlook also means that physical, emotional,
psychological, and spiritual health are considered together.

3. CONCEPT OF ILLNESS 2.0
 Definition of disease considers several dimensions that
may operate singly or in combination: moral or
spiritual, biological or pathological, psychosocial, or
normative statistical.
 Overall disease is a state of dis-equilibrium, khuruuj
al badan ‘an al i’itidaal.
 A distinction must be made between disease as a
pathological manifestation and illness that is a
subjective feeling.
 There is a 2-way interaction between diseases of the
heart, amradh al qalb, and diseases of the body,
amradh al badan.
 The Islamic position is to approach most diseases
empirically and to be guided by experimental science.
 Islam rejects superstitious beliefs and practices in all

4. CONCEPT OF FAMILY HEALTH 3.0
A healthy family promotes the health of all its members.
There is no alternative to the family for child up-bringing.
The family teaches trust, loyalty, a sense of belonging, and
rights and responsibilities.
It is is an economic unit.
It is the main source of primary health care.
It is a source of calmness and tranquility.
Threats to the family are extra-marital sexual relations,
neglect of family duties in pursuit material goods, extreme
individualism and self-interest, and bad socio-economic
circumstances.
Dysfunctional families are not healthy in the physical and
psychological sense and have long-term impact on the
children.
The causes of family dysfunction are multiple: economic
pressures, a hedonistic life-style, and decline of moral and

5. CONCEPT OF COMMUNITY 5.0
HEALTH 1
Private and public efforts of individuals, groups, and
organizations to promote, protect, and preserve the
health of those in the community.
Involves community development, community
organization, community participation, and community
diagnosis. Community health is affected by physical
factors )geography, the environment, community size,
industrial development, socio-cultural factors )beliefs,
traditions, prejudices, economic status, politics, religion,
and social norms, individual behavior, and community
.organization
Whereas public health is government-driven, community
health is community-driven. Communities both in pre-
history and the historical era undertook measures to
.protect health

6. CONCEPT OF COMMUNITY 6.0
HEALTH 2
 The Qur’an has described good and bad communities in
the past. It described communities that were punished or
destroyed by Allah sue to moral deviations. No
community is destroyed or is punished until it receives a
warning from Allah.
 Community diagnosis is identifying and describing
health problems in a community with a view to initiating
public health interventions.
 Many communities are unhealthy in the physical and
social or mental sense.
 Underlying causes of poor community health are social
and moral such as social injustice, immorality, sexual
promiscuity, over-nutrition, and addiction to alcohol and
drugs.
 Community health can be improved by having healthy

7. CONCET OF PREVENTIVE 7.0
: MEDICINE,TIBB WIQA’I
 Preventive medicine, tibb wiqa’i, is covered under the
Qur’anic concept of wiqayat. Prevention is therefore one of
the fixed laws of Allah in the universe and its application to
medicine therefore becomes most obvious.
 The concept of prevention, wiqayat, does not involve
claiming to know the future or the unseen, ghaib, or even
trying to reverse qadar. The human using limited human
knowledge attempts to extrapolate from the present
situation and anticipates certain disease conditions for
which preventive measures can be taken.
 Only Allah knows for sure whether the diseases will occur
or not. The human uses knowledge of risk factors for
particular diseases established empirically to predict
disease risk. Preventive action usually involves alleviation
or reversal of those risk factors.

8.
CONCEPT OF HEALTH PROMOTION 8.0
 Most diseases can be prevented using spiritual
approaches. These involve aqiidat, ibadat, avoiding
haram and promoting halaal.
 Spiritual promotion at the community level involves
enjoining the good and forbidding the evil.
 Physical health promotion at the individual level
includes immunization, good nutrition, personal
hygiene, and disinfection.
 Physical promotion at the community level involves
environmental sanitation.
 Health promotion involves pro-active measures that
make health better such as exercise, good nutrition;
adequate rest; mental calmness; tranquility of family
life, iman and spiritual calmness.

9. ETHICAL ISSUES IN SCREENING 9.0
The benefit of screening must outweigh the harm
The efficacy of screening must be proved in a
proper trial
Confidentiality must be maintained
.Informed consent must be obtained

10.
ETHICAL ISSUES IN VACCINATION 10.0
Autonomy vs compulsion
Mass immunization of children
Mass immunization in epidemics
Individual risk vs public benefit )concept of herd
immunity)

11. INFECTOUS DISEASE
CONTROL
 Isolation, quarantine
 Compulsory treatment / immunization
 Notification )confidentiality)
 Contact tracing

12. ETHICAL ISSUES IN ADDICTIONS 12.0
Personal autonomy vs public interest
Restriction of smoking
Passive smoker
Society bears costs of treating diseases
Drug addiction: criminal vs victim

13.
ETHICAL ISSUES IN DISASTERS 13.0
Triage: who has priority
Short term vs long term
Medical intervention vs respect for local culture
and customs

14. ETHICAL ISSUES IN HEALTH 14.0
ECONOMICS
Monetary value of human life and human life
Equity: access, accessibility, coverage, quality
Public vs private
Subsidizing unhealthy life styles