Journal of Medical Ethics and History of Medicine The necessity of observing ethical liability in bioethics: Instruction of the principles of bioethics should be launched from school Ata Pourabbasi 1* , Meysam Tavakkoli Bina2, Mahnaz Sanjari 3 1.Research fellow, Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran; Ehsan Educational & Cultural Institute, Endocrinology and Metabolism Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2.PhD Student, Sciences and Research Branch, Islamic Azad University, Tehran, Iran; Educational & Cultural Institute, Endocrinology and Metabolism Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 3. Research fellow, Endocrinology and Metabolism Research center, Tehran University of Medical Sciences, Tehran, Iran. *Corresponding author: Ata Pourabbasi Address: Endocrinology and Metabolism Research Center, Shariati Hospital, Kargar St., Tehran, Iran. Tel: (+98) 21 88 22 00 37 E-mail: atapoura@sina.tums.ac.ir Received: 02 Oct 2010 Accepted: 26 Dec 2010 Published: 28 Dec 2010 J Med Ethics Hist Med. 2010; 3:7. © 2010 Ata Pourabbasi et al.; licensee Tehran Univ. Med. Sci. Introduction The current students at classrooms and schools are the future doctors and health adminis- trators of our country. As a matter of fact, their current learning would lead to better ways of passing the medical and health learning paths. Nowadays, high school textbooks are loaded with scientific and technical concepts; the very concepts the students need in order to succeed in entrance exams to medical schools. At high school, the students focus on challenging issues such as reproductive system, development, neuroscience, stem cells science and other challenging issues. These topics contain intense academic load for learners; and at the same time, they are full of spiritual, moral and ethical meanings. When these aspects of learning are neglected, new and im- mense moral and ethical challenges emerge. This is especially true in current cultural background of our society; in which moral and cultural challenges are discernible. One should keep in mind that "morality" de- void of beliefs and cognitive principles would transform into formal and legal commands. In the absence of supervision, it would lead to a disaster. So far, notable cases have occurred in scientific field. Therefore, creating a basis for moral and cognitive beliefs should be considered as a com- plementary gesture; the one which should be kept in mind at the outset of any scientific or technolo- gical learning process. Hence, commitment to the necessary and original principles of religion is one of the prominent methods of institutionalized medical ethics. For example, if the literature for teaching re- productive system to students aged 15 to 17 years old is not managed properly, it would transform to a factor of collapse which leads to moral decadence in the society. Likewise, concepts related to neuroscience or stem cells research could lead to inconsistencies in beliefs, religious teachings and J Med Ethics Hist Med 2010, 3:7 Ata Pourabbasi et al. Page 2 of 3 (page number not for citation purposes) scientific education of the students. Clearly, these challenges should be dealt with at a simultaneous level to teaching. Consequences of such training methods, regardless of problems and moral outcomes, would be seen in a generation free from any strong cognitive and ethical principles, soon to enter the universities and medical schools. At the same time, the main ethical beliefs should be considered as regularized irrepressible manners. The question is, to what extent such a generation can be receptive to transcendental education on bioethics and medical ethics at universities? The answer is clear. As this introduction suggests, the transfer of ethical values and beliefs should complement the existing scientific concepts in school textbooks. The authors of this article are simultaneously concerned with bio issues and ethical-faith ones. Based on a preliminary needs assessment and a designed curriculum for high school students of experimental sciences, the first trial phase of the plan was executed on third-year students of one high school in Tehran. The plan was taught in one academic semester; and the program's headings were as follows: “Vanity, perfection pest”: Pride is always harmful to wisdom; especially when the knowledge is considered necessary for the community and few people can master it. This assumption can be verified in all concepts and courses in experimental sciences; because knowledge may lead to egocen- trism among the adolescents. Nowadays, one of the ethical issues making an impact on medical community is pride and arrogance against the patient (1). “Sanctify the spirit, sanctify the body”: The medical profession deals with the human body or other living creatures. So from a professional viewpoint, body is the original theme of the study; and this may lead to some challenging situations. For example, in autopsy halls of medical schools, one is not far from witnessing indignities towards the human corpse and dignity. Some examinations and interventions performed in this regard are not considered as dignifying towards humanity. In this course, students would learn that human body as well as his soul is valued and respected and it must always be appreciated in professional contacts (2). “Death, rebirth”: Death is a concept that has a major role in ethical teachings of Islam. In so many narratives and traditions of our religion, death and remembrance of death is a pivotal instrument in practicing piety and virtue in human beings. Occasionally, in scientific field, the concept of death is discussed as a totally natural process. The science tries to explain physical and molecular aspects of this event; but the eminence and importance of death is hidden in our thoughts. If such a phenomenon is presented as only a normal biological process, the moral teachings of the learners would be useless. In this course, the phenomenon of death is regarded as a great numinous event. “Intellect is inside the proof”: In our religious believes, human wisdom and some proofs -such as the messengers of God- guide human beings towards perfection (3). Some debates in areas of neuroscience are trying to simulate the neural processes; in order to illustrate molecular and cellular functions of the nervous system. As mentioned before, such an approach restricts the scientific insight to nerves sciences and mental processes. It would also present the human wisdom as mere collection of chemical reactions. In such a situation, the human mind would not be able to act as a resource of rational principles and regulations; and therefore, commitment to ethical principles would be of no importance. “From gene to God”: Genetic concepts act as bilateral topics in faith and moral regulations. On one hand, understanding and thinking about genetic themes is the best method to recognize the Creator; and on the other hand, astonishing advances in this area, such as duplication, artificial life, bio robot, etc may lead to unstable mental approaches towards the Creator. Therefore, transmissions of these themes can play a crucial role in reinforcing the profundity of religious beliefs in young students. Such doctrines can be used in promoting ethical and ideological standards of medical community in future. When young people learn that pride is always harm to wisdom; they would have no problem in accepting professional codes of ethics in future. Teenagers should learn that the human body is respected by its credible spirit. In doing so, they would not be inclined to vainly injuring even a rabbit in labs and classes. In the same way, they would accept patients' bodies and souls as respect- ful; and they would not behave differently in their investigation and studying of human body. When the concept of death is shaped in a stu- dent's mind, he/she would not be ignorant to it in his/her professional challenges. So when a patient is in pain, the doctor (the ex-student) would not be able to sit calmly in his room. So the adolescent who learns scientific discoveries should not underestimate the mind authority. Relying on this authority would show him/her numerous profes- sional ethics in the future. It should not be forgotten that, the science as general and biology as particular are bilateral issues regarding the intellectual teachings. It means that on one hand, it can be consistent with ethical obligations and on the other hand it can be in conflict with it (4). So far, there is no adequate attention to moral-religious training alongside medical education. But the public health needs them both. Ignorance towards this particular point would lead to misinterpretations regarding personal J Med Ethics Hist Med 2010, 3:7 Ata Pourabbasi et al. Page 3 of 3 (page number not for citation purposes) values and beliefs among young people. To prevent this, scientific studies in eastern world should be suitable to the values of these societies. Learning these concepts in adolescence and in schools has a much more lasting effect compared to their learning in an older age. It would be imprinted on teenagers' minds and it would also facilitate the transference of medical ethics' teaching in universi- ties and colleges. As it follows, other educational topics are de- signed according to scientific concepts and the educational needs of students and they will be presented in the next academic year. The future of this project will be based on accurate professional assessments and designing issues in the academic level and interdisciplinary courses. The emphasis on age and developing period especially in high school is basically meant to modify fundamental of ethics in medical societies. Keep in mind that this approach to bioethics' education for students is a new approach and the headings are provided according to assessment needs. Since this approach emphasizes the prin- ciples of Islamic ethics, authors were not able to find similar educational content in the other countries. A number of activities on bioethics' education have been performed in some countries such as China, Japan, Philippine and India; and all of them have been based on cultural characteristics of the respective country (5). In this approach, innovation provides an op- portunity to evaluate the effectiveness of education. After revision, this curriculum would be suitable enough to be distributed, at least among Islamic countries. References 1. Koleini. Kafee Principles, 4th edition. Tehran: Islamieh Darolkotob; 1365, Vol 2, p. 309-28. (in Persian) 2. Larijani B. Physician and Ethical Concerns. Overview on Ethical Principles. Tehran: Baray-e-Farda; 1383, Vol 1. (in Persian) 3. Koleini. Kafee Principles, 4th edition. Tehran: Islamieh Darolkotob; 1365, Vol 1, p. 15. (in Persian) 4. Barbo E. Science and Religion. Translated by Khoramshahi B. Tehran: University Press; 1362. (in Persian) 5. Macer D. Bioethics education for informed citizens across cultures. Sch Sci Rev 2004; 86(315): 83-6.