Critical analysis of the Pakistan Medical Dental Council Code and Bioethical Issues

Sammanfattning: Medical paternalism is a common practice in Pakistan, it can be justified on the principles of beneficence and non-maleficence in certain clinical situations but in the research medicine it can pose many ethical implications. Islam is a communitarian religion but it provides full autonomy to the competent individuals. Pakistan Medical and Dental Council (PM&DC) codes of ethics have been formulated in line with the World Medical Association and it also states in its preamble that it follows Islamic bioethical laws. The PM&DC guidelines do not provide substantial system for obtaining consent from patients and the research participants. Neither does it comply with the Islamic bioethical laws nor with the International Declarations. The language used in the codes is ambiguous that can have different interpretations and there is no legal support from the civil law of the country. These factors supplemented with the cultural values have elevated the status of the physician and gives complete authority to them for medical decisions. Medical paternalism in research medicine can be a violation of the dignity and autonomy of the research participants. Patients are used as means and commodities rather than end in themselves. The research involves risks of harms no matter how low these risks are – the matter of concern is that research participants are involved in research accompanied with risks about which they are not aware.