{"id":4730,"date":"2025-12-15T03:51:55","date_gmt":"2025-12-15T02:51:55","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4730"},"modified":"2025-12-15T03:51:55","modified_gmt":"2025-12-15T02:51:55","slug":"the-moral-core-of-medicine-moral-authority-and-ethical-presence","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2025\/12\/15\/the-moral-core-of-medicine-moral-authority-and-ethical-presence\/","title":{"rendered":"The moral core of medicine, moral authority and ethical presence"},"content":{"rendered":"

By Hana Abbasian<\/p>\n

Medicine occupies a distinctive moral position in society. Medical authority is grounded in an ethical orientation toward care, healing, and understanding human vulnerability.<\/a> This relational perspective is sustained through trust, presence, and responsiveness to suffering.<\/p>\n

In my recent article in the Journal of Medical Ethics<\/a>, I examine how medical ethics is transformed when care becomes secondary to political or institutional rationalisation. I argue that medicine\u2019s moral authority depends on ethical presence, the continuous attentiveness to patients as moral subjects whose vulnerability demands response. This involves a conscious moral stance that prioritizes visibility of suffering even within systems of constraint and limitations.<\/p>\n

In low-resource settings, Islamic moral philosophy offers conceptual clarity through the concept of Niyyah (intention). Niyyah<\/a> refers to the moral orientation that gives ethical meaning to every action. In medicine, intention aligns clinical practice with Hifz al-nafs (the preservation of life)<\/a>, a foundational ethical objective. Under such frameworks, clinical acts cannot be reduced to technical performance, procedural compliance, or institutional necessity. Through intention, care remains morally anchored even when outcomes are uncertain.<\/p>\n

When intention fades from medical practice, care risks becoming administrative. Ethical reasoning can shift toward explanation, justification, or optimisation, with diminishing attention to lived vulnerability. Islamic ethics responds to this risk through the concept of kar\u0101mah al-ins\u0101n (inherent human dignity)<\/a>. Kar\u0101mah refers to the intrinsic worth of every human being, a worth that remains intact regardless of circumstance, status, or productivity. Ethical presence requires continuous recognition of this dignity. When patients are framed primarily as cases, burdens, or logistical challenges, dignity recedes from ethical view, and medicine\u2019s moral authority weakens.<\/p>\n

This concern resonates with Hannah Arendt\u2019s analysis of the \u201cbanality of evil\u201d<\/a> which describes how harm can arise from ordinary institutional processes when moral reflection gives way to routine. In medical contexts, this danger appears when ethical judgment is replaced by procedural compliance. Islamic moral thought protects conscious intention as a safeguard against moral numbness. Through purifying intention, clinicians remain ethically accountable for the human meaning of their actions.<\/p>\n

Reflection and compassion expand moral responsibility beyond institutional boundaries and protect care as a moral practice even when systems constrain action. Maintaining intention under such conditions becomes a form of ethical resistance.<\/p>\n

Medical ethics, in this view, functions as a form of moral memory. When medicine remains committed to its moral core, it retains its authority as a practice of healing that recognises human life as ethically significant. Medicine can continue to speak a moral language capable of sustaining care under the most demanding conditions.<\/p>\n

 <\/p>\n

Article: <\/strong>On the death of intention and the dehumanisation of medicine: an Islamic ethical reflection<\/a><\/p>\n

Author: <\/strong>Hana Abbasian1,2<\/sup><\/p>\n

Affiliations:<\/strong><\/p>\n

1 Harvard Medical School, Boston, MA, USA<\/p>\n

2 Centre for Addiction and Mental Health, Toronto, ON, Canada<\/p>\n

Conflicts of Interest and Sources of Funding:<\/strong> No conflicts of interest or external funding sources for this manuscript are reported.<\/p>\n","protected":false},"excerpt":{"rendered":"

By Hana Abbasian Medicine occupies a distinctive moral position in society. Medical authority is grounded in an ethical orientation toward care, healing, and understanding human vulnerability. This relational perspective is sustained through trust, presence, and responsiveness to suffering. In my recent article in the Journal of Medical Ethics, I examine how medical ethics is transformed […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":503,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[968],"tags":[],"class_list":["post-4730","post","type-post","status-publish","format-standard","hentry","category-clinical-ethics"],"yoast_head":"\nThe moral core of medicine, moral authority and ethical presence - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2025\/12\/15\/the-moral-core-of-medicine-moral-authority-and-ethical-presence\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The moral core of medicine, moral authority and ethical presence - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Hana Abbasian Medicine occupies a distinctive moral position in society. 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