Despite wide spread commercialization and corruption in health services and ever increasing unethical medical practices by the medical profession and unethical marketing practices by the pharmaceutical trade and industry, bioethics movement in Pakistan is making steady progress. National Bioethics Committee (NBC) was formed in 2004 and during the last ten years it has accomplished a few things though its performance cannot be termed satisfactory due to various reasons. However, now there is an increased awareness about bioethics, people have started talking and thinking about it and this subject is often discussed at various forums. There is also increased awareness about scientific misconduct including plagiarism and its likely consequences among the academicians and all this augurs well for the bioethics movement.
National Bioethics Committee has finalized and published its guidelines on Stem Cell Research as well as Physicians Interaction with the Pharmaceutical trade and Industry and now it is upto the regulatory authorities like Pakistan Medical & Dental Council to get it implemented. The Health Care Ethics Committee (HCEC) a component of National Bioethics Committee which is looking at clinical ethics under the leadership of Prof. Farhat Moazam Chairperson of CBEC has almost finalized the final draft of curriculum of medical ethics which is to be taught to the undergraduate medical and dental students. It also provides resource material for teaching bioethics besides guidance how it has to be taught i.e. lectures, case scenarios etc., and how the students have to be evaluated. Once approved by the National Bioethics Committee, it will be presented the Pakistan Medical & Dental Council to get it implemented.
Some progress has also been made as regards formation of Provincial Bioethics Committees. It has been formed in Punjab as well as Baluchistan while some progress has also been made in Khyber PK. However, no progress is visible in this regard as regards the province of Sindh. A training session for members of the provincial bioethics committees was held in Lahore, NBC had its first meeting at Peshawar and more recently NBC also had its meeting at Quetta in Baluchistan on November 13th followed by two days of training workshop for Provincial Bioethics Committee Members on November 14-15th 2014. Despite some initial problems, the interest and enthusiasm which the provincial bioethics committee members had shown at Quetta by actively participating in the discussion gives lot of hope that some of these members will prove to be quite useful in promoting the bioethics movement in the province. Teaching videos prepared by CBEC were used for training and it helped the provincial bioethics committee members understand the problems much better.
Pakistan Medical & Dental Council is reported to have fixed fifty hours for teaching of bioethics to undergraduate medical and dental students. Center for Bioethics at SIUT and Aga Khan University are running Diploma as well as Masters Programme in Bioethics producing the much needed human resource which will be required to teach bioethics in the medical and dental institutions. Bioethics Committees and Institutional Review Boards have been constituted in many medical universities and medical colleges, healthcare facilities though composition and functioning of some of them cannot be termed ideal but hopefully with the passage of time it will also improve. Research proposals are now being discussed not only in the Research Ethics Committee of NBC but also by the various Institutional Bioethics Committees. Pakistan Association of Medical Editors (PAME) has also organized training courses for its members how to tackle scientific misconduct, advising them to screen all the manuscripts for plagiarisms before they are accepted for further processing and external review. Late Prof. S.M.Rab and Prof. Kh.Saadiq Hussain both eminent physicians and former Presidents of College of Physicians & Surgeons Pakistan whenever invited to speak at any medical event have been constantly highlighting the unethical practices indulged in by the healthcare professionals. They have been constantly reminding their colleagues to uphold professional ethics. Prof. Kh.Saadiq Hussain in particular during the last couple of years has never missed an opportunity to shake the conscience of healthcare professionals calling upon them to listen to their conscience while dealing with the patients. All these developments are a healthy sign that we in Pakistan have at last started moving in the right direction. Certainly the movement is very slow and its pace of progress needs to be accelerated. While regulations and regulatory bodies are needed and they have a role to play but ethics has a lot to do with morality. Efforts need to be made to increase awareness about these issues, convince and encourage all the stake holders to play their role in checking and eventually eliminating unethical practices and uphold professional ethics whether it is practice of medicine or marketing of drugs, scientific instruments and equipment. Our objective should be to ensure patient safety and make available cost effective affordable healthcare besides promoting research culture, art and science of scientific publishing.