We have sown the seeds and there is great future
for Bioethics in Pakistan – Prof. Farhat Moazam
CBEC celebrates 20th Anniversary
KARACHI: Centre for Bioethics and Culture at Sindh Institute of Urology and Transplantation (SIUT) celebrated its 20th anniversary by organizing a conference on “The Warp and Woof of Human Morality” on January 10th and 11th 2025.The programme was a mix bag of presentations by guest speaks from oversea on ethical issues faced by the healthcare professionals, presentation by some Alumni of CBEC of their professional journey in Bioethics, Cultural issues, the plight of Women in Sindh particularly in the interior besides presentation on contributions by female poets and scholars.
Speaking in the inaugural session about the establishment of CBEC Prof. Farhat Moazam Chairperson of CBEC said that we were there just at the right time. Established in the Year 2004, this institution has made tremendous development and progress. It has spread the Bioethics message not only in Pakistan but also in other countries in this region. So far we have produced seventeen Masters in Bioethics and one hundred twelve have earned Postgraduate Diploma in Bioethics. Many of these Alumni’s are working in Ethics Committees as well as National Bioethics Committee with which they are affiliated. We have sown the seeds and there is great future for Bioethics in Pakistan.
Dr. Amir Jafary another important member of the faculty who is affiliated with the CBEC since its inception in his pictorial presentation traced the history of CBEC and depicted various phases of its journey since then. He pointed out that it was started in the Year 2003 when the idea was conceived to establish this centre after a meeting with Prof. Adeeb Rizvi and Prof. Anwar Naqvi. The concept paper was prepared in 2004. After functioning for ten years, we had an external audit wherein representatives from various educational institutions of higher education were invited to have their input.
We used to have many students from Africa as well. The CBEC KEMRI initiative materialized in 2016. CBEC has produced thirteen educational Videos which are being regularly used for teaching and training not only in Pakistan but a few other centers as well. We also started internship programme and in 2017 CBEC was declared as a WHO Collaboration Centre for Bioethics in this Region. This was followed by a Video conference presentation by Caesar Atuire President International Association of Bioethics who is a noted Philosopher and Health Ethicist from University of Ghana. He delivered the keynote address on “Pluriversality in Bioethics”. Bioethics, he said, has done a lot to prevent abuse in research. It is a relatively young discipline. However, the present principles, he opined, will not be enough to guide us in the future. These principles will not help us. He also referred to the Asian and African Network of Bioethics. In his presentation he highlighted important issues like effects of climate change, antimicrobial resistance, disease outbreaks, pandemic threats hence we need to develop Pluriversality between communities and countries. Euro American solution in Bioethics will no longer find acceptance for various reasons. As such we need to find new pathways to do bioethics.
Dr. Caesar Atuire said that we have common world but there are different ways of being, knowing and acting. Pluriversality calls for respect and working with differences. It is just like more of a finding a consensus on shared goals and enforcing full theoretical agreements. He also referred to challenges from Artificial Intelligence in Research. He reiterated that we must respect culture, communities, enrich approaches to unchecked problems, De silencing and listening. We need to enrich the ethical tools that we have at our disposal for ethical realization. There is no single way we can approach an issue. We have to compromise on values to get consensus so that the best view gets importance. Western society, he stated is individualistic whereas in Asia and Africa, it is the community which matters the most.
Scientific Session
The first session was dedicated to the CBEC Alumni spreading the world of Bioethics. Dr. Amjad Mahboob Associate Professor at MTI-Gajju Khan Medical College, Swabi from KPK was the first speaker. He described his journey through the rough Terrain of Biomedical Ethics in Pakistan. He pointed out that when we were students, we used to have a two hour lecture on Ethics by Prof. Sirajuddin Ahmed. He discussed in detail the politics of Health, interest of the pharma trade and industry, their interactions with the healthcare professionals which lead to lot of unethical practices. Other issues which he highlighted included the rising cost of care, declining trend of professionalism in healthcare, role of insurance companies. During Covid pandemics, we were faced with ill equipped Intensive Care Units and untrained healthcare staff to manage this emergency. Every day working in the periphery, he said, was a story in itself. We had to learn the art of engaging students, working with Personal Protection Equipment’s (PPEs), handle the problems of shortage of oxygen supplies. Then how to handle dying and dead patients, how to bury those who died was an important issue. We were constantly faced with the problem of shortage of supplies. We had a clinical audit but these were the most difficult times for the healthcare professionals when many worked with devotion and dedication at great personal risk, he added.
Dr. Nida Wahid Bashir Consultant Surgeon described her journey in the field of bioethics. She stated that I confronted some ethical issues when I started my practice. One of the patient said that “No hole in the Neck. Let me die in peace”. When I was asked to form an Ethics Committee at Patel Hospital, I did not know what to do and I sought help and assistance from colleagues from CBEC. We had good faculty engagement at CBEC, and unbiased listening. Here at CBEC I found a place for intellectual growth. Healthcare professionals, she said, need a platform for self-reflection. We need clinicians with interest in Bioethics, she remarked.
Dr. Natasha Anwar Consultant Molecular Pathologist spoke on “Contextualizing Genome Ethics in Pakistan: Engaging Minds from class rooms to Clinics”. She pointed out that many studies which are performed are not published for various reasons. Apart from National Bioethics Committee now we have many Institutional Review Boards/Ethics Committees registered functioning in various institutions. Genome is rapidly moving from Labs to Clinics. We have very high prevalence of genetic disorders in Pakistan. We have been teaching genetics to undergraduate art students. We also organized a camp for high school students. Genome ethics in Pakistan, she said, was a brave new world.
Dr. Arcana Mallah Human Rights Activist who is a member of Women Action Forum threw light on the plight of women in Sindh who are caught between Feudalism and Fundamentalism. She painted a very horrifying frightening picture as to what goes on in Sindh in the name of Honour. Many years ago, she said, a folk song was very popular which meant that “It is crime to give birth to Girls”. Over the years we have seen tremendous increase in violence against women. She disclosed that during 2024 six hundred fifty women were murdered in the name of Honour Killing. One hundred ninety were reported to have committed suicide. This figure, she clarified, do not include those cases which are not reported. Most of the victims are between the ages of fourteen to twenty four years. She then described a few selected case studies what happened to the young women in the name of Karo Kari- the honour killings.
Women Action Forum, she said, started campaign against this honour killing. Human Rights Commissions of Pakistan also became active. This movement had actually started at a small scale in 1980s.Women continued their struggle and eventually the State also started taking notice of what was happening. Waderas she said, get payment, women is considered property of landlords. They cannot live and decide anything at their own. Any girl getting married at her will in another tribe is punished. She also discussed the Sindh Code of Honour and Baluchistan Code of Honour, the functioning of Jirga’s where these cases are discussed and decided. When the Waderas saw situation going out of their control, they involved religious leaders and made it an issue Women vs Religious leaders.
These cases occur routinely in the districts on Sindh Baluchistan Border. In some areas it is the Sardars who rule. Now Sardars have also taken a back seat and brought Maulvis on the front. We still have Kari graveyards. During unprecedented floods, Nature helped to weaken the hold of Waderas since there was lot migration of population but the Baloch Sardars are still very powerful. The tribal system stays as such. Those who speak for the rights of women are harassed, tortured, punished through different means. Some years ago we heard mass conversion of Hindu girls to Islam. There has been reported reconciliation but it is the reconciliation between the Sardars and Waderas not the common people, hence they continue their nefarious activities of holding Jirga’s, announcing punishments with the result that many young girls become victim of Karokari every years.
The highlight of the second day of the conference was presentation by US based historian and Bioethicist Dr. Paul Lambardo on Philosopher and Physician Ibne Sina. Dr. Nomanul Haque from IBA narrated the story of Ibne Yaqdhn an Arabic Philosophical Novel written by Ibne Tufayl in the early 12th century. Dr. Nauman from School of Social Sciences and Humanities at Lahore University of Management Sciences discussed different approaches of living an ethical life. In the evening on first day Dr.Fatima Hasan was scheduled to speak on Female consciousness and Female Urdu Poets.
