There is burgeoning interest in the field of “Islamic” bioethics within public and professional circles, and both healthcare practitioners and academic scholars deploy their respective expertise in attempts to cohere a discipline of inquiry that addresses the needs of contemporary bioethics stakeholders while using resources from within the Islamic ethico-legal tradition. This manuscript serves as an introduction to the present thematic issue dedicated to Islamic bioethics. Using the collection of papers as a guide the paper outlines several critical questions that a comprehensive and cohesive Islamic bioethical theory must address: (i) What are the relationships between Islamic law (Sharīʿah), moral theology (uṣūl al-Fiqh), and Islamic bioethics? (ii) What is the relationship between an Islamic bioethics and the lived experiences of Muslims? and (iii) What is the relationship between Islamic bioethics and the state? This manuscript, and the papers in this special collection, provides insight into how Islamic bioethicists and Muslim communities are addressing some of these questions, and aims to spur further dialogue around these overaching questions as Islamic bioethics coalesces into a true field of scholarly and practical inquiry.

This paper is a critical analysis of Tristram Engelhardt's attempts to avoid unrestricted nihilism and relativism. The focus of attention is his recent book, The Foundations of Bioethics (Oxford University Press, 1996). No substantive or “content-full” bioethics (e.g., that of Roman Catholicism or the Samurai) has an intersubjectively verifiable and universally binding foundation, Engelhardt thinks, for unaided secular reason cannot show that any particular substantive morality (or moral code) is correct. He thus seems to be committed to either nihilism or relativism. The first is the view that there is not even one true or valid moral code, and the second is the view that there is a plurality of true or valid moral codes. However, Engelhardt rejects both nihilism and relativism, at least in unrestricted form. Strictly speaking, he himself is a universalist, someone who believes that there is a single true moral code. Two argumentative strategies are employed by him to fend off unconstrained nihilism and relativism. The first argues that although all attempts to establish a content-full morality on the basis of secular reason fail, secular reason can still establish a content-less, purely procedural morality. Although not content-full and incapable of providing positive direction in life, much less a meaning of life, such a morality does limit the range of relativism and nihilism. The second argues that there is a single true, content-full morality. Grace and revelation, however, are needed to make it available to us; secular reason alone is not up to the task. This second line of argument is not pursued in The Foundations at any length, but it does crop up at times, and if it is sound, nihilism and relativism can be much more thoroughly routed than the first line of argument has it.

Engelhardt's position and argumentative strategies are exposed at length and accorded a detailed critical examination. In the end, it is concluded that neither strategy will do, and that Engelhardt is probably committed to some form of relativism.

The maxim “parents should do what is in the best interests of their child” seems like an unassailable truth, and yet, as I argue here, there are serious problems with it when it is taken seriously. One problem concerns the sort of demands such a principle places on parents; the other concerns its larger social implications when conceived as part of a national policy for the rearing of children. The theory of parenting that creates these problems I call “optimizing parentalism.” To avoid them, I define and defend a new and more morally appealing theory, “satisficing parentalism.”

The concepts of health and disease are crucial in defining the aim and the limits of modern medicine. Accordingly it is important to understand them and their relationship. However, there appears to be a discrepancy between scholars in philosophy of medicine and health care professionals with regard to these concepts. This article investigates health care professionals’ concepts of health and disease and the relationship between them. In order to do so, four different models are described and analyzed: the ideal model, the holistic model, the medical model and the disjunctive model. The analysis reveals that each model has its pros and cons, and that health care professionals appear to apply more than one models. Furthermore, the models and the way health care professionals’ use them may be helpful for scholars in philosophy of medicine with regard to developing theories and communicating them to health care professionals.

Diagnosis of dementia in primary care is both difficult and important. The recommendations by several authors to improve the diagnosis of dementia by general practitioners are important, but insufficient. It is argued that perhaps the disease concept in itself is a cause of confusion for clinicians. Primary care physicians need an adapted procedure, gradually leading to the final diagnosis of dementia. It has to be a stepwise labelling strategy, using global descriptions and non-disease specific labels in the beginning, ending up with well-defined disease criteria. In this process, there is circularity: previous diagnoses have to be kept in mind because symptoms and signs may gradually change during the progression of the disease, leading to reconsideration of previous deleted options. To frame this properly, the primary care physician needs to adopt a broad “frail elderly” geriatric concept. Implementation of this concept not only helps the diagnostic process, but also stimulates the care for dementing patients and their caregivers. Relevant arguments for early diagnostic involvement of primary care physicians can be put forward on condition that a new concept, adapted procedures and adapted instruments are used.