Ethics and Education: Forming the Healer

Sam Jarada – Ihya Publications

Bimaristans not only cured patients but also moulded physicians who were not only competent but also of good character. The classical Islamic medical texts stressed the importance of ethics in medicine, while medical training involved observation, mentorship, and evaluation. Al-Ruhawi argued that physicians must master both the science of medicine and the art of virtuous conduct to truly benefit society. These concepts are relevant today to Muslim doctors facing contemporary workplace issues.

Adab al‑tabib: More than bedside manners

Adab al-tabib, which means "the conduct of the physician," comprises some of the earliest writing on medical ethics, with Al-Ruhawi’s 9th-century work standing out as a key example. He saw doctors as guardians of both the body and the soul, saying real healing starts with honest intentions grounded in faith. Humility mattered, as did honesty and confidentiality. He instructed physicians to bathe, trim nails, use perfume, and pray before patient visits, emphasising that personal purity aids professional integrity and conduct. He pushed physicians to avoid bragging and to keep patient information private, even after the patient’s death and for everyone to be treated with dignity, no matter their social standing, gender, or beliefs. There was no leeway on hygiene, personal grooming, or treating colleagues and nurses with respect; Al-Ruhawi believed that poor character among could ruin even the best treatments. These weren’t just abstract ideals, either; he connected them to everyday routines, such as starting every morning with prayer and ensuring he was clean before seeing patients. Interestingly, Patients were often discharged once they demonstrated their capacity to consume a whole chicken, a sign of well-being equivalent to eating a three-course meal. From a Muslim patient’s perspective, the doctor's gender, communication, language, personality, and moral conduct were critical factors influencing their decision to seek treatment or adhere to prescriptions. Moreover, the workforce attitude in bimaristans, which focused on patient well-being and a spiritual ethos, influenced European medicine, leading to the emergence of comparable institutes.

How education actually worked

The bimaristan education system, influenced by the Qur’an’s teaching that "above anyone who possesses knowledge, there is one with greater knowledge," fostered modesty and recognition that every individual has a unique contribution. Also, the spiritual and religious aspects of bimaristans, including prohibitions on alcohol and gambling, played a significant role in motivating trainees and cultivating resilience. Furthermore, the medical training back then was truly centred around close mentorship. It usually happened in bimaristans or right in doctors’ homes, not in formal schools like today. Trainees progressed from observation to supervised practice, with mentors correcting errors in real time during rounds. Students didn’t just read, they watched their mentors during ward rounds, saw how they diagnosed patients, and slowly got involved themselves, always under a supervisor’s watchful eye. Memorising key texts like those of Galen and Hippocrates was part of the deal, but the real test was in performing procedures, not just knowing them. To prove they were ready, medical trainees had to pass oral exams or demonstrate their skills in practice. If they succeeded, they earned an ijazah, a certificate that attested to mastery of specific knowledge and skills. Mentors didn’t just teach the technical stuff; they also showed how to treat patients respectfully by greeting them kindly, admitting when you don’t know something, and always putting the patient first. Moreover, keeping records was standard for every symptom, every treatment, every outcome. This allowed peer review and accountability, with colleagues able to scrutinise cases if malpractice was alleged. That way, if questions came up, colleagues could review what happened; it was a simple but effective way to keep everyone honest.

Today’s learners: bias, belonging and faith

Muslim medical students and doctors in the UK deal with the usual stress of training, plus a whole layer of faith-related challenges; one recent survey from 1000+ Muslim physicians showed that about 44% of them regularly experience discrimination. This included everything from microaggressions and being excluded, to having people scrutinise their need for prayer, wearing hijab, or fasting during shifts. Reported incidents included rota changes blocking Jumu'ah prayer and pressure to remove religious attire. It’s tough to feel like you belong when there aren’t enough prayer spaces, the work schedules aren’t accommodating, and stereotypes make others doubt your professionalism or dedication. Systemic Islamophobia contributes to higher burnout rates and career hesitancy among Muslim trainees. These issues push them to be resilient, but they also point to bigger problems with how training environments handle inclusivity. The ethical side of medicine, once at the heart of healing, is now shoved aside by burnout and bias built into the system.

Applications: small practices that shape healers

Classic adab still offers modern tools. Mentors could explicitly discuss virtues such as humility during debriefs, modelling Al-Ruhawi's emphasis on self-care to improve patient care. Mentors could weave character reflections into feedback, model humility by taking ownership of errors or promoting anti-bias, and learners keep a reflective journal that combines the why (e.g., "Why this speciality?") with the what (e.g., "What went well?"). Such reflection aligns with adab's focus on intention (niyyah) as the root of ethical action. A circle for discussing dilemmas of faith and ethics around end-of-life care during Ramadan provides peer support without a formal programme. Institutions could introduce low-footprint adaptations to the training environment (e.g., prayer rota flexibility, faith-literacy workshops, or a "quiet room" that serves many purposes). These are steps that echo bimaristans' integration of spiritual care without compromising clinical standards. All of these reflect Al-Ruhawi's call for systems that produce ethical as well as technically competent physicians. Therefore, it is important to consider how to implement the ideas and insights from Bimaristans.

Conclusion

Al-Ruhawi's vision that medicine demands moral excellence alongside skill challenges modern systems to nurture the whole healer. The classical tradition reminds us that the healer comes from a setting where body, soul, and community are treasured. Using adab al-tabib brings us back to those foundations, enabling Muslim health professionals to achieve excellence in the modern world.

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