Indian Journal of Medical Ethics

'Bioethics' stems from the Greek words 'bios' meaning life and 'ethikos' meaning ethics or mores. It encompasses moral issues in clinical medicine and medical research. This book attempts to present the Hindu viewpoint in bioethics.
In the introductory chapter, the author, a professor of religion, traces the growth of bioethics globally from the 1960s. He laments the lack of engagement of Hindu philosophers in bioethics, unlike Christian and Jewish philosophers. The author views Hindu bioethics as flowing from three principles of Hindu philosophy: "(a) the transcendent character of human life, expressed through the principles of sanctity and quality of life; (b) the duty to preserve and guard individual and communal health; (and) (c) the duty to rectify imbalances in the processes of nature and to correct and repair states that threaten life and well being, both of humans and nonhumans." (p 6).
The author begins by exploring the concept of ethics in Hinduism. The highest ideal is the state of liberation or moksa, in which a person finds self-fulfilment and deepest bliss. Moksa is the result of right conduct and can be achieved through actions characterised by truth, non-violence, sacrifice and renunciation.
A detailed description follows of ancient Indian medical lore and Ayurveda. The divisions of Ayurveda and the work of Charaka and Sushruta are mentioned. Ayurveda is seen as a compendium of science (ensuring the health of mind and body) and philosophy (going beyond the preservation of health and the curing of disease) calling for a more humanist approach to medicine. A description of the philosophy underlying Ayurveda is given. The ethics of teamwork is highlighted through the description of the four-legged therapeutics: the physician possessing the professional qualities of theoretical knowledge, extensive practical experience, dexterity and cleanliness; the drug which must have abundance, efficacy, various pharmaceutical forms and normal composition; the attendant who possesses knowledge of attendance, dexterity, loyalty and cleanliness, and the patient, having qualities of memory, obedience, fearlessness, and providing information about the disorder. A translation of Charaka's oath of initiation for vaidyas is also provided.
The second part of the book dwells on issues at the beginning and end of life. The author opines that Hinduism permits in vitro fertilisation, embryo transfer and surrogate motherhood, when practiced under limits and social norms. This is because procreation and propagation of the species is a central tenet of Hinduism. There is respect for all forms of life, able or disabled. The author thinks that xenotransplantation will be acceptable as there is worship and utility of animals in Hinduism.
The next set of chapters deals with reproduction and issues surrounding it. The author states that Hinduism gives value to all living beings with the central belief that the Supreme Being is present in all living beings and objects. Hence, discrimination against the female sex would not be acceptable, and practices such as prenatal sex selection and sex-selective abortions would be a violation of the Hindu faith. The author suggests that the concept of Hindu dharma would be served by intelligent planning of the family, postponing childbearing, educating women, getting men to assume reproductive responsibility, and enhancing gender equality, equity and the empowerment of women. While advances in genetics would be permissible if used to benefit humankind, there are differences of opinion in the various schools of Hindu thought about cloning.
The last couple of chapters explore aging and death in Hinduism. The author suggests that Hinduism has a greater acceptance of the inevitability of mortality, and better preparation, both cognitively and emotionally to aging and dying. A dignified death is considered welcome, especially if it is not untimely. Hinduism discourages hastening of one's own death or the death of another person by direct means. This would indicate that euthanasia and physician-assisted suicide are not tolerable.
While this book is written primarily for clinicians in the West it is a useful introduction to Hinduism and moral thought in relation to health care, and would be of interest to Indian readers too. Some sections tend to glorify the Hindu religion. The reader must be circumspect, realising the dangers of misinterpretation of religion. It would be interesting if the book manages to spark further discussion on this topic.