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An innovative method of self-education through a bioethics group: the Ziauddin experience, Karachi, Pakistan

World advancement in biotechnology has emerged as a challenge to humanity as well as physicians working in the community. With changing traditions and values, it is the need of the day to identify the ethical implications of our profession in order to deal with clinical dilemmas with a better understanding (1). 
 
The importance of bioethics teaching was overlooked till late 1990s in Pakistan and for the first time this subject gained recognition by Pakistan Medical and Dental Council (PMDC) in 2002 (2). As a result of this, all public and private medical colleges are bound to incorporate ethics as a subject in their curriculum. However, the young doctors who begin their career in university hospitals were not exposed to bioethics education; they feel the need of a formal training because they encounter problems in facing ethical dilemmas emerging from their clinical practice (3). In addition, they have to participate in undergraduate bioethics teaching. In order to meet these demands physicians have started showing their enthusiasm to educate themselves. 
 
The centre of biomedical ethics and culture (CBEC) introduced a one year postgraduate diploma (PGD) program in 2006. It is the only postgraduate-awarding degree program in biomedical ethics in Pakistan. The focus of CBEC is to educate mid-career health care professionals particularly belonging to university hospitals throughout Pakistan (4). One of the mandatory requirements of this diploma course is to take up a project with an objective of disseminating bioethics education in different spheres of medical field. 
 
Ziauddin University started organizing bioethics-related activities in its campus about seven years back. It is among one of the few private medical universities of the country which is forward looking and open to accept the challenges of new medical world. This institution recognized the need of teaching ethics even before its inclusion in PMDC code and started formal lectures for faculty by a consultant who had background in ethics. 
 
Ziauddin hospital comprises of three campuses based in Karachi. Keamari campus is a 110 bedded, low cost, tertiary care hospital which caters to a large population of Keamari (it is the main coastal town of Karachi situated in the central and western parts of the city) (5). The hospital includes specialties like general medicine and allied, general surgery and allied, obstetrics and gynecology, eye, ear, nose and throat (ENT), pediatrics etc. The clinical teaching of the medical students has been divided into three campuses and this campus provides a great opportunity for third and fourth year students to gain knowledge and skills (6). 
 
The group coordinator has been working in the campus as an assistant professor in the department of general surgery and is actively involved in under-and post-graduate teaching. 
 
The majority faculty at this campus felt the requirement of initiating bioethics related activities. The need for starting bioethics education was raised because of a particular case of a woman having Down’s pregnancy. The ethical issues related to this pregnancy were discussed in a weekly multidisciplinary meeting in which the author was invited as she had background knowledge of bioethics. This specific activity set a stage to develop a bioethics group that could address such issues. The author could sense the need for a forum and it was the opportune time to start a bioethics group as a project.