Conflict of Interests

When I was a medical student, I have to honestly say that the lecture hall was not always the best place to be. The best time of my medical life had been in the ACC library of my uni … NOT at the lecture hall.

But just as for anything general, there was an exception.

Among all the lessons I have ever attended,  MEDICAL  ETHICS topped my list of favourite  class. I loved the way my lecturer banter with the students; I enjoyed seeing him playing the role of ‘devil advocate’.  I liked all the thought-provoking questions he threw towards the students. I devoured all the cases of ethical dilemma that he presented. I replayed his questions in my mind again and again; I found myself arguing and then counter-arguing my own opinion as I thought things through. Through that exercise, I have since found out that one of the most entertaining conversations I have ever had was with myself. (so please don’t consign me to a mental institution if you are ever in the position of seeing me in one of my conversation with myself. I do that a lot. I spaced out a lot and at that moment, know that I am having the best tete-a-tete of my life.)

The lecturer wasn’t exactly the epitome of tall, dark and handsome…not someone I would look twice in the street  – okay, we all know  that second gaze to the opposite sex is haram,😉 – but when he took up the role of the Medical Ethics lecturer, THEN he became handsome in my eyes.

Well, enough about him.

One of the topics that we always discussed was ‘conflict of interests’. Can we receive  goodies from drug reps …. How much does the receiving of such things influence our decision making in choosing our drug preference? Can a registrar fall in love with his/her medical student … why or why not? Can we develop a romantic relationship with a patient…. Why and why not?  Is it okay for a teacher to fall in love with his/her student?

The truth is, conflict of interest exists. You will find yourself to be in that situation some time or other; so what can you do about it?

One of the lessons I got from my ethics class was: when you have conflict of interest…DECLARE  IT!

For example:

“Look, I know I am supposed to do the evaluation sheet on all the medical students under my tutorial. However, Amanda and I have recently developed a romantic relationship. While I will always try to be fair and not bias towards or against anyone, I have to declare my conflict of interest and request that someone else replace me from tutoring that particular class. That way, it will be fair for everybody. I will teach another class.”

Declare!

“Look, Amy is actually my niece – my most favourite niece. So I have to decline teaching form 5 student this year. I don’t want to be seen favouring anyone in particular. I also don’t want anyone to downgrade Amy’s achievement as a student…I don’t want people to think that her achievement was because of her relationship with me. It’s not fair to her, it’s not fair to me and it’s not fair to other students. So please let me teach another class.”

Declare!

“Look, I can’t do the evaluation for that intern. We had a bad history once…I must admit I don’t like him very much and it will truly colour my perception of him, and thus my evaluation of him. To be fair, can you arrange for another specialist to do her evaluation? I will stay out of it altogether”

Declare!

“Look, I am of the opinion that the best dressing for your wound is Aquacel  Ag. Now, I have to declare that I do receive benefits from the company. Sometimes they give our department pens, notebooks, sometimes they give us lunches. Sometimes, our HOD gets a trip overseas to medical conferences. It’s true that your wound can be adequately dressed with bactigrass or gauze with saline, but I do believe that the outcome will be much better and the wound healing will be much faster with Aquacel Ag.  Aquacel Ag IS a bit expensive, however. Now it’s up to you what you decide to use. I will follow your decision.”

Declare!

“I am a prime minister but my son is a businessman. I don’t want people to grant him projects just because he is my son. Likewise, I also don’t want people to use my son to get my approval for any future projects. Therefore, I will make it a policy that all projects that is recommended through my son will get an automatic rejection. If you want projects, go through the right door.”

Declare!

Declare so that the public knows and they won’t question your integrity.

***

As a muslim living in a secular system, conflict of interest is rampant! You may not realize it, but it’s there, everywhere. In everything that we do, we face conflict of interest.

One of my constant conflict of interest was when it was  said “Kita buat semua lillah hi taala.”

Intellecually, I recognize that as a Muslim everything good that we do – a smile, a kind gesture, a good word, even eating and drinking halal food – is considered as ibadah as long as we do it ‘lillah hi taala.”

But the question is: when you are faced with yummy food right in front of you, are you really thinking of doing it for God when you start to eat?

Most of the time, I did not. Well I recite the usual meal prayer, of course. But did I really eat ‘lillah hi taala’ or did I eat because I was hungry and the food is yummy?

However just because I did not –most of the time- have Allah uppermost in my mind when eating, I am not saying that I couldn’t believe others couldn’t feel that they eat solely for Allah. Just because I found it hard to do, doesn’t mean I am arrogant enough to think that other people couldn’t too.

However it IS a conflict of interest, right?  Are you REALLY sure you are not eating just because you are hungry and the food is mouth-watering?

***

The Rasul (S) was asked the meaning of Ikhlas and he said that he would ask the Great Angel Jibra’eel (AS). When he asked the archangel, he said that he would have to ask Allah, thus showing the importance of the question and of getting the right answer from the Highest authority.

Allah’s reply was: “It is a secret of My secrets. I have deposited it in the heart of the Abd (slave) that I love. No angel knows it, so it is not written, and no shaytan knows it, so it is not spoiled.” (Shaykh Ahmad Ibn Ajiba – The Basic Research, 1998, page 24.)

In short, sincerity is like “a black ant walking on a black rock on a dark moonless night.”

No one can see whether you are sincere or not.

Sometimes not even YOU know of how sincere you are.

****

Ku-Ja (above) Ku-Teh (below) – they are partners and have two daughters.
Ku-NI –>The first daughter
Ku-Shan, the second daughter

I also have another conflict of interest revolving around these four cats that I have. My mother and the rest of the family are not really into cats. But I do. So I told them “Bela kucing dapat pahala juga. Ikut sunnah. Nabi  SAW sayang kucing kan?”

Well!  It’s easy for me to quote that ‘nabi sayang kucing’ and make that as a  justification of my love for cats and the time I spend with them. However, it only happens to be my good luck that our prophet loved cats. What if he loved another animal altogether that I couldn’t find myself loving? What would I say then?

My love of cats is a conflict of interest. Will I get a reward/pahala for following the sunnah of loving cats, when deep inside I know that I would love cats anyway, regardless?

Do you get what I mean?

How about working as ibadah? If I don’t get a salary out of the grueling hours that I put in daily, I might sound halfway believable when I declare “I am doing it for Allah.”

But I DO get a salary, which sometimes makes it so hard for me to sincerely say “I am doing it for Allah. This is fardhu kifayah.”

I mean, I COULD say it. Everybody could say “I do everything for Allah” but do they really mean it? Really, truly mean it? Really, truly mean it in a way that there is NO conflict of interest?

Because if you do, I envy you.

The best of jobs are those that are volunteered. It makes saying “I do it for Allah” more believeable to yourself. It doesn’t matter whether or not what you said is believable to others, but is it believable to you, yourself; truly and sincerely?

When I was a student, my greatest conflict of interest was “Kita belajar kerana Allah.”

I wanted to believe that statement with ALL MY HEART AND SOUL. I knew that we SHOULD learn and study for  the sake of Allah. But it was hard to say that (and believed it too) when I only struggled with the books when the exam was right at the corner. How could I honestly say that I learned for the sake of Allah when I only burned the midnight oil when the exam was near? No matter how sincere I MIGHT be in saying that I was learning for the sake of Allah –let’s forget the factor of the timing of the exam for awhile – still was there a conflict of interest there?

Oh yes, one can’t deny it.

And I am not denying it.

Conflict of interests are interwoven in our daily Islamic lives, for the average people.

However there still leaves the non-average ones – the ones who DO believe what they are saying when they say it. I envy them the confidence that they have in saying “Kita buat kerana Allah” – and usually these people are those who do not receive any material benefits from what they do, yet they still do it.

That’s why to be on the safe side, I never said “I work as a doctor for the sake of  Allah.” I find that I cannot say it without feeling like I sound too pretentious. Because I cannot decide for myself whether or not I am doing it for HIS sake. If I did do it for HIS sake, let HIM be the judge without me having to say it to others. Let me find out in the hereafter whether or not I was doing things for HIS sake, because in this world, I cannot say it without fear that I might be lying.

In short, I cannot say it without being utterly and irrevocably sure that there was no conflict of interest. After all, I got paid. Would I be passively willing to work long hours the way that I do merely on a voluntary basis? Most likely not.

I am not saying that I am totally materialistic and mercenary in nature. I have done volunteer works…but not in a manner of DAILY LONG HOURS. DAILY LONG HOURS is a job that you got paid for – so I find that I cannot be truthful to myself if I say that I work for the sake of  Allah alone (alone being the key word here).

I recognize my conflict of interest.

The best I could say is “I work because I got paid for it. If I don’t work properly while getting paid, Allah will question me for it. So that’s why I work. Whether or not I work for HIS sake alone, it is not my place to say it. It’s His knowledge, His secret.”

So that’s my conflict of interests.

What’s yours?

One thought on “Conflict of Interests

  1. Pingback: Logic and Religion – My Life Poetries That May Not Rhyme

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