Thalia Arawi, PhD
Founding Director, Salim El-Hoss Bioethics and Professionalism Program
Clinical Bioethicist and Clinical Ethics Consultant
Vice Chair, Medical Center Ethics Committee
Telephone: 00961-1-374374 ext.: 4895
Email: ta16@aub.edu.lb

Diana Mikati
Program Coordinator
Tel: +961-1-374374 ext. 4896
Email: dm29@aub.edu.lb

Carmen Karim
Research Assistant
Tel: +961-1-374374 ext. 4847
Email: ck39@aub.edu.lb

Affiliated Faculty:
SHBPP collaborates with a team of AUB and AUBMC faculty members from various disciplines to teach the modules of the physicians, patients, and society courses (PPS-1, 2 & 3).

• Bedside Clinical Ethics Consultations
• Organ Transplant Consultations
• Patient Education
• Workshops and Conferences
• Ethics Matters Lectures
• Dean’s Professionalism Lecture Series
• Undergraduate medical education courses

Workshops and Conferences 

Ever since its launch, the SHBPP has been actively involved in the dissemination of a culture of bioethics and professionalism, both in Lebanon and the region. To date, the SHBPP has held 33 conferences and workshops both inside and outside AUB, bringing together physicians, nurses, residents, healthcare professionals and policy-makers from Lebanon and the region.

Lectures

The Ethics Matters (EM) Lecture Series is an initiative that aims to raise general awareness to the importance and relevance of ethical issues in healthcare within AUB community, the Faculty of Medicine, the Medical Center, as well as professionals and institutions in the region. It also provides opportunities to stay abreast of new developments in bioethics and professionalism. The EM lecture series also aims to develop the educational program in bioethics at the Faculty of Medicine.
To date, the SHBPP has held 54 EM lectures, which include the new EM Dean’s Professionalism Series which was also launched in 2015 with several talks and workshops.

Bedside Clinical Ethics Consultations

Back in 2013, the SHBPP introduced a bedside clinical ethics consultation program at AUBMC, the first of its kind in Lebanon and the Arab world. Patients, family members, and/or members of the healthcare team can, at any time, request a bedside clinical ethics consultation. This program is at the core of the AUBMC 2020 Vision in “providing patients with the highest standards of patient-centered care”.

Organ Transplant Consultations

Organ donation saves lives, improves transplantation outcomes in certain situations and reduces waiting time for patients. At the SHBPP-AUBMC, ethics assessments for recipients and donors involved in organ transplants are conducted on individual basis with the AUBMC clinical bioethicist. This process discusses ethical concerns related to selection, voluntariness, informed consent, disclosure of benefits and risks to the potential donor, the potential recipient, etc. The heroes of the transplant equation, both donor and recipient, are always grateful that AUBMC continuously takes care of the little details to ensure all is well. For many who have been at other hospitals before, the experience was the distinguishing feature of AUBMC.

Patient education

The SHBPP also aims to educate patients and their families about relevant issues in bioethics by providing them with necessary knowledge to participate in making informed decisions in their healthcare.
For this purpose, the SHBPP has published a patient guide about research participation entitled “Human Research: Should I Participate” in English and Arabic. With the collaboration of the Ministry of Public Health, this flyer will be made available at all the hospitals and research centers in Lebanon.
The SHBPP also collaborated with the Nuffield Council on Bioethics, the highest bioethics authority in the UK, to produce an Arabic version of an animated short video about research ethics for children: “Health research: making the right decision for me”. This animation reveals ethical issues from the perspective of Mia – a character who goes through some of the questions and issues that might be raised when a young person is invited to take part in clinical research.

Medical Humanism as part of Medical Teaching

It might seem extraordinary to note that medicine must be listed under Humanities, but the reason for such a possibly audacious statement is that medicine is the most humane of the sciences and the most scientific of the humanities! Starting from this belief and from the conviction that we need to graduate physician healers and not only healthcare practitioners, the SHBPP has made significant additions and changes to the undergraduate medical education program by integrating Bioethics and Medical Humanities as a requirement and introducing required courses and activities throughout the undergraduate medical curriculum by introducing the Physicians, Patients, and Society (PPS) course series for Med 1 to Med 4 students, now an integral part of the Impact Curriculum. This is in addition to several integrated lectures that reveal the intricate connection between bioethics and medicine.

Physicians, Patients and Society 1 (PPS-1)
It aims to allow students to appreciate the psycho-social dimension of illness. This course explores the place of medicine, illness, suffering and the human body in human culture expressed through art, literature and history of medicine, and the psychosocial dimension of illness through close encounters with patients (the Caring Spotlight Experience). PPS-1 brings together a more holistic approach that focuses on the whole patient (and physician-patient relationship) and not just the specific disease, condition, injury, or symptom. Reflecting on PPS1, one student noted that “it was interesting how we approached clinical topics from various and completely different aspects. It is important to get a comprehensive view of medicine, and this module really emphasized how broad the field can be.” Another student highlighted another dimension, “It is a well needed humanity course that develops the stu­dent into a better more empathetic and understanding doctor.”

Physicians, Patients and Society 2 (PPS-2)
It aims to increase the awareness of students on the broad range of ethical issues that they might face at the bedside. The course consists of four modules: Palliative Care, Bioethics and Patient Care, Research Ethics (replacing the Spirituality in Medicine module which might experience a quick comeback), and Caring Spotlight Experience 2 (nurse shadowing).
With its various components and activities, the PPS-2 course aims to teach students the skill of ethical decision making at the bedside and give them the initial tools for looking at, and understanding, ethically loaded situations. This course also allows students to examine the numerous possibilities of dealing with such issues and reinforces their personal sense of compassion, commitment and care. Ultimately, it teaches them to appreciate the fact that clinical ethics is part and parcel of medicine and patient centered care. As noted by a recent PPS-2 graduate, this course “introduces us to lessons that will help us handle our future experiences as physicians and it brings to light many things that some of us have never even thought of or considered.”

Physicians, Patients and Society 3 (PPS-3)
Revamped in 2015, PPS-3 builds upon the need to increase the awareness of students on the various ethical issues that they might face in the clinical setting, as future physicians and members of the healthcare profession. With time, students appreciate the impact of these issues on patient care and become sensitized to them. In PPS-3, students discuss and analyze ethical issues and dilemmas in pediatrics, internal medicine, OBGYN, ED, mental health, public health and others. They are also introduced to the medical law and the bearing it has on their profession. Students tackle issues related to bioethics and medicine, public health, medical law and others. The PPS-3 course also aims to teach the students the importance of being patient advocates.

Physician, Patients, and Society 4 (PPS-4)
Part of the Family Medicine rotation , PPS-4 is a culmination of the PPS series, in which Med 4 students get the chance to put into practice what they have learned in PPS-1, 2, and 3. In PPS-4, students are able view and experience all of this in context, and learn how to factor in the psycho-social, spiritual, and economic dimensions of healthcare in disadvantaged communities first-hand, in the aim of making a difference in the lives of their patients.
PPS-4 runs in parallel with the Family Medicine rotation. Students in each rotating group are assigned site visits to the two resource centers at least once over the span of the four week rotation. The aim of these visits is to familiarize the student with medical care given to patients in disadvantaged communities outside the tertiary care setting, and to introduce new concepts and new skills which involve on-the-ground interaction with a very underprivileged sector of society. The visits also include home visits with a formal reflection component.

 Workshops and lectures

SHBPP has been committed to traverse the boundaries of AUBMC and influence other institutions and communities in Lebanon and the region through its various outreach initiatives. SHBPP has held a number of training workshops and lectures on child protection, and mediation in the school environment at the International College in Beirut. SHBPP has also partnered with other outreach programs at AUB to organize workshops for school students on various bioethics issues in an effort to nurture bioethical values in students from an early age.

Social Media Campaigns

In an effort to spread awareness and knowledge on several issues related to bioethics and humanism, the SHBPP created online media campaigns targeting various audiences in the region. To date, SHBPP has launched an “Aging is Beautiful Campaign” on the occasion of the International day of Older Persons, which aims at highlighting the value of older people in our societies in an effort to shift perspectives about aging from stereotypical and prejudicial attitudes to more positive and supporting attitudes. SHBPP also created a Women’s Day Campaign on the occasion of International Women’s Day encouraging the importance of recognizing women and the corresponding ethical issues that the Middle East women deal with. The posters created for these campaigns were released and shared on SHBPP’s and AUBMC’s social media platforms

Community Service and Learning to Care – SHBPP and SANAD join forces! 

Students at AUB FM learn the importance of becoming healers as opposed to healthcare practitioners and skilled technicians. To that effect, The SHBPP has introduced the Physicians, Patients and Society courses which aim at helping students appreciate medicine as an art and not only a science; they learn that humanism and empathy are part and parcel of being a doctor.
To bridge the gap between theory and practice even further, the SHBPP and The Home Hospice Organization of Lebanon (SANAD) have collaborated on a pilot project to provide an opportunity for second year Medical Students at the AUB FM to volunteer with SANAD in meeting the social, emotional, spiritual, and practical needs of individuals and families living with a life-threatening illness through working with terminally ill patients and their families at their homes, under the full supervision of SANAD’s medical team.

Medical students were offered an opportunity to appreciate and see first-hand the psycho-social dimension of illness. In addition, this experience allowed medical students to gain hands-on experience in volunteerism. It sensitized and equipped them with the skills needed when working with patients and their families. Patients suffer, but so do their families: a perspective often ignored in medical schools, but now appreciated by Med I, Med II, and Med III volunteers.

Brochures:

• Research Participants’ Guide “Human Research: Should I participate?” (English | Arabic)
• SHBPP brochure

Newsletter:

Al Mashrabiya (English | Arabic)

Papers :

• Arawi, Thalia (2016), “BROWnies: bioethics rounds on the wards”, Medical Education, 50: 1145–1172
• Arawi, T, “The Lebanese Physician: the public’s point of view”, Developing World Bioethics, 2010, vol. 10, no. 1, pp. 22-29.
• Arawi, T, “Using Medical Drama to teach Biomedical Ethics to Medical Students”, Medical Teacher, 2010, vol. 32, no. 5, pp.2205- e210.
• Charafeddine L. , Ammous F., Arawi T., “Pediatricians’ opinion and attitudes towards pre-viable infants in a developing country”, Early Human Development, vol. 86, Supplement 1, Nov. 2010, p. S14.
• Arawi, T. “The Muslim Physician and The Ethics of Medicine.”, Journal of The Islamic Medical Association of North America, 2010, vol. 42, no.3. pp. 111-116.
• Arawi, T. “The painter as a Teacher of Medical Ethics”, Academic Medicine, January 2011, vol. 86, no. 1, pp. 114-115.
• Arawi, T. “The Lures of Modern Medicine”, Lebanese Medical Journal, vol. 59, no. 1, 2011, pp. 40-43.
• Medicine and the arts. Self-portrait with Dr. Arrieta by Francisco José de Goya y Lucientes. Commentary. Arawi TA, Academic medicine: journal of the Association of American Medical Colleges, Jan 2011.
• Arawi, T. “The Muslim Physician and the Legacy of Mohammad”, Journal of the Islamic Medical Association of North America, 2011, vol. 43, pp. 35-38.
• First Regional Conference on Biomedical Ethics in Medical Schools. Organized by the Salim El-Hoss Bioethics and Professionalism Program at AUB-FM. Arawi T. Le Journal médical libanais. The Lebanese medical journal. Jan 2011. Journal Data: ISSN: 0023-9852. Volume (Issue):59(1). Pages: 44-7.
• Towards implementing medical ethics and bioethics education in Lebanon. Arawi T, Daher M, Kallab K, Sabra R. Le Journal médical libanais. The Lebanese medical journal (Introductory Journal Article). Jan 2011.Journal Data: ISSN: 0023-9852. Volume (Issue):59(1).Pages:2-3.
• Arawi, T. “Should Medical Ethics Researchers Care What The Public Thinks?”, South Asia Journal of Family Medicine, February/March 2011, vol. 2, no. 2, pp. 20-24.
• Arawi, T, and Nassar, A, “Prenatally Diagnosed Fetal Malformations and Termination of Pregnancy: the Case of Lebanon” (First and Corresponding author), Developing World Bioethics, April 2011, vol.11, no. 1, pp. 40-47.
• Zgheib N.K, Arawi T, Mahfouz R.A, Sabra R; “Attitudes of health care professionals toward pharmacogenetic testing”, Molecular Diagnosis & Therapy, 2011 Apr 1; 15(2):115-22. doi: 10.2165/11589490-000000000-00000.
• Arawi, T., Rosoff, P., “Competing Duties: Medical Educators, Underperforming Students and Social Accountability”, Journal of Bioethical Inquiry, 2012 Jun; 9(2):135-47. doi: 10.1007/s11673-012-9365-z. E-pub 2012 Mar 13. DOI 10.1007/s11673-012-9365-z.
• Christopher Church and Thalia Arawi, “Truly Intensive Clinical Ethics Immersion at the Washington Hospital Center”. The Journal of Clinical Ethics, summer 2012, vol. 23, no. 2, pp. 152-155.
• “الطبيب المسلم وأخلاقيات الطب” , تاليا عراوي in مركز دراسات الوحدة العربية , 08-04-2013. Solicited Article
• Lama Charafeddine, Farah Ammous, Mariam Kayle, Thalia Arawi, “Survival at the Threshold of Viability: A Nationwide Survey of the Opinions and Attitudes of Physicians in a Developing Country”, Pediatric and Perinatal Epidemiology, 2014 May; 28(3):227-34. doi: 10.1111/ppe.12118. E-pub 2014 Mar 21.
• Farra, Nassar, Arawi, Achkar, Monsef, Awwad, “The utilization of pre-implantation genetic testing in the absence of governance: a real-time experience”, Clinical Genetics, Aug 2014, ISSN:0009-9163. Volume(Issue):86(2). Pages:177-80.
• Thalia Arawi, PhD and Diana Mikati, MS: “Bioethicsing: medical students engaged in bioethics”. Accepted for publication in the Cambridge Quarterly (The Cambridge University Press).
• Arawi T. and Berri, N. (2015) Einstein Revisited- Medicine’s New Formula: M=EC2. Mededpublish. DOI: 10.15694/mep.2015.006.0003
• Altawil, Z. and Arawi, T. (2015), Uterine Transplantation: Ethical Considerations within Middle Eastern Perspectives. Developing World Bioethics. doi: 10.1111/dewb.12085
• Arawi Thalia, Letaif Mondher, Siddiqi Sameen, Wi Ho Calvin. (2015), Medical Malpractice and Patient safety: Exploring uncharted territory in Eastern Mediterranean Region. WHO Report.

Any planned expansion in the move?

The new SHBPP offices in the Halim and Aida Academic and Clinical Center will offer the program the opportunity to grow and better establish itself as a distinguished program in Lebanon and the region. The SHBPP is looking forward to expanding its team with the recruitment of a research assistant, administrative assistant, project coordinator, and eventually a faculty member, to help manage the growing projects and services initiated by the program. In addition to that, the SHBPP will be inaugurating the first dedicated Bioethics library that will hold a wide collection of books on the topics of bioethics and medical professionalism, received from the generous donations of universities, bioethics centers, departments and professionals abroad. Finally, the new location of the SHBPP in midst of the state-of-the-art academic and clinical center will place us at closer proximity to the various academic, clinical and research departments, which will facilitate and foster existing and new collaborations.