Leadership in medicine does not begin with a title, an appointment, or a position of authority. It begins the moment a person chooses to serve others through the profession of medicine. From that point onwards, every doctor carries leadership responsibilities, whether visible or not, formal or informal, recognised or unnoticed. Leadership is not something added to a medical career, it is woven into it and practised daily across a lifetime.
Competence is the head of leadership. A doctor who leads must first be able to do, not merely instruct. Competence allows a leader to think clearly, decide wisely, and act safely. Leadership without competence erodes trust and places others at risk. In the life of a doctor, competence is practised continuously. As a medical student, it is shown through preparation for ward rounds, knowing one’s patient thoroughly, taking responsibility for learning, and helping peers understand without being asked. As a house officer or junior doctor, competence is demonstrated by performing the procedures one expects others to do, personally checking investigations, recognising limitations early, and seeking senior input before harm occurs. As a specialist or senior doctor, competence means remaining clinically relevant, staying updated with evidence, guiding complex cases by example, and making sound decisions during uncertainty. Competence is not optional, it is part of the amanah entrusted to every doctor.
Compassion is the heart of leadership. Leadership is not about being served, it is about serving. Compassion allows a leader to understand the people they serve before making decisions that affect them. In the daily life of a doctor, compassion begins with patients. It is expressed by listening before deciding, explaining diagnoses and plans even when time is limited, and recognising fear, pain, and uncertainty alongside clinical findings. Compassion extends to colleagues and healthcare workers. It is shown by understanding workload and fatigue, correcting mistakes privately rather than humiliating publicly, supporting nurses and allied health professionals, and fostering a safe working environment. In leadership roles, compassion means understanding the impact of policies on people before implementing change, doing the best sincerely without seeking recognition, and remembering that recognition, if it comes, is only a bonus. Without compassion, leadership becomes mechanical and disconnected from those it is meant to serve.
Conscience is the soul of leadership. It is the inner compass that keeps a doctor accountable to Allah above all else. Leadership guided by conscience requires moral courage and clarity. In a doctor’s life, conscience is tested in moments of pressure and power. It is practised when patient safety is prioritised despite inconvenience, when one speaks up against unsafe practices, and when ethical principles are upheld even at personal cost. As authority increases, conscience is reflected in resisting misuse of power, acting with integrity when no one is watching, and remaining sincere when recognition or reward is absent. Towards the later stages of leadership roles, conscience is shown by preparing successors, mentoring juniors, and being ready to let go of position willingly. Leadership is temporary, accountability is not.
Leadership as a doctor is not measured by how long one holds power or how many titles one accumulates. It is measured by how faithfully the trust was carried across a lifetime of service. When competence guides the head, compassion shapes the heart, and conscience anchors the soul, leadership becomes not only effective, but meaningful and sincere. This is leadership that honours the profession, serves humanity, and seeks only the acceptance of Allah.
From a public health perspective, harm reduction is not confined to lowering biological risk alone. It must also address the behaviours that generate that risk. While HIV pre-exposure prophylaxis, or PrEP, is effective in reducing the probability of HIV transmission, it does not modify sexual risk behaviour and cannot replace personal responsibility or behavioural change.
From the standpoint of the Health Belief Model, behaviour is strongly influenced by an individual’s perceived susceptibility and perceived severity of harm. When PrEP is introduced without structured behavioural intervention, it may substantially reduce the perceived risk of HIV transmission. This lowered perception of harm weakens the motivation to change behaviour, resulting in the continuation, or even escalation, of high-risk sexual practices. In this context, PrEP risks undermining the behavioural drivers essential for sustainable prevention.
When PrEP is promoted without mandatory and structured behavioural interventions, it ceases to function as genuine harm reduction and instead becomes a mechanism that enables the continuation of unhealthy and high-risk sexual behaviours under the false assurance of biomedical protection. This represents a shift from prevention to harm containment, which is inconsistent with established public health principles.
Beyond biomedical and behavioural considerations, public health interventions must also recognise the moral, ethical, and spiritual dimensions of human behaviour. For Muslim communities in particular, health promotion should not be detached from faith. Islam emphasises accountability before God, moral conduct, self-restraint, and the pursuit of what is good and beneficial for oneself and society. Prevention strategies should therefore encourage individuals not only to avoid harm, but also to return to values grounded in belief in God and commitment to doing good.
Crucially, HIV prevention and control cannot be addressed by the Ministry of Health alone. It requires a deliberate, coordinated, and sustained multi-agency approach. Ministries responsible for education, youth and sports, higher education, religious affairs, social welfare, women and family development, as well as law enforcement, community leaders, religious institutions, non-governmental organisations, and families must all share responsibility. Behaviour, values, and social norms are shaped far beyond the healthcare system, and ignoring this reality weakens any national response.
The provision of PrEP must therefore be embedded within a comprehensive and structured prevention framework that is multi-sectoral by design. This includes rigorous behavioural risk assessment prior to initiation, continuous sexual health counselling, reinforcement of safer practices, adherence monitoring, and periodic reassessment of ongoing need, supported by education, moral guidance, and community engagement across multiple agencies. Without these elements, the use of PrEP risks normalising sustained high-risk behaviour and may contribute to rising rates of other sexually transmitted infections.
A relevant comparison is nicotine replacement therapy. Nicotine patches are never offered in isolation. They are part of structured cessation programmes with counselling, monitoring, and a clear objective of stopping smoking. PrEP, in contrast, is too often framed as a long-term biomedical solution without a defined behavioural trajectory or exit strategy. This difference is significant and must be addressed in policy and implementation.
If the Ministry of Health advocates PrEP as part of the national HIV prevention strategy, it carries a responsibility to ensure that its delivery is ethically sound, behaviourally anchored, and evidence informed. Biomedical tools must support behavioural change, moral responsibility, and ethical reflection, not substitute for them, and this must be reinforced through coordinated action across agencies.
PrEP can play a role in HIV prevention, but only as an adjunct within a structured, monitored, behaviour-focused, values-conscious, and genuinely multi-agency strategy. Sustainable HIV control will not be achieved through medication alone. Behavioural modification, ethical responsibility, moral guidance, and shared societal accountability remain central and must be treated as non-negotiable components of any effective national HIV prevention programme.
Modern democracies increasingly face a paradox. Leaders are elected through popular vote, yet popularity does not reliably translate into improved communities, functional cities, or stronger nations. Charismatic figures may win elections, dominate public discourse, and command loyal followings, but their tenure often leaves institutions weakened and public trust diminished. This tension forces a difficult question. Is the failure one of leadership, or of society itself?
This paper argues that leadership outcomes in democratic systems reflect not only the quality of leaders but also the moral, cognitive, and institutional maturity of society. Improving leadership therefore requires more than producing better individuals. It requires reshaping the conditions under which leadership is chosen, sustained, and constrained.
Popularity is not leadership
Leadership theory has long distinguished influence from responsibility. Popular leaders are often highly influential, but influence alone does not ensure meaningful outcomes. Transformational leadership theory explains how leaders inspire and mobilise followers through vision and emotional connection. Yet inspiration without ethical grounding, systems awareness, and delivery capability risks becoming performance rather than progress.
The repeated failure of popular leaders to improve cities and nations suggests that charisma, while electorally powerful, is insufficient for governing complex societies. Leadership in complex systems demands moral restraint, competence, and institutional stewardship, qualities that are rarely captured by popularity alone.
Values as the foundation of responsible leadership
Before discussing voter behaviour or institutional constraints, it is necessary to address a more fundamental issue, values. Leadership does not emerge in a moral vacuum. Leaders act based on what they believe is right, acceptable, or negotiable. Likewise, societies choose leaders based on what they admire, tolerate, or excuse.
Values therefore sit at the core of leadership quality. A leader with technical brilliance but weak values may deliver short-term gains while corroding trust, justice, and institutional integrity. Conversely, leaders grounded in strong values are more likely to exercise restraint, accept accountability, and prioritise long-term societal wellbeing over personal or political survival.
From this perspective, nation-building is inseparable from values formation. Development is not merely economic or infrastructural. It is moral and civilisational.
Values shape both leaders and voters
People who believe in and act upon values tend to recognise those same values in leadership. Where honesty, justice, responsibility, and humility are socially respected, leaders who lack these traits struggle to sustain legitimacy. Where values are weak or selectively applied, leaders without integrity can still thrive, provided they remain entertaining, divisive, or symbolically reassuring.
This explains why leadership reform cannot rely solely on replacing individuals. Societies that wish to be led by leaders with values must themselves value integrity, truthfulness, competence, and service. In this sense, leadership choice becomes a mirror of collective moral priorities.
This is not a moral judgement on citizens. It is a sociological reality. People respond to norms that are consistently rewarded in their environment.
A tawhidic perspective on values and leadership
In Islam, values are not socially negotiated preferences. They are rooted in tawhid, the affirmation of the oneness of Allah, which unifies belief, ethics, and action. A tawhidic mind does not separate power from accountability, success from responsibility, or leadership from moral consequence.
From this worldview, leadership is an amanah, a trust, not a personal entitlement. Authority is exercised with the consciousness that all actions are accountable beyond worldly institutions. Justice is not optional, truth is not strategic, and service to people is inseparable from obedience to Allah.
When values flow from tawhid, leadership is restrained by moral consciousness even when institutional oversight is weak. Equally important, a society shaped by tawhidic values is less easily deceived by rhetoric, because it evaluates leaders not only by what they promise, but by how they act, decide, and govern.
Thus, values in Islam are not abstract virtues. They are operational principles that shape governance, accountability, and public trust.
Leadership outcomes depend on decision conditions, not voter character
It is tempting to conclude that societies simply choose poorly. This framing is misleading. Behavioural science shows that individuals operate under bounded rationality. Faced with complex policy choices, people rely on emotional cues, identity alignment, familiarity, and trusted narratives. These are not moral shortcomings but cognitive adaptations to uncertainty and information overload.
However, values influence which cues people trust. Where values are strong, emotional manipulation loses effectiveness. Where values are weak or fragmented, deception becomes easier. The quality of leadership choice is therefore shaped by both cognitive constraints and moral orientation.
Institutions determine whether values are protected or eroded
Strong institutions reinforce values by making ethical behaviour normal and misconduct costly. Weak institutions allow values to be overridden by expediency and personality. Over time, this erodes public expectations, creating a cycle where both leaders and citizens lower their standards.
Institutions alone cannot create values, but they can protect them. Likewise, values alone cannot guarantee good leadership, but they provide the moral compass without which institutions become hollow.
Civic maturity is cultivated, not innate
The ability to evaluate leadership is learned. Civic maturity develops when societies normalise ethical reasoning, discuss trade-offs honestly, and expose manipulation without cynicism. Education, public discourse, and moral leadership all contribute to this maturation.
In societies where values are continuously reinforced, leadership quality improves not through coercion, but through expectation.
Conclusion
It is accurate to say that people matter in a democratic system. It is incomplete to say that people simply need to change.
Leadership quality emerges from the interaction between values, institutions, and public choice. In the absence of values, popularity becomes dangerous. In the absence of institutions, values become fragile. In the absence of informed citizens, both are easily undermined.
From an Islamic perspective, strengthening leadership therefore begins with strengthening values grounded in tawhid. A society that believes and acts upon values will choose leaders with values, not perfectly, but consistently enough to change its trajectory.
Ultimately, societies do not merely elect leaders. They cultivate them.
As someone who works in education, I often think about how AI is changing the way we learn and teach. Artificial intelligence has become part of our daily routine, from helping us write to generating art or analysing data. It makes things faster and more convenient, but I sometimes wonder if it also makes us forget what being human really means. Professor Osman Bakar, in his recent essay Artificial Intelligence and the Future of Creative Thinking: A Reflection from Islamic Perspective (2025), raises the same concern. He reminds us that the question is not how powerful AI can become, but how wisely we decide to use it.
He writes that AI, like all forms of knowledge, carries both benefit and harm. It can stimulate creativity and make learning more accessible, but it can also weaken our capacity for deep thought, especially when we let machines do the thinking for us. He shares Sweden’s experience of moving education from printed textbooks to digital tools, which coincided with a decline in reading comprehension and overall student well-being. The lesson is clear: technology is useful, but it is not neutral. It shapes how we think and who we become.
In Islam, knowledge is also never neutral. The Prophet Muhammad (peace be upon him) taught us to seek ‘ilm naf‘, or beneficial knowledge, and to seek refuge from unbeneficial knowledge. This means that knowledge becomes valuable only when it improves the human being, both morally and spiritually. Professor Osman argues that AI should be guided by this same principle. It must help us grow in wisdom and compassion, not just in productivity or speed.
He also reminds us to keep AI in its proper place. The machine can process information, but it cannot determine what is good or right. Only humans, guided by intellect (‘aql) and spirit (ruh), can make that judgment. AI should therefore assist us in developing creativity and critical thinking, not replace them. If we rely too heavily on technology to think for us, we risk losing our sense of purpose and accountability.
Another point he makes is about balance. While digital tools can enrich education, they should not completely replace traditional and physical forms of learning. Reading a printed book, having a real conversation, or reflecting quietly on what we have learned are still vital experiences that shape our character. Over-digitalisation may make learning more efficient, but it can also make it shallow. Without space for empathy, humility, and reflection, education loses its human soul.
The heart of Professor Osman’s idea is the unity between intellect and spirituality. True creativity, he says, happens when the mind and the soul work together. Thinking without spirituality becomes cold and mechanical. Spirituality without thinking can become blind and directionless. When both are integrated, creativity becomes meaningful, ethical, and transformative. In that sense, AI can be a tool that helps us think better, as long as we use it with moral awareness and spiritual grounding.
For Muslim educators, researchers, and students, this has real implications. We need to design AI applications that serve higher goals. AI should help us address issues that truly matter, such as improving public health, promoting justice, caring for the environment, and nurturing compassion. It should not exist simply to make us faster or wealthier. Ethical principles drawn from maqasid al-shariah (the objectives of Islamic law) should guide how we create and use technology, ensuring it protects life, intellect, faith, lineage, and property.
At the end of his essay, Professor Osman quotes a hadith stating that the world will not end until no one remembers God. It is a profound reminder that remembrance of the Divine is the foundation of human existence. Without that remembrance, all our progress loses meaning. In the same way, if AI advances but humanity forgets its spiritual purpose, we will end up with brilliant machines and empty hearts.
Perhaps the real question for our time is not how intelligent AI can become, but how wise we can remain while using it. Technology will continue to evolve, but our task is to ensure it serves what is good, just, and beneficial. As Professor Osman beautifully reminds us, knowledge must be both true and good. AI, too, must follow that path.
So, as generative tools like ChatGPT become part of our daily thinking and writing, how can we really adapt them to nurture not only intelligence but also conscience and compassion?
Reference
Bakar, O. (2025). Artificial intelligence and the future of creative thinking: A reflection from Islamic perspective. In The Muslim 500, 2025 Edition. The Royal Islamic Strategic Studies Centre. https://themuslim500.com/2025-edition/guest-contributions-2025/artificial-intelligence-and-the-future-of-creative-thinking-a-reflection-from-islamic-perspective/
Statistics is the science of learning from data. Every time researchers use a sample to understand a population, they are practising statistical inference. Over the past century, the way we make these inferences has changed dramatically. Each new approach has brought a different philosophy about what “truth” means and how we can best estimate it.
This article explains the main schools of thought in statistical inference, showing how they evolved from the early 1900s to the computer age. The discussion draws on Efron and Hastie’s Computer Age Statistical Inference (2021), which describes how classical, Bayesian, resampling, and modern computational methods all aim to uncover truth from limited data.
The Classical or Frequentist Era
The first formal school of statistical inference is known as the classical or frequentist approach. Developed by statisticians such as Ronald Fisher, Jerzy Neyman, and Egon Pearson in the early twentieth century, this framework treats the truth as something fixed but unknown. The data we observe are random samples from a larger population, and by studying these samples, we can estimate the true values that describe the population (Efron & Hastie, 2021).
In this view, probability represents the long-run frequency of events. For example, if we say there is a 5 percent chance of a test result being significant when there is no real effect, we mean that if we repeated the same experiment many times, about 5 out of 100 would show a false signal.
A key tool in this school is maximum likelihood estimation (MLE). It finds the values of unknown parameters that make the observed data most likely. This approach became the foundation for many classical methods, including hypothesis testing and confidence intervals. Classical inference is elegant and mathematically precise, but it depends on strong assumptions and analytical formulas. As problems became more complex, those formulas were often too difficult to compute.
The Bayesian Revival
An alternative view, known as Bayesian inference, was proposed much earlier, by Reverend Thomas Bayes in the 1700s. However, it became practical only in the late twentieth century, when computers made its calculations possible. Bayesian inference treats truth as something we hold beliefs about rather than something fixed and unknown.
In this view, we start with a prior belief—what we think is likely before seeing any data—and then update it using the evidence we collect to form a posterior belief. The process reflects how humans naturally think and learn. For instance, a doctor might believe a patient probably has a certain illness based on symptoms, but then revise that belief after seeing lab results.
Unlike classical inference, which relies on repeated sampling theory, Bayesian methods focus on how data change our level of belief. This approach is flexible and intuitive, but it requires specifying prior beliefs, which can introduce subjectivity. With modern computing, especially techniques such as Markov Chain Monte Carlo (MCMC), Bayesian methods have become widely used in fields such as medicine, economics, and artificial intelligence (Efron & Hastie, 2021).
The Resampling Revolution
By the 1980s, statisticians began to take advantage of computers to bypass complicated formulas entirely. Bradley Efron introduced the bootstrap, a resampling method that lets data “speak for themselves.” Instead of depending on mathematical derivations, the bootstrap repeatedly resamples from the observed data to estimate variability and uncertainty (Efron & Hastie, 2021).
This approach belongs to what Efron and Hastie call the computer age of inference. It does not require assumptions about theoretical distributions or prior beliefs. Instead, it uses the computer to generate thousands of simulated datasets from the original sample. By examining how results vary across these resamples, statisticians can understand how stable or uncertain their findings are.
Resampling methods changed the practice of statistics. They made inference accessible for complex problems where mathematical solutions were impossible. The bootstrap also bridged classical and modern approaches, keeping the idea of estimation but relying on computation instead of theory.
The Modern Predictive and Machine Learning Era
As data grew larger and more complex, statisticians faced a new challenge. Classical and Bayesian models often became too limited or too slow to handle modern datasets with thousands of variables. This led to new methods that emphasised prediction rather than pure inference.
Techniques such as penalised regression (for example, ridge and lasso regression) and machine learning algorithms emerged to handle this complexity. These approaches trade a little accuracy for much greater stability and predictive power. Instead of focusing on exact parameter estimates, they aim to predict outcomes reliably for new data (Efron & Hastie, 2021).
Philosophically, this represents a shift from “What is the true parameter?” to “Can we make good predictions?” Machine learning methods such as decision trees and neural networks no longer rely on probability theory in the traditional sense. They learn directly from data patterns and have transformed fields such as healthcare, finance, and climate science.
Comparing the Philosophies
Each school of inference reflects a different way of thinking about knowledge and truth.
School
View of Truth
View of Probability
Key Question
Classical (Frequentist)
Truth is fixed; data are random
Long-run frequency
What value makes the data most likely?
Bayesian
Truth is uncertain; beliefs can change
Degree of belief
How should we update what we believe after seeing data?
Resampling
Truth can be estimated from data directly
Empirical variation
What does the data itself say about uncertainty?
Modern Predictive / Machine Learning
Truth may be too complex to model
Often not used explicitly
How can we best predict new outcomes?
Despite their differences, these schools share one purpose: to draw meaningful conclusions from imperfect data. Each arose to overcome the limitations of the previous one. The classical approach provided solid mathematical foundations. The Bayesian approach added flexibility and belief updating. Resampling empowered statisticians through computation. Modern predictive methods embraced the complexity of real-world data.
Conclusion
The story of statistical inference is the story of how humans have tried to reason about the unknown. From equations written by hand to millions of simulations run by computers, each generation of statisticians has pushed the boundaries of what can be learned from data.
Efron and Hastie (2021) describe this journey as a transition from the “formula age” to the “computer age.” The essence of inference, however, remains the same: using limited evidence to understand the world. Whether through classical, Bayesian, resampling, or machine learning approaches, all aim to find truth in uncertainty and to make knowledge from data.
References
Efron, B., & Hastie, T. (2021). Computer age statistical inference: Student edition. Cambridge University Press.
We live in the Anthropocene, an era defined by human impact on the planet. From greenhouse gases altering the climate to plastics filling our oceans, the footprint of humankind is everywhere. While this age is often spoken of with despair, Islam offers a way of looking at the world that can transform how we live in it.
The Islamic lens shifts our gaze. Planetary health is not only about survival or managing resources. It is about recognising the Creator, honouring the trust He has placed on us, and living responsibly in balance with the rest of creation.
Consumption and moderation
The Anthropocene is marked by overconsumption: fast fashion, fast food, endless energy demands. Islam teaches the opposite: eat and drink, but waste not by excess (Qur’an 7:31). Imagine if Muslims, who number nearly two billion, practiced this daily. Wasting less food, eating simply, and valuing halal and tayyib (wholesome) consumption would reduce emissions from food production, cut landfill waste, and preserve resources. A prophetic tradition teaches us to use water sparingly even while standing by a flowing river. In the Anthropocene, where water stress affects billions, such guidance is transformative.
Balance in land and resources
Deforestation, soil degradation, and loss of biodiversity define the Anthropocene. The Qur’an describes creation as set in mīzān (balance) and warns not to disrupt it. Classical Islamic societies applied this through hima (protected zones) where grazing and logging were restricted to preserve ecosystems. Reviving this ethic today could mean Muslims leading in protecting forests, restoring landscapes, and creating green sanctuaries in cities. Restoring balance is not only ecological work but also a fulfilment of our role as khulafā’ (trustees).
Energy and responsibility
The burning of fossil fuels drives much of the Anthropocene’s crisis. While large systems are slow to change, Islamic ethics can shape individual and community responsibility. A mosque that runs on solar power, an institution that reduces energy waste, or families that choose public transport over private cars are all examples of acts of worship. When energy use is guided by the principle of amānah (trust), conservation becomes an expression of faith.
Waste and plastics
Plastic is a defining pollutant of our age, choking rivers and oceans. Islam directly prohibits wastefulness. The Prophet ﷺ taught that even a small crumb of bread should not be discarded. This mindset, if truly lived, means resisting the throwaway culture of the Anthropocene. Carrying reusable containers, supporting circular economies, and avoiding single-use plastics become not only environmental actions but also spiritual duties.
Justice across generations
The Anthropocene has created deep inequities. The poorest often suffer most from climate change while contributing least to its causes. Islam’s principle of justice (ʿadl) and doing good (iḥsān) requires that we think of others, including future generations. Cutting waste, living simply, and advocating for fair policies are ways Muslims can enact intergenerational justice. The Prophet ﷺ said: “If the Final Hour comes while you have a seedling in your hand, plant it.” This teaching encourages us to act responsibly today even if we may not see the results.
A different Anthropocene
If Muslims were to live fully by these principles of moderation, balance, justice, and responsibility, the Anthropocene would look very different. Instead of being an age defined by human exploitation, it could become an age defined by human stewardship.
Planetary health through an Islamic lens is not only about protecting ecosystems but also about aligning our daily lives with the recognition of Allah. In doing so, we rediscover balance, reduce waste, live responsibly, and honour the trust of creation. That is how Islam, if practiced with consciousness, can truly change the world.
Speech to the MBBS Graduates of the Kulliyyah of Medicine, IIUM 2025
My dear graduates,
Today is a moment of deep significance — not just for you and your families, but for all of us at the Kulliyyah of Medicine. We come together to celebrate your journey, your sacrifices, and your growth. But more than that, we celebrate the beginning of your noble path ahead as doctors who will serve not just with skill, but with soul.
At IIUM, we have always aspired to produce more than just competent doctors. We have aspired to nurture healers. Healers who see their work as an act of worship. Healers who recognise that every breath of a patient, every touch of healing, every word of comfort — is part of their ibadah. This is what we mean when we say: medicine with a soul.
In our Kulliyyah, we uphold a Tawhidic epistemology — a worldview where all knowledge comes from Allah and must lead back to Him. Tawhid is not only the foundation of our faith; it is the foundation of how we teach, how we learn, and how we serve. And so, when you step into the hospital or the clinic, you do so not only as a professional, but as someone who carries the weight of trust — a trust from Allah, a trust from the ummah.
You are graduating into a world that is in need of people who are not only skilled, but principled. Not only precise, but compassionate. Not only efficient, but ethical. That is why we remind you — competence, compassion, and conscience must always go together. They are not three separate paths. They are one.
Competence is the foundation. It is your clinical judgment, your scientific knowledge, your professional performance. It is the standard we all expect of you. It is what allows your patients to trust you. But competence alone is not enough.
Compassion is the heartbeat of medicine. Without it, even the best treatment feels cold. With it, even simple care can become transformative. And yet, compassion will be tested. There will be moments when you feel exhausted, discouraged, or detached. That is when you must renew it — by returning to Allah, by recalling your niyyah, by reminding yourself that you are here to serve.
Conscience is your internal compass. It is the integrity you uphold when no one is watching. It is your fear of Allah and your love for the truth. It will protect you when systems fail you. It will anchor you when everything else becomes uncertain.
You chose this path because you felt a calling. A desire to help. A desire to heal. That desire must always be kept alive, not for applause or accolades, but because you see this profession as part of your faith. That is what makes your work sacred. Every diagnosis you make, every decision you take, is an act of responsibility and submission.
The world will not always be kind. The job will not always be easy. There will be pressure, bureaucracy, burnout. And yet, I want you to remember — compassion is not finite. It can be replenished. Through prayer. Through rest. Through reflection. When you feel tired, do not only rest your body. Rest your heart in the remembrance of Allah.
Remember also that you are not alone. You are part of a family — this Kulliyyah, this university, this ummah. Reach out when you need help. Lean on your peers. Stay close to your mentors. Keep learning. Keep growing.
Your graduation is not an end. It is the beginning of a lifelong commitment to serve, to uplift, and to bring healing. You are now ambassadors of the Kulliyyah of Medicine and the spirit of IIUM. You carry with you a sacred trust — to practise medicine with a soul.
May Allah SWT bless you, protect your sincerity, and make your hands a means of healing, your tongue a source of comfort, and your heart a light for those in darkness. May He guide you with wisdom, strengthen you with patience, and reward your service with barakah in both worlds.
Congratulations, my dear doctors. May your journey be one of competence, compassion, and conscience.
In the history of psychiatric research, few studies have made an impact as profound as David Rosenhan’s 1973 paper, “On Being Sane in Insane Places.” It challenged the validity of psychiatric diagnosis and exposed the depersonalisation of patients in mental hospitals. Decades later, journalist Susannah Cahalan revisited the same study in her 2019 book, The Great Pretender, only to uncover troubling questions about its accuracy and documentation. Together, their work presents more than a disagreement. It is a reminder that no matter how compelling a message may be, research must rest on a foundation of reliable records and sound methodology.
Rosenhan’s Experiment
Rosenhan led a group of eight pseudopatients who each presented themselves at different psychiatric hospitals claiming to hear voices. Once admitted, they behaved entirely normally and reported no further symptoms. Despite this, all were diagnosed with serious mental illnesses, mostly schizophrenia, and were prescribed strong antipsychotic medication. The average hospital stay was 19 days, with one patient held for 52 days. None were identified by staff as imposters, although other patients often suspected the truth.
In a second phase, a hospital challenged Rosenhan to send more pseudopatients as a test of their ability to detect imposters. Over the following months, the staff identified 41 such individuals. In reality, Rosenhan had sent no one. This revealed how psychiatric labels could cloud judgement and foster error.
The study was published in Science and quickly became one of the most influential critiques of psychiatry. It led to greater scrutiny of mental health institutions, the development of new diagnostic manuals, and the closure of many asylums.
Cahalan’s Re-examination
Susannah Cahalan approached Rosenhan’s study with admiration, but her investigative journey revealed serious flaws. Despite extensive effort, she was only able to locate two of the supposed eight pseudopatients. The others could not be verified. Hospital records, raw data, and detailed transcripts were either missing or had never been released. Even more concerning, one of the individuals who had taken part described their experience positively, in contrast to Rosenhan’s bleak narrative.
Cahalan also discovered an unpublished manuscript written by Rosenhan. It contained inconsistencies and altered case details, raising concerns that parts of the study may have been exaggerated or fictionalised. This lack of transparency stood in sharp contrast to the study’s enduring influence.
Scientific Integrity
Rosenhan’s core argument about the dangers of psychiatric labelling was valid. However, the absence of clear documentation raises questions about the reliability of his findings. The study lacked:
Clear and replicable methodology Comprehensive records and raw data Transparency in patient selection and hospital procedures
Scientific research depends on verifiability. Without access to original data, no study can be replicated or properly critiqued. Rosenhan’s failure to preserve and share such records weakens the credibility of what was once considered a foundational piece of psychiatric literature.
Why This Still Matters
The debate between Rosenhan and Cahalan is not only about psychiatry. It highlights a broader concern within science: the need for rigorous, accountable research practices. Especially in fields that affect people’s lives so directly, such as mental health, ethical research must be rooted in truth and open to scrutiny.
Public trust in science depends not only on powerful stories, but on the integrity of the research behind them. Narrative alone cannot replace evidence. Researchers must ensure that their work can withstand examination, even many years after it is published.
Conclusion
Rosenhan’s study brought attention to real issues in mental health care, and Cahalan’s investigation reminded us that lasting change must be based on fact, not fiction. Their contrasting accounts demonstrate that bold claims require careful evidence. Proper documentation, transparent methods, and reproducibility are not optional features of good science. They are its very foundation. Without them, the line between truth and assumption becomes dangerously unclear.
References
Cahalan, S. (2019). The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness. New York, NY: Grand Central Publishing.
Rosenhan, D. L. (1973). On being sane in insane places. Science, 179(4070), 250–258. https://doi.org/10.1126/science.179.4070.250
Spiegel, A. (2008, July 31). On being sane in insane places: Revisiting a classic study. NPR. https://www.npr.org/templates/story/story.php?storyId=93646216
Carey, B. (2019, November 27). The Rosenhan experiment: On being sane in insane places. The New York Times. https://www.nytimes.com/2019/11/27/books/review/the-great-pretender-susannah-cahalan.html
The modern university, especially in the fields of science and medicine, often functions within a paradigm that disconnects knowledge from values, science from ethics, and intellect from faith. This fragmented epistemology, rooted in secular modernity, results in professionals who are technically proficient but morally and spiritually unmoored. In the Muslim world, this disjunction has precipitated a crisis of meaning in education.
The International Islamic University Malaysia (IIUM), since its inception, has sought to address this crisis through the vision of Islamisation of Human Knowledge (IoHK). First conceptualised by Syed Muhammad Naquib al-Attas and institutionalised by IIUM’s early leadership, especially the late Tan Sri Professor Dr. Mohammad Kamal Hassan, the founding Rector, IoHK proposes that all branches of knowledge must be critically assessed, purified, and realigned with Islamic values, ethics, and metaphysical worldview.
This foundational vision has evolved. Under the guidance of Professor Emeritus Datuk Dr. Osman Bakar, the current Rector of IIUM, the process of Islamisation is being deepened through the framework of Tawhidic Epistemology (TE). TE serves not only as a tool for knowledge reform but also as a worldview that re-centres all human inquiry on tawhid, the oneness of Allah.
In the Kulliyyah of Medicine (KOM), this renewed vision is operationalised through seven TE principles, which guide the holistic development of future Muslim doctors, competent in skill, rich in character, and conscious of divine accountability.
Tawhidic Epistemology – Rebuilding the Unity of Knowledge
Tawhidic Epistemology asserts that all knowledge, whether revealed (naqli) or acquired through reason (aqli), emanates from a single divine source. It rejects the artificial division between “religious” and “secular” knowledge and calls instead for a unified understanding of reality, rooted in tawhid.
TE addresses the intellectual fragmentation of modern education by emphasising:
The unity of truth under the oneness of Allah
The integration of scientific inquiry with spiritual ethics
A holistic view of the human being as a physical, moral, intellectual, and spiritual entity
This philosophy underpins the contemporary direction of IIUM. Rector Osman Bakar’s notion of the Tawhidic Mind, Ummatic Mind, and Ummatic Excellence encapsulates a developmental framework in which students are nurtured to become not only learned individuals but ethical leaders and khalifahs of Allah.
Seven Principles of Tawhidic Epistemology in Medical Education
1. Unify Divine Knowledge
Students are taught that the Qur’an, Prophetic traditions, and empirical knowledge are not in conflict but are harmonious components of a unified truth.
Example 1: In organ transplantation modules, students learn both the medical criteria and the ethical rulings from Islamic jurisprudence, fostering an integrated approach to decision-making.
Example 2: In anaesthesiology, students examine the issue of euthanasia by exploring both biomedical perspectives, such as the management of end-of-life pain and palliative sedation and Islamic ethical positions, which uphold the sanctity of life and prohibit any form of deliberate life-ending interventions. This integrative teaching helps students distinguish between relieving suffering and violating divine principles regarding life and death.
2. Uphold Ethical Trust
Knowledge is an amanah, a trust from Allah. This principle instils sincerity, fairness, and accountability as part of the student’s ethical compass.
Example 1: Research ethics and professional conduct are framed as spiritual obligations, not merely institutional requirements. Students are taught that informed consent, avoiding plagiarism, and honest data reporting are forms of worship when done with integrity and consciousness of divine accountability.
Example 2: In clinical practice, maintaining patient privacy and dignity is emphasised as both a professional and spiritual duty. For example, when examining patients of the opposite gender, students are trained to use a chaperone, lower their gaze, and seek consent respectfully, upholding Islamic adab (etiquette) while fulfilling clinical responsibilities.
3. Pursue Higher Purpose
Through the Ummatic Mind, students are aligned with the maqasid al-shariah (higher objectives of Islamic law), such as the preservation of life, intellect, and faith. Medical education is framed not merely as skill acquisition, but as a sacred journey that integrates clinical excellence with spiritual awareness.
Example 1: The intention behind treating patients is not only to preserve life and advance knowledge in medicine, but also to serve as a means of drawing both the caregiver and the patient closer to Allah. This transforms everyday clinical tasks into acts of worship and service to humanity.
Example 2: In palliative care training, students are taught to go beyond symptom control by addressing the emotional, psychological, and spiritual dimensions of dying. Upholding dignity at the end of life becomes an act of compassion and a reflection of the Islamic value of mercy (rahmah).
4. Contribute Meaningful Impact
Knowledge must serve the ummah and uplift the marginalised. Learning is not solely for personal success, but for advancing social justice, improving equity, and fulfilling the duty of khilafah (stewardship) on Earth.
Example: During the community medicine posting, students engage in health outreach activities in underserved and remote areas. These efforts, which include screening programmes, health education, and preventive care, go beyond academic fulfilment. They are expressions of the Islamic imperative to use knowledge in the service of others, especially the vulnerable and neglected.
5. Develop Professional Mastery
Professional mastery in medicine demands the structured attainment of competencies, not only in clinical knowledge and technical skills but also in communication, decision-making, and professionalism. Within the Tawhidic framework, competence is pursued as an obligation (fard) and a form of amanah (trust), to ensure safe, effective, and ethical care.
Example: The curriculum is designed to ensure students achieve clearly defined learning outcomes and clinical competencies, including history-taking, examination, procedural skills, and clinical judgement. These are continuously assessed through workplace-based methods and objective clinical examinations, ensuring graduates are both capable and accountable in fulfilling their professional responsibilities.
6. Embody Compassionate Care
Inspired by the divine attribute of rahmah (mercy), compassion in medical practice is seen as a form of renewed empathy that is conscious, purposeful, and ethically grounded. It involves a sincere commitment to alleviate suffering, preserve human dignity, and foster meaningful human connections.
Example: Communication training emphasises emotional intelligence and empathy, especially in situations such as delivering difficult news or managing patients with chronic and terminal illnesses. Students are taught to listen attentively, respond sincerely, and maintain a respectful presence. This compassionate approach extends beyond patients, fostering kindness and mutual respect in interactions with colleagues, healthcare staff, and the wider medical team.
7. Practice Moral Integrity
Spiritual growth must be accompanied by a strong moral compass that guides both personal and professional conduct. This principle draws upon the concepts of ihsan (excellence in worship and character) and tazkiyah (purification of the soul), nurturing sincerity, truthfulness, and ethical discipline in all aspects of life.
Example: Students are taught that integrity applies to every action, from being honest in assignments and examinations to being truthful in logbooks and research reports. For staff, this extends to making accurate claims and fulfilling responsibilities with trust and fairness. Upholding Islamic adab includes maintaining respectful and appropriate interactions across genders, observing Shariah-compliant boundaries in communication and behaviour. Moral integrity is nurtured not only for personal salvation but also to uphold public trust and professionalism in medicine.
Islamisation of Knowledge – Reforming the Content
While TE provides the worldview, Islamisation of Knowledge remains the methodological backbone of IIUM’s academic reform. It aims to critique, filter, and reconstruct modern knowledge according to Islamic ethical and ontological principles.
At KOM, this includes:
Evaluating medical knowledge through the lens of Shariah and ethics
Reintroducing Islamic concepts into contemporary discourse on health
Creating new integrative models of care based on the Islamic view of the human being
Examples:
Mental health modules include nafs, qalb, and fitrah alongside DSM-based diagnosis.
Public health courses incorporate maqasid-oriented strategies.
Students conduct research exploring the intersection of Islamic ethics and epidemiology.
Tawhidisation and Islamisation – Complementary Approaches
Aspect
Tawhidic Epistemology
Islamisation of Knowledge
Nature
Foundational worldview based on tawhid
Methodological process for content reform
Focus
How knowledge is sourced, internalised, and valued
How knowledge is critiqued, refined, and applied
Function
Shapes the learner’s consciousness and ethical disposition
Shapes the curriculum and scholarly output
Application
Seven TE principles guide the values and learning culture
Islamised content in clinical, behavioural, and social sciences
Conclusion
The journey of IIUM, from its Islamisation of knowledge focus to its expansion into Tawhidic Epistemology, reflects a continuous pursuit of holistic and purposeful education. These are not competing philosophies, but rather stages in the development of an Islamic intellectual tradition that seeks to integrate revelation, reason, and reality.
In medical education, this integration results in a curriculum that goes beyond technical training. At KOM, Tawhidic Epistemology influences the mindset. Islamisation of Knowledge reforms the curriculum content. Together, they guide the formation of doctors who are technically skilled, spiritually aware, and socially responsible.
This represents a medicine with a soul. It signifies a return to the Islamic civilisation’s tradition of learning that heals both the body and the spirit, and a renewal of education as a sacred trust to be fulfilled in the service of Allah and humanity.
References
Al-Attas, S. M. N. (1978). Islam and secularism. Muslim Youth Movement of Malaysia.
Bakar, O. (2022). Tawhid and science: Islamic perspectives on religion and science. Penerbit UTM Press.
Hassan, M. K. (1981). A return to the Qur’anic paradigm of development and its implications for education policy and the curriculum. International Institute of Islamic Thought and Civilization.
Nasr, S. H. (1968). Science and civilization in Islam. Harvard University Press.
Rahman, F. (1982). Islam and modernity: Transformation of an intellectual tradition. University of Chicago Press.
Vaping has emerged as a growing public health and security crisis in Malaysia. Once promoted as a safer alternative to smoking, vaping is now strongly linked to nicotine addiction, youth uptake, serious health harms, and even drug abuse. The enforcement of the Akta Kawalan Produk Merokok Demi Kesihatan Awam 2024 (Act 852), effective 1 October 2024, is a positive step but its implementation has proven difficult. The Ministry of Health (MOH) is now burdened with too many roles including policymaking, regulation, licensing, monitoring, and enforcement. With limited resources, MOH cannot manage this growing threat effectively. An immediate ban on all vape products is necessary. In the longer term, stronger measures must be taken to restrict cigarette use and move toward a smoke-free future.
Key Issues
1. Act 852 is difficult to implement
Act 852 requires comprehensive regulation of vape products, including licensing of all retailers, monitoring of product contents and marketing, control of online and physical sales, and enforcement of advertisement bans. MOH is expected to take full responsibility for these tasks while also managing other core public health functions. This regulatory and enforcement burden is unrealistic and unsustainable.
2. Vaping is not harm reduction
Peer-reviewed research in BMJ Open (2023) involving ASEAN tobacco control experts confirms that nicotine vaping products are not viewed as effective cessation tools and are instead considered a public health threat. Most adult vapers in Malaysia (75%) are dual users who continue smoking cigarettes, thus undermining the notion of risk reduction.
3. Vaping causes serious health harms
Published studies report that Malaysian vape users commonly experience dry mouth, cough, headaches, and dizziness. More severe outcomes include EVALI (e-cigarette or vaping product use-associated lung injury), which has been documented in Malaysia. Each case costs an estimated RM150,000 to treat, with a projected national healthcare burden of RM368 million annually by 2030 if left unregulated.
4. Estimated cost burden for Malaysia
With over 1 million adult daily users in Malaysia (based on 5.4% prevalence), even a 0.1% complication rate requiring hospitalisation would result in 1,000 EVALI cases annually. At RM150,000 per case, this would translate to RM150 million in direct inpatient costs alone, not accounting for outpatient care, productivity loss, or future chronic disease management. Meanwhile, vape tax revenue of RM500 million per year is unlikely to cover the rising health and enforcement costs.
5. Vaping as a vehicle for drug abuse
An increasingly alarming trend in Malaysia involves the misuse of vape devices as covert drug delivery tools. Law enforcement and the National Anti-Drugs Agency (AADK) have reported seizures of vape devices containing methamphetamine, ketamine, THC oil, and synthetic cannabinoids. These substances are often inhaled using modified pods or liquids indistinguishable from regular vape products. Students and youths are particularly vulnerable due to the discreet nature of vape use, making enforcement nearly impossible under current regulations. This trend represents both a public health emergency and a national drug control challenge.
Policy Recommendations
1. Ban all vape products immediately
Enact a full ban on the manufacture, import, sale, promotion, and possession of all vape devices and liquids. Strengthen controls on online and cross-border purchases. Declare a national public health and security emergency linked to youth vaping and drug misuse.
2. Reduce the burden on MOH
MOH should focus on public health policy, surveillance, and prevention. Licensing, inspections, and enforcement functions should be delegated to other agencies, including municipal councils and the Ministry of Domestic Trade. MOH resources should be redirected toward cessation programmes and school-based health promotion.
3. Begin long-term restrictions on cigarette sales
Malaysia should adopt a structured roadmap toward a cigarette-free society. Immediate steps include increased tobacco taxation, plain packaging, limiting retail outlets, and expanding access to evidence-based cessation support. Stronger action is also needed against illicit tobacco trade.
References
Gravely, S., Yong, H. H., Reid, J. L., et al. (2022). The prevalence of e-cigarette use in Malaysia: Findings from the 2020 ITC Malaysia Survey. Tobacco Induced Diseases, 20(42). https://doi.org/10.18332/tid/146917 Wong, L. P., Alias, H., Aghamohammadi, N., et al. (2023). Self-reported side effects, dependence, and behaviour in e-cigarette users in Malaysia. Substance Abuse Treatment, Prevention, and Policy, 18(1). https://doi.org/10.1186/s13011-023-00558-7 Hamilton, W. L., et al. (2022). E-cigarette markets and policy responses in Southeast Asia: A scoping review. International Journal of Health Policy and Management, 11(10), 2236–2246. https://doi.org/10.34172/ijhpm.2021.104 De Guia, M. C., et al. (2023). Implications of nicotine vaping products for tobacco control in ASEAN LMICs: In-depth interviews with experts. BMJ Open, 13(9): e073106. https://doi.org/10.1136/bmjopen-2023-073106 Ibrahim, N., et al. (2023). Emerging trends in drug delivery through vaping devices. Frontiers in Public Health, 11:1198763. https://doi.org/10.3389/fpubh.2023.1198763 United Nations Office on Drugs and Crime (UNODC). (2021). Synthetic Drugs and Novel Psychoactive Substances: A Global Threat. https://www.unodc.org Ministry of Health Malaysia. (2024). Cost estimation for EVALI treatment and projections. MOH official communications reported in multiple government briefings.