For all his gloss and polish - and his dexterity in deploying fashionable jargon - Ramadan displays a medieval mindset. This is apparent in the most "radical" of his proposals, that the classical sources of legal theory - the Koran and prophetic traditions, the practice of analogy, the consensus of the community - be expanded to include the "Universe". Ramadan capitalises the word because he views creation as a kind of text mirroring the Koranic revelation. This is the "context" which stands in divine correlation with the "text". If creation itself is considered a "root" of the law, it behoves Muslim scholars to include scientific and humanistic studies in their training, so that their rulings can reflect the actual complexity of the contemporary world. This isn't a bad idea but there's nothing new about it. It is as old as Islam itself and turns on the fact that the Arabic word ayah signifies both a Koranic "verse" and "a sign". This led commentators, and especially mystics, to search out correspondences, sometimes of the most literal sort, between the Koran and the creation. There is a vast literature in Arabic and Persian on the "wonders of creation" which takes its inspiration from this linguistic coincidence.

What does this mean in practice? Though Ramadan denies that he wishes to "Islamise modernity", his proposals for reform seem designed to do just that. At every stage, whether he is discussing medical ethics or scientific research or the status of women, he takes pains to give these subjects an Islamic spin. Even when he appears commendably broad-minded he insinuates little disclaimers to qualify his position. Sometimes these are comical. When he discusses the Hippocratic Oath, for example, he notes that "the framework established by Hippocrates - like its many later versions - created no problem as far as medical practice itself was concerned, but it did give rise to reservations regarding the references it included (initially, ancient gods) or those it did not include (no reference to a Creator or a religious framework)". As an alternative, he offers the oath formulated at the first International Conference on Islamic Medicine, held in Kuwait in 1981, which among provisions enjoining physicians "to protect human life in all its stages", includes such items as the following: "To be, all the way, an instrument of God's mercy, extending my medical care to near and far, virtuous and sinner and friend and enemy" and "To keep people's dignity, cover their privacies and lock up their secrets." What is striking in this document, apart from its quaintness, is that it is at such pains to spell out what most of us take for granted. After all, what reputable physician would even pause to consider whether a patient was virtuous or sinful? As in Ramadan's own proposals, it's what's left unsaid that disturbs: the implication that in an "Islamised" medicine, a pious quack might be more concerned with patients' morals than with their health, however he may be admonished to "cover their privacies".