Department of Philosophy and Classics
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Item Bioethics In Africa: A Contextually Enlightened Analysis Of Three Cases(Developing World Bioethics, 2021) Jecker, N.S.; Atuire, C.Across sub-Saharan Africa, bioethics is an emerging field of scholarly inquiry informed by contextual features distinct to the region. a cultural mix comprised of European influences, indigenous traditions, Christian faiths, and Muslim communities, a bioethics for the sub-Saharan region must be responsive to this milieu. This paper asks: What values and methods can best promote the practice of bioethics in Africa? We set forth a strategy that leans one way or another in response to the contextual features of a particular setting. Since our aim is to be responsive to context, we begin with a series of cases and develop values and methods in response to each case as we work through its ethical analysis. Section 1 introduces a case involving setting priorities for public funding of services that produce large benefits for a small group of people, using the example of dialysis in Ghana. Section 11 presents a situation involving determining the permissibility of a double standard of quality for healthcare devices in rich and poor nations, using the example of explanting peacemakers from deceased people in wealthy nations for use by people in low and middle-income nations. Section 111 describes a scenario where international groups clash with religious and spiritual healers over the chaining of people with severe mental illness at prayer camps and healing centres in Ghana. Section IV articulates a three-pronged strategy for engaging in bioethics brought to light by the case analyses and defends it against objections. Throughout the paper, we tag certain views as African and others as Western to indicate ethical beliefs commonly found in these regions and less commonly found elsewhere. We do not mean to imply that all Africans hold a certain ethical stance or that all Westerners do, nor do we mean to suggest that people outside these regions do not hold the views in question.Item Bioethics’ Duty to Conference in Qatar: Reply to Magnus(The American Journal of Bioethics, 2024) Jecker, N.S.; Savulescu, J.; Atuire, C.; et al.Is it unethical to host an international bioethics conference in Qatar? In an editorial in this issue, David Magnus (2024) argues that conferencing in Qatar or other places where human rights violations occur, is not ethically justified. According to Magnus, the International Association of Bioethics’ (IABs’) decision to host the 2024 World Congress of Bioethics (WCB) at a Qatari-based university was “a major mistake by the IAB board.” We hold a much different view. In the face of unjust laws and human rights violations, more than one response is ethically defensible, as some of us have argued (Jecker and Ravitsky 2023; Jecker et al. 2024a; Jecker et al. 2024b; Jecker, Verweij, et al. 2023; Ghaly, El Akoum, and Afdhal 2023). Boycotting is one way to seek to change an unjust situation, but so too is engaging with people who are willing to host, hear, and take seriously challenges and objections to their prevailing norms (Jecker, Ravitsky, et al., 2023). Qatari-based hosts have invited bioethicists from around the world to engage with them in an open exchange of ideas, and offered a conference venue where this can occur. Bioethicists should engage and should foster open and respectful dialogue. To avoid redundancy with arguments, some of us have developed elsewhere (Jecker and Ravitsky, 2023; Jecker et al. 2024a; Jecker et al. 2024b; Jecker, Verweij, et al. 2023; Ghaly, El Akoum, and Afdhal 2023), we limit our response mostly to points not considered previously.Item The Ethics of International Bioethics Conferencing: Continuing the Conversation(The American Journal of Bioethics, 2024) Jecker, N.S.; Atuire, C.; Ravitsky, V.; et al.Our article, “Proposed Principles for International Bioethics Conferencing: Anti-Discriminatory, Global and Inclusive,” urged a critical conversation with bioethicists around the globe on the ethics of international bioethics conferencing (Jecker et al., 2024). Focusing on site selection, we tentatively set forth seven principles: anti-discriminatory, international, green, fair-minded, leave no one behind, free exchange of ideas and epistemic justice. We appreciate the vigorous response our proposal generated and the overall recognition of the ethical importance of the topic. We are grateful to Van Der Graaf and colleagues, who were the first in the literature to pinpoint the need for sustained debate within bioethics on the ethics of ethics conferencing (Van Der Graaf et al., 2023). We cannot do justice to all the points colleagues raised across 15 separate commentaries. In this short response, we focus on objections and proposed addenda to the seven principles.Item Preparing ethical review systems for emergencies: next steps(BMC Medical Ethics, 2023) Wright, K.; Aagaard, N.; Atuire, C.; et al.Ethical review systems need to build on their experiences of COVID-19 research to enhance their preparedness for future pandemics. Recommendations from representatives from over twenty countries include: improving relationships across the research ecosystem; demonstrating willingness to reform and adapt systems and processes; and making the case robustly for better resourcing.Item Public health research using cell phone derived mobility data in sub-Saharan Africa: Ethical issues(Ethics of mobility data in sub-Saharan Africa, 2023) Rennie, S.; Atuire, C.; Mtande, T.; et al.The movements of humans have a significant impact on population health. While studies of such movements are as old as public health itself, the COVID-19 pandemic has raised the profile of mobility research using digital technologies to track transmission routes and calculate the effects of health policies, such as lockdowns. In sub-Saharan Africa, the high prevalence of cell phone and smartphone use is a source of potentially valuable mobility data for public health purposes. Researchers can access call data records, passively collected in real time from millions of clients by cell phone companies, and associate these records with other data sets to generate insights, make predictions or draw possible policy implications. The use of mobility data from this source could have a range of significant benefits for society, from better control of infectious diseases, improved city planning, more efficient transportation systems and the optimisation of health resources. We discuss key ethical issues raised by public health studies using mobility data from cell phones in sub-Saharan Africa and identify six key ethical challenge areas: autonomy, including consent and individual or group privacy; bias and representativeness; community awareness, engagement and trust; function creep and accountability; stakeholder relationships and power dynamics; and the translation of mobility analyses into health policy. We emphasise the ethical importance of narrowing knowledge gaps between researchers, policymakers and the general public. Given that individuals do not really provide valid consent for the research use of phone data tracking their movements, community understanding and input will be crucial to the maintenance of public trust.Item WHO guidance on COVID-19 vaccine trial designs in the context of authorized COVID-19 vaccines and expanding global access: Ethical considerations(Vaccine, 2022) Singh, J.A.; Kochhar, S.; Wolff, J.; Atuire, C.; Bhan, A.; Emanuel, E.; Faden, R.; Ghimire, P.; Greco, D.; Ho, C.; Moon, S.; Shamsi-Gooshki, E.; Touré, A.; Thomé, B.; Smith, M.J.; Upshur, R.E.G.While the degree of COVID-19 vaccine accessibility and uptake varies at both national and global levels, increasing vaccination coverage raises questions regarding the standard of prevention that ought to apply to different settings where COVID-19 vaccine trials are hosted. A WHO Expert Group has developed guidance on the ethical implications of conducting placebo-controlled trials in the context of expanding global COVID-19 vaccine coverage. The guidance also considers alternative trial designs to placebo controlled trials in the context of prototype vaccines, modified vaccines, and next generation vaccinesItem Just allocation of COVID-19 vaccines(BMJ, 2021) Herlitz, A.; Lederman, Z.; Miller, J.; Fleurbaey, M.; Venkatapuram, S.; Atuire, C.; Eckenwiler, L.; Hassoun, N.