The default position in Western ethics is that survivor’s guilt is either irrational or not rational, i.e., that while survivor’s guilt might be understandable, it is not justified in the sense of there being good reason for a person to exhibit it. From a widely held perspective, for example, one ought to feel guilty only for having done wrong, and in a culpable way, which, by hypothesis, a mere survivor has not done. Typical is the following: ‘Strictly speaking, survivor guilt (...) is not rational guilt, for surviving the Holocaust, or surviving battle….is not typically because a person has deliberately let another take his place in harm’ (N Sherman, ‘Guilt in War’). However, I find in the African tradition resources that promise to entail and plausibly explain why it would be reasonable, and specifically morally desirable, for a person to feel survivor’s guilt. The core idea that I take from this tradition is that a person is virtuous insofar as she is communal in her actions and attitudes. In my contribution I develop the hypothesis that feeling guilty upon the dumb luck of survival can be apt as a virtuous form of one’s attitudes being positively bound up with others. (shrink)

English-speaking research on morally right decisions in a healthcare context over the past three decades has been dominated by two major perspectives, namely, the Four Principles, of which the principle of respect for autonomy has been most salient, and the ethic of care, often presented as a rival to not only a focus on autonomy but also a reliance on principles more generally. In my contribution, I present a novel ethic applicable to bioethics, particularly as it concerns human procreation, that (...) I argue is a promising alternative to these two approaches. According to this new moral theory, an act is right just insofar as it treats people’s capacity to commune with respect, where communing is a matter of identifying with others and exhibiting solidarity with them. This ethic is inspired by relational ideals of communion and harmony from the African philosophical tradition, but is shown to be attractive to a broad, indeed global, audience, with regard to its implications for the morality of reproduction. (shrink)

This paper addresses whether, and to what extent, the African ethic of Ubuntu can contribute to ethical thinking in general and provide an alternative to stakeholder theory specifically. The conception of Ubuntu that is employed to further the analysis is Thaddeus Metz’s Ubuntu principle of right action, which focuses on promoting harmonious social relations premised on a shared identity and solidarity amongst people. This principle is used to develop an Ubuntu heuristic for organisational decision-making, which serves as the basis for (...) a relationholder theory. It is argued that this relationholder theory can overcome the weaknesses identified with a libertarian account of stakeholder theory, as well as serve as a profitable framework for determining both the purpose of the firm, and the responsibilities that management has towards those parties who affect, and who are affected by, the firm. (shrink)

The response to feeding needs in advanced dementia patients is a subject of ethical inquiry. Advanced dementia is the debilitating result of a range of neurodegenerative diseases. As this terminal illness progresses, patients develop mild to severe dysphagia that can make swallowing difficult. Of the two available options, artificial tube feeding or oral hand feeding, an estimated one-third of these patients will receive artificial tube feeding. However, observational studies have failed to validate the clinical benefits of tube feeding. Ethics of (...) care, the feminist philosophical perspective, and Ubuntu philosophy offer arguments for the choice of oral hand-feeding as a preferrable first option by caregivers as far as possible. These moral theories acknowledge that human beings can be dependent for long periods, mostly early and later years of life. Both views reflect an approach that draws people into a system of interdependent caring relationships. They encourage hand feeding as a way of exhibiting solidarity and respecting human dignity even at the end of life. (shrink)

BackgroundMedical researchers in resource-constrained settings must make difficult moral decisions about the provision of ancillary care to participants where additional healthcare needs fall outside the scope of the research and are not provided for by the local healthcare system. We examined research stakeholder perceptions and experiences of ancillary care in biomedical research projects in Malawi. MethodsWe conducted 45 qualitative in-depth interviews with key research stakeholders: researchers, health officials, research ethics committee members, research participants and grants officers from international research funding (...) organisations. Thematic analysis was used to analyse and interpret the findings. FindingsAll stakeholders perceived the provision of ancillary care to have potential health benefits to study participants in biomedical research. However, they also had concerns, particularly related to the absence of guidance to support it. Some suggested that consideration for ancillary care provision could be possible on a case-by-case basis but that most of the support from research projects should be directed towards strengthening the public health system, emphasising public good above individual or personal benefits. Some researchers and ethics committee members raised concerns about potential tensions in terms of funding, for example balancing study demands with addressing participants’ additional health needs.ConclusionOur findings highlight the complexities and gaps in the guidance around the provision of ancillary care in Malawi and other resource-constrained settings more generally. To promote the provision of ancillary care, we recommend that national and international guidelines for research ethics include specific recommendations for resource-constrained settings and specific types of research. (shrink)

BackgroundA key ethical question in genomics research relates to whether individual genetic research results should be disclosed to research participants and if so, which results are to be disclosed, by whom and when. Whilst this issue has received only scarce attention in African bioethics discourse, the extension of genomics research to the African continent has brought it into sharp focus.MethodsIn this qualitative study, we examined the views of adolescents, parents and caregivers participating in a paediatric and adolescent HIV-TB genomic study (...) in Botswana on how solidarity and reciprocity obligations could guide decisions about feedback of individual genetic research results. Data were collected using deliberative focus group discussions and in-depth interviews.ResultsFindings from 93 participants demonstrated the importance of considering solidarity and reciprocity obligations in decisions about the return of individual genetic research results to participants. Participants viewed research participation as a mutual relationship and expressed that return of research results would be one way in which research participation could be reciprocated. They noted that when reciprocity obligations are respected, participants feel valued and not respecting reciprocity expectations could undermine participant trust and participation in future studies.ConclusionsWe conclude that expectations of solidarity and reciprocity could translate into an obligation to feedback selected individual genetic research results in African genomics research. (shrink)

We are in the midst of a global crisis of climate change and environmental degradation to which the healthcare sector directly contributes. Yet conceptions of health justice have little to say about the environment. They purport societies should ensure adequate health for their populations but fail to require doing so in ways that avoid environmental harm or injustice. We need to expand our understanding of health justice to consider the environment and do so without reinforcing the epistemic injustice inherent in (...) the field of bioethics. This paper considers what work in philosophy related to the environment should be applied to help build that understanding and develops ideas about the healthcare sector’s responsibilities of justice to the environment. It first introduces the dominant multivalent environmental and ecological justice (EJ) concept in philosophy and each of its dimensions: distribution, participation, recognition and well-being. It then shows why applying that conception alone to broaden our understanding of health justice will reinforce epistemic injustice within bioethics. Drawing on EJ literature from the global South, the paper demonstrates that different ontological and experiential starting points identify additional EJ dimensions—power and harmony—and give rise to a nuanced understanding of the recognition dimension relative to the dominant EJ conception. The paper concludes by applying them to articulate healthcare sector responsibilities of justice to the environment, demonstrating they ground responsibilities beyond reducing its carbon emissions. (shrink)

In this article, I expound and assess two theories of meaning in life informed by the indigenous sub-Saharan African philosophical tradition. According to one principle, a life is more meaningful, the more it promotes community with other human persons. According to the other principle, a life is more meaningful, the more it promotes vitality in oneself and others. I argue that, at least upon some refinement, both of these African conceptions of meaning merit global consideration from philosophers, but that the (...) vitality approach is more promising than the community one for capturing a wider array of intuitions about what confers meaning on a life. I further argue, however, that there are objections that apply with comparable force to both theories; neither one does a good job of entailing that and explaining why certain types of reason and progress can make a life more meaningful. Although these objections are characteristic of a ‘modern’ western outlook, I maintain that they are difficult for contemporary African philosophers to ignore and consider some ways they might respond to the objections. (shrink)

This article draws on the indigenous African intellectual tradition to ground a moral-philosophical theory of leadership that is intended to rival accounts prominent in the East Asian and Western traditions. After providing an interpretation of the characteristically sub-Saharan value of communion, the article advances a philosophical account of a good leader as one who creates, sustains and enriches communal relationships and enables others to do so. The article then applies this account to a variety of topics, including what the final (...) end of an organisation should be, how decisions ought to be made within it, who counts as a stakeholder and how to deal with non-performing or misbehaving employees. For each topic, the article notes respects in which Afro-communal leadership supports approaches that differ from those prescribed by other, more internationally familiar philosophies such as Confucianism and Kantian contract theory, and it suggests that its implications are prima facie attractive relative to them. (shrink)

In this article I address the question of what makes addiction morally problematic, and seek to answer it by drawing on values salient in the sub-Saharan African philosophical tradition. Specifically, I appeal to life-force and communal relationship, each of which African philosophers have at times advanced as a foundational value, and spell out how addiction, or at least salient instances of it, could be viewed as unethical for flouting them. I do not seek to defend either vitality or community as (...) the best explanation of when and why addiction is immoral, instead arguing that each of these characteristically African values grounds an independent and plausible account of that. I conclude that both vitalism and communalism merit consideration as rivals to accounts that Western ethicists would typically make, according to which addiction is immoral insofar as it degrades rationality or autonomy, as per Kantianism, or causes pain or dissatisfaction, à la utilitarianism. (shrink)

Focusing on black communities in Africa, in this paper, I attempt an African bioethico-aesthetic deconstruction of the falsehood in colorist definitions of beauty purveyed by the migration of non-surgical cosmetics to Africa. I provide a novel ethical evaluation of the act of skin bleaching using principles of the African ethic of communion. I argue that skin bleaching is morally wrong to the extent that it promotes disharmonious relations and false identity in the beauty industry in Africa. Drawing on scientific studies (...) that link toxic ingredients in many skin-bleaching products to adverse health effects, I discuss the public health impact of bleaching cosmetics and other problems occasioned by their strategic expansion into African markets. I propose that there is an urgent need for a relational ethic of polycentric governance that would harmoniously regulate the production and distribution of cosmetic products across regions in order to avoid the exploitation of consumers in black African societies, while also protecting consumers’ right to make informed choices through education. (shrink)

This study adopts a heuristic technique to argue the thesis that a set of norms rooted in the African philosophy of Ubuntu can usefully supplement current research guidelines for dealing with incidental findings discovered in genomic research. The consensus regarding incidental findings is that there is an ethical obligation to return individual genetic incidental findings that meet the threshold of analytic and clinical validity, have clinical utility, and are actionable, provided that research contributors have not opted out from receiving such (...) information. This study outlines the hurdles that may hinder the integration of this consensus in mainstream clinical practice, and shows how an ethical theory from the global south may be used to address the same. This will advance the field of ethical, legal and social issues of personalized medicine by providing exposure to the under-represented African perspective on the ethical, legal, and social issues of genomics. (shrink)

Big Data has amplified some challenges in the healthcare context. One significant challenge is how to use healthcare big data in ways that honor individual rights to informed consent or privacy. Careful analysis from diverse backgrounds will be vital in contributing ethical guidelines that can adequately address healthcare Big Data's growing complexities globally. Especially, the study argues that an under-explored African philosophy of Ubuntu can usefully influence big data practices in ways that address this challenge without undermining its benefits. Ubuntu (...) emphasizes harmonious relationships. Harmonious relations entail identifying with one another and exhibiting solidarity to each other. One can identify or exhibit solidarity with others through psychological attitudes such as thinking of oneself as part of a “we” and acting in ways that will more likely improve the quality of life of others. The African relational philosophy of Ubuntu deserves to be given an audience not only for epistemic justice but also because the continued absence of African perspective in the discourse on ethical use of HBD science represents a missed opportunity to enrich ethical thinking about HBD from diverse backgrounds. Research is, however, required to provide greater specificity on how Ubuntu values may be integrated into HBD analytic techniques. (shrink)

Carrying out research on brains is important for medical advances in various diseases. However, such research ought not be carried out on human brains because the benefits do not outweigh the potential risks. A possible alternative is the use of brain surrogates. Nevertheless, some scholars who uphold a threshold account of moral status suggest the possibility that, with technological advances in the near future, more advanced brain surrogates will have very similar features to humans. This may suffice for these having (...) the same moral status as humans, and as a result, the situation may have implications for brain research, indeed, leading to the implication that this ought also not to be carried out upon brain surrogates. In this article, we present a relational approach to moral status which upholds that brain surrogates do not have the same moral status as human beings. Hence, brain research ought not be rejected on the grounds of equality of moral status between humans and brain surrogates. (shrink)

There has been the recurrent suspicion that community, harmony, cohesion, and similar relational goods as understood in the African ethical tradition threaten to occlude difference. Often, it has been Western defenders of liberty who have raised the concern that these characteristically sub-Saharan values fail to account adequately for individuality, although some contemporary African thinkers have expressed the same concern. In this chapter, I provide a certain understanding of the sub-Saharan value of communal relationship and demonstrate that it entails a substantial (...) allowance for difference. I aim to show that African thinkers need not appeal to, say, characteristically Euro-American values of authenticity or autonomy to make sense of why individuals should not be pressured to conform to a group’s norms regarding sex and gender. A key illustration involves homosexuality. (shrink)

Shortened version of an article first appearing in the African Journal of Business Ethics (2018).