In a feature article in the Journal of Medical Ethics entitled ‘Where is knowledge from the global South? An account of epistemic justice for a global bioethics’,1 Pratt and de Vries give a highly persuasive account of global injustices within global bioethics especially health ethics against the global South that every bioethicist needs to read and to reflect on. The opening three sentences of the abstract of this account capture the ethical essence of the whole article. > The silencing of (...) the epistemologies, theories, principles, values, concepts and experiences of the global South, constitutes a particularly egregious epistemic injustice in bioethics. Our shared responsibility to rectify that injustice should be at the top of the ethics agenda. That it is not, or only is in part, is deeply problematic, and endangers the credibility of the entire field.1 It is quite significant that both authors of this article are scholars of the global North with research interest in the global South; so where are the scholars of the global South, the putative conceptualisers and creators of global South knowledge who should be complaining about the injustice in question? The answer to this question is part and parcel of the question itself that has been so boldly raised by Pratt and de Vries. They go on to describe in some detail the general conditions and requirements of epistemic justice for global health ethics and bioethics including even a consideration …. (shrink)

What does it mean to be a bioethicist? How should the role(s) of bioethics be understood in the context of a world of intense value conflict and polarisation? Bioethics is—in all its various forms and traditions—potentially well-positioned to contribute to addressing many of the most pressing challenges of value polarisation and conflict in diverse societies. However, realising this potential is going to require moving beyond currently foregrounded methods and developing new models for engaging with moral disagreement. This paper proposes an (...) approach, ‘adversarial cooperation,’ drawing on the concepts of ‘adversarial collaboration’ from the sciences and ‘antagonistic cooperation’ from the humanities. Adversarial cooperation aims to combine the rigour and structured methodology of adversarial collaboration with the cultural sensitivity and expansive vision of antagonistic cooperation. The paper also addresses key challenges to adversarial cooperation, including ethical considerations, tensions between substantive and procedural values, the problem of misinformation and the need for decision-making amidst ongoing disagreement. Ultimately, adversarial cooperation suggests a reimagining of bioethical expertise, emphasising skills in mediation, the arts and humanities and participatory decision-making alongside established philosophical competencies. This implies a model of normative bioethical authority grounded in the ability to facilitate inclusive and trustworthy processes of moral deliberation. Realising the potential of adversarial cooperation will require significant changes in bioethics training and practice, as well as a commitment to reflexivity, humility and the amplification of marginalised voices. By embracing this approach, bioethics can play a vital role in navigating the complex moral landscapes of pluralistic societies. (shrink)

What does justice in global health bioethics require, and how might we achieve it? Two important contributions to this issue of the Journal address theoretical and practical aspects of these questions in different but complementary ways. From their careful analysis of ‘epistemic injustice’ in global health ethics (‘injustice as it applies to knowledge’ which in one way or another puts a person at a disadvantage), Pratt and de Vries1 conclude that to achieve justice, much depends on what is meant by (...) ‘we’ (‘the people designing, conducting and using knowledge from research’) as well as the ‘what’ (‘the overall purpose/goal’) and the ‘where’ (‘the context in which it is undertaken’) of research. At present, they argue, epistemic injustice in bioethics is characterised by ‘coloniality of knowledge’: the ‘silencing of the epistemologies, theories, principles, values, concepts, and experiences of the global South’ is evident, for example, in ‘an ignoring or rejection of the plurality of knowledge’ and the ‘presentation of the works of a few European philosophers as “universal truths”’. ‘Cognitive justice’, by contrast, ‘affirms the epistemological diversity of the world’ and draws ‘attention to inequalities in the knowledge that is valued in today’s world, including …. (shrink)

Jecker et al. (2024) propose seven ethical principles to guide international bioethics conferencing, applying them to the selection of Qatar as the location for the 2024 World Congress of Bioethics...

In social systems or spaces, distance between the centre and the periphery breeds epistemic injustice. There are growing accounts of epistemic injustice in health-related fields, as in the article by Pratt and de Vries.1 The title of the article asks: ‘Where is knowledge from the global South?’ Like me, you may answer by saying: ‘Knowledge from the global South is in the global South’. That answer says a lot about how we right epistemic injustice done to actors in the global (...) South or the periphery, including in health ethics. Pratt and de Vries identified four sets of actors (individuals, institutions, journals and funders) responsible for righting epistemic injustice. For three of the four sets of actors, they recognised the need for—or the possibility of—symmetry between global North and global South. Except journals. They did not seriously consider that journals are either present in or could belong to the global South; to the periphery. Platforms for knowledge exchange, circulation, cultivation and curation—such as journals, conferences, publishers, blogs, archives, seminars, books and the media, social or traditional—are neither physically nor epistemically neutral. They are situated. The BBC cannot do for Nigeria or Australia what it does for Britain; neither can the BMJ. Many of us take our position at the centre or periphery as neutral, natural, necessary or permanent. But the African American writer Toni Morrison proved the opposite with her career: ‘I stood at the border, stood at the edge and claimed it as central. l claimed it as central, and let the rest of the world move over to where I was.’2 Although physically in the USA, Toni Morrison was writing …. (shrink)

Earlier this year, the International Association of Bioethics (IAB) hosted the biennial World Congress of Bioethics (WCB) in Doha, Qatar. Understandably, controversy surrounded the decision to hold the conference there. Opponents thought Qatar’s human rights record rendered it incompatible with the IAB’s mission. 1 2 Proponents felt that the location was overall justified to advance equitable participation in the WCB. 3 4 The discussion about the Qatar venue was an important one. But unlike in real estate, where the mantra of (...) ‘location, location, location’ highlights the often singular importance of geophysical coordinates, the debate about equity in global bioethics scholarship and practice is broader than where the WCB takes place. As we entered the intercongress time frame, it is helpful to consider in what other ways the IAB—and leading journals such as the JME—can contribute to equity in bioethics outside of events such... (shrink)

This paper opens a critical conversation about the ethics of international bioethics conferencing and proposes principles that commit to being anti-discriminatory, global, and inclusive. We launch this conversation in the Section, Case Study, with a case example involving the International Association of Bioethics’ (IAB’s) selection of Qatar to host the 2024 World Congress of Bioethics. IAB’s choice of Qatar sparked controversy. We believe it also may reveal deeper issues of Islamophobia in bioethics. The Section, Principles for International Bioethics Conferencing, sets (...) forth and defends proposed principles for international bioethics conferencing. The Section, Applying Principles to Site Selection applies the proposed principles to the case example. The Section, Applying Principles Beyond Site Selection addresses other applications of the proposed principles. The Section, Objections responds to objections. We close (in the Section, Conclusion) by calling for a wider discussion of our proposed principles.One-Sentence Capsule Summary: How should bioethicists navigate the ethics of global bioethics conferencing? (shrink)

Pratt and de Vries1 pose an important and uncomfortable question to all stakeholders in the global bioethics space. If global bioethics as they define it is ‘the ethics of public health and healthcare problems that are characterised by a global level effect or that require action beyond individual countries, and the ethics of research related to such problems’, one would expect justice and inclusivity to be among the ethical priorities. Yet, Pratt and de Vries carefully demonstrate how different forms of (...) epistemic injustice and coloniality are embedded in the structure, generation of knowledge and praxis of global bioethics. They do this by unpicking three layers at which coloniality and epistemic injustice operate; knowledge-producer, knowledge-applied and knowledge-solicited. The authors also offer a three-pronged incremental approach to how individual and institutional actors in global bioethics can contribute to epistemic justice in the field. Pratt and de Vries present their work as ‘a first step towards reorienting the field’ of global health bioethics away from epistemic injustice. Indeed, theirs is a mapping, problem statement and recommendations piece …. (shrink)

Over the last two decades or so, the need to decolonise bioethics and make it inclusive, equitable and accommodative of voices from the traditionally marginalised global South has received increasing attention in academic scholarship. The recent publication by Pratt and de Vries offers a very comprehensive critical analysis and thoughtful overview of the issue, using global health ethics as its starting point.1 I fundamentally agree with their characterisation of the issue as an ‘epistemic justice’ problem. I further find their recommended (...) conceptual and practical ideas for measuring epistemic injustice and ethical responsibilities to promote epistemic justice very thoughtful and insightful. However, I find their responses to possible objections to their arguments a bit hasty and unclear, especially the idea that ‘greater epistemic justice calls for global health ethics to advance a transcultural framework of ethical values and principles’ (p. 7). They look ambiguous on their position on the fundamental global bioethical question regarding the possibility of an intercultural ethical framework. I think the question of whether there are global ethical values and principles that are commonly shared among human beings in the global world is a fair and legitimate issue that deserves deep attention and a persuasive answer by those who call for more inclusive and equitable global bioethics. I attempt to flesh out this issue in a bit more detail to further enrich the discussion. Pratt …. (shrink)

Jecker et al. (2024) offer seven principles with which to guide conference organizers and assess how ethically a conference is organized. While focused on bioethics, these principles are relevant t...

In their paper titled “Proposed Principles for International Bioethics Conferencing: Anti-Discriminatory, Global, and Inclusive,” Jecker et al. eloquently present essential principles for Internati...

Doctors Pratt and de Vries propose a well-structured and courageous approach to analyse and repair an insufficiently recognised discussion about epistemologies and knowledge production in bioethics.1 The authors invite researchers, scholars, public health experts and bioethicists from the global North to reflect about their lack of imagination regarding different sources of narratives produced by the global South. There is a critical analysis of injustices and an urgent call for global bioethicists to reorient their field and focus on the analysis and (...) development of ethical interventions to achieve a comprehensive epistemic justice for global health ethics. Feminist bioethicists from the global South already argued about the importance of the voices and biographies of the people and groups in the communities to reframe the bioethical reasoning regarding the meaning of individual’s needs during public health and humanitarian emergencies.2 Over a decade ago, Diniz and Guilhem described the role and goal of feminist bioethics in Latin America, shaped in an oppressive context promoted and created by …. (shrink)