Clinicians and health researchers frequently encounter opportunities to rescue people. Rescue cases can generate a moral duty to aid those in peril. As such, bioethicists have leveraged a duty to rescue for a variety of purposes. Yet, despite its broad application, the duty to rescue is under-analyzed. In this paper, we assess the state of theorizing about the duty to rescue. There are large gaps in bioethicists’ understanding of the force, scope, and justification of the two most cited duties to (...) rescue—the individual duty of easy rescue and the institutional rule of rescue. We argue that the duty of easy rescue faces unresolved challenges regarding its force and scope, and the rule of rescue is indefensible. If the duty to rescue is to help solve ethical problems, these theoretical gaps must be addressed. We identify two further conceptions of the duty to rescue that have received less attention—an institutional duty of easy rescue and the professional duty to rescue. Both provide guidance in addressing force and scope concerns and, thereby, traction in answering the outstanding problems with the duty to rescue. We conclude by proposing and propose research priorities for developing accounts of duties to rescue in bioethics. (shrink)

In this article, I consider whether there are values intrinsic to development theory and practice that are dubious in light of a characteristically African ethic. In particular, I focus on what a certain philosophical interpretation of the sub-Saharan value of communion entails for appraising development, drawing two major conclusions. One is that a majority of the criticisms that have been made of development by those sympathetic to African values are weak; I argue that, given the value of communion, development should (...) not be rejected because it is essentially, say, overly materialistic and scientistic, or insufficiently spiritual and local. The second conclusion, however, is that three criticisms of development are strong from the perspective of Afro-communalism and are particularly powerful when set in that context. I argue that development theory and practice are characteristically anthropocentric, individualist and technocratic, and that a reading of the sub-Saharan value of communion provides a unitary foundation for rejecting these features and for grounding an alternative, more relational approach to social progress and to what justice demands from the West in relation to Africa. (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)

This article repudiates the dichotomy that African ethics is communitarian (relational) and Western ethics is individualistic. ‘Communitarianism’ is the view that morality is ultimately grounded on some relational properties like love or friendship; and, ‘individualism’ is the view that morality is ultimately a function of some individual property like a soul or welfare. Generally, this article departs from the intuition that all morality including African ethics, philosophically interpreted, is best understood in terms of individualism. But, in this article, I limit (...) myself to the literature in the African moral tradition; and, I argue that it is best construed in terms of individualism contrary to the popular stance of communitarianism. I defend my view by invoking two sorts of evidences. (1) I invoke prima facie evidence, which shows that both secular and religious moral thinkers in the tradition tend to understand it in individualistic terms. And, (2) I invoke concrete evidence, I show that the two terms that can be said to be definitive features of African ethical framework, namely: personhood and dignity, are individualistic. I conclude by considering possible objections against my defense of individualism as a central feature of African ethics. (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)

Much new global genetic research employs whole genome sequencing, which provides researchers with large amounts of data. The quantity of data has led to the generation and discovery of more incidental or secondary findings and to vigorous theoretical discussions about the ethical obligations that follow from these incidental findings. After a decade of debate in the genetic research community, there is a growing consensus that researchers should, at the very least, offer to return incidental findings that provide high‐impact, medically relevant (...) information, when it is not unduly burdensome to the research enterprise to do so. Much as genetic research has been limited to U.S. and European settings, the incidental findings debate has primarily focused on research conducted in high‐income countries. In a 2015 paper, Alberto Ortiz‐Osorno, Linda Ehler, and Judith Brooks note salient differences between the circumstances of research participants in low‐ and high‐resource settings that alter the analysis of when and why incidental findings should be offered to research participants. In this article, we expand on their analysis and present a framework for thinking about how investigators’ obligations to return genomic data might change in low‐resource settings, particularly in settings where participants do not have access to the medical care needed to treat, assess, or monitor incidental findings that are actionable in settings with plentiful resources. (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)

The belief that human rights are culturally relative has been reinforced by recent attempts to develop more plausible conceptions of human rights whose philosophical foundations are closely aligned with culture-specific ideas about human nature and/or dignity. This paper contests specifically the position that a conception of human rights is culturally relative by way of contesting the claim that there is an African case in point. That is, it contests the claim that there is a unique theory of rights. It analyses (...) three examples of what often passes as African conception of human rights arguing that they have little or nothing to do with human rights, are simply inadequate or are not African in the sense at issue in a cultural relativism. Along the way, it distinguishes between two meanings of the term African contending that to the extent that the practice of prizing the ‘community’ higher than any other value is definitive of African, the idea of African human rights remains suspect. (shrink)

The return of individual research results and incidental findings from biobanking research is a much debated ethical issue globally but has extensive relevance in India where the burden of out of pocket health care expenses is high for the majority. The views of 21 ethics committee (EC) members and 22 researchers from Bengaluru, India, concerning the ethics of biobanking research were sought through in‐depth interviews using an unfolding case vignette with probes. A shared view among most was that individual research (...) results which are ‘actionable’ or have ‘clinical significance’ should be returned to the sample contributors through their treating physicians. This was seen as an ethical obligation and a moral duty on the side of the researcher to “give back” to the person who contributed to the research. The challenges foreseen were that of resources, both financial and personnel, for the time and counseling needed to accompany the disclosure of results. Perceptions of ‘ownership’ appear to influence the concept of benefit sharing. While benefit sharing in financial terms was considered ethically challenging, certain researchers and ethics committee members made a case for “two way altruism” where the researcher in return for the altruistic ‘valuable contribution’, shares with the contributor/ community, benefits of the research which could include research findings, improved patient care, and more affordable access to the new diagnostic tests or products arising from the research. This defines the emerging ethic of “giving back” which goes beyond individual rights and ensures reciprocity and distributive justice. (shrink)

In a carefully argued article, Haley K. Sullivan and Benjamin E. Berkman address the important question of whether investigators have a duty to report incidental findings to research participants in low‐resource settings. They suggest that the duty to rescue offers the most plausible justification for the duty to return incidental findings, and they explore the implications of this duty for the context of research in low‐resource settings. While I think they make valuable headway on an important problem, in this commentary, (...) I identify a significant difference between the paradigmatic rescue case and the return of incidental findings in low‐resource settings. This difference, I suggest, implies that their framework may be too narrow in scope. If investigators (and their sponsors) really wish to fulfill their duty to rescue, they must consider factors that are left out of Sullivan and Berkman's framework. (shrink)