Southern African countries have the highest HIV infection rates in the world. In most of the countries in the region, the rate among adults is at least 10%. The fight against HIV/AIDS has mostly been inadequate owing to the lack of proper consideration of ethical and cultural issues. In this article, the authors discuss the ethical and cultural dilemmas concerning HIV/AIDS, with Malawi as a case in point. It is argued that increasing financial resources alone, as exemplified by the Global (...) Fund to Fight AIDS, Tuberculosis and Malaria initiative, without proper attention to ethical issues, morals and appropriate legal obligations, are unlikely to reduce the spread of HIV in southern Africa. (shrink)

For decades now, moral philosophy and bioethics have been dominated variously by universalist and particularist impulses, both of which exert legitimate pull on our thinking. Although there is little prospect of settling the debate by recourse to theory, classifying the cases in which particularist and universalist demands compete reveals a rough practical guide.

Ethical issues in international nursing research are identified and the perspectives of the International Centre for Nursing Ethics are offered in an effort to develop an international consensus of ethical behaviour in research. First, theoretical issues are reviewed, then initial conditions for ethical conduct are defined, and protocol design and procedure considerations are examined. A concerted effort is made to identify and avoid a western bias. Broad guiding principles for designing and reviewing research are offered: (1) respect for persons; (2) (...) beneficence; (3) justice; (4) respect for community; and (5) contextual caring. A collaborative model of the researcher-participant relationship is suggested and discussed. (shrink)

This article derives from a doctoral thesis in which a particular discourse was used as a ‘paradigm case’. From this discourse an ethic set within a South African culture arose. Using many cultural ‘voices’ to aid the understanding of this narrative, the ethic shows that one can build on both a ‘justice’ and a ‘care’ ethic. With further development based on African culture one can take the ethic of care deeper and reveal ‘layers of understanding’. Care, together with compassion, forms (...) the foundation of morality. Nursing ethics has followed particular western moral philosophers. Often nursing ethics has been taught along the lines of Kohlberg’s theory of morality, with its emphasis on rules, rights, duties and general obligations. These principles were universalistic, masculine and noncontextual. However, there is a new ethical movement among Thomist philosophers along the lines to be expounded in this article. Nurses such as Benner, Bevis, Dunlop, Fry and Gadow - to name but a few - have welcomed the concept of an ‘ethic of care’. Gilligan’s work gave a feminist view and situated ethics in the everyday aspects of responsiveness, responsibility, context and concern. Shutte’s search for a ‘philosophy for Africa’ has resulted in finding similarities in Setiloane and in Senghor with those of Thomist philosophers. Using this African philosophy and a research participant’s narrative, an African ethic evolves out of the African proverb: ‘A person is a person through other persons’, or its alternative rendering: ‘I am because we are: we are because I am.’ This hermeneutic narrative reveals ‘the way affect imbues activity with ethical meaning’ within the context of a black nursing sister in a rural South African hospital. It expands upon the above proverb and incorporates the South African constitutional idea of ‘Ubuntu’ (compassion and justice or humanness). (shrink)