Personhood, Cultural Ethics, and Biomedical Research: African vs. Euro-American Perspectives

Introduction

This chapter rides on the premise that the concept of personhood,¹ as embedded in research ethics principles, needs re-examining. Having been ignored and/or taken for granted thus far, that need has become urgent. As the base upon which the principles were developed and falsely universalized, it needs stressing that personhood in the Euro-American² sense differs markedly from what obtains in non-Western cultures such as in Africa. A careful delineation and recalibration of this understanding should be a teaching moment for researchers, clinicians, bioethicists, students and academics as they confront multicultural perspectives in health research. Hence, it helps to properly inform and effectively erase presumptive tendencies, so people can avoid any voluntary or involuntary unethical behavior that might arise from ignorance particularly in multicultural settings. The core task of this chapter is to contrast the African with the Euro-American perspectives on personhood in relation to biomedical research.

While most clinical studies today are initiated and registered in the Global North (predominantly in the U.S.), many of the actual trials are sometimes outsourced and offshored (DuBois, 2003; Petryna, 2009); often to the Global South (Rehnquist, 2001). Owing to this intensified practice of transnational biomedical research, plus the considerable controversy about the mainstream ethics of research which is narrowly constructed with Western individualistic philosophy, the following question which is shaped by the realities of globalization will serve as guide. In what ways can researchers remain respectful of other cultures as transnational borders continue to disappear? To contextualize, how can researchers ensure compliance, guideline consistency, and checks and balances across borders as well as recognize and respect multicultural systems and not project hubris?

The proposal in this chapter is, to some extent, related to, though also different from, that of Marshall and Koenig (2004) who sought for answers on how global bioethics might account for profound - and constantly transforming - sources of cultural differences. This proposal is similar in the sense that it highlights something that is distinctively and culturally ethical in an African context. But at the same time this chapter’s agenda – personhood – is much more specific than that of Marshall and Koenig’s. Analysts including Marshall & Koenig (2004), Levitt & Zwart (2009), and Olweny (1994), have worked to bridge the divide in bioethical discourse, and have managed to elicit some measured response from relevant US agencies which review the regulation and oversight of internationally sponsored research (Nuffield Council on Bioethics, 1999). Nonetheless, more dissenting voices in the Global South who seek to expand the debate have largely been ignored (Bhutta, 2002).