This chapter aims to prominently position the African philosophical notion of the self within the clinical trials context (and the larger bioethics project). As opposed to autonomy-based principlism, this other-regarding or communalist perspective is proposed as the preferred alternative model. The intent is to draw further attention to the inadequacy of the principlist approach particularly in multicultural settings. It also engenders a rethink, stimulates interest, and re-assesses the failed assumptions of universal ethical principles. As a novel attempt that runs against much of the prevailing (Euro-American) intellectual mood, this approach strives to introduce the African view point by making explicit the import of the self in a re-contextualized (nay, globalized) arena. Viewed as such, research ethics is guided to go beyond autonomy-based considerations for the individual with absolute right to self-determination; to embrace more holistic-based approach, recognizing that the individual is embedded in his/her family, community, and the environment.
TopIntroduction
The collective progress in the field of biomedical research is astonishing, thanks to R&D. This feat represents the heights human brain power has attained in making dreams a reality and in improving our physical, emotional, and material conditions. However, scientific research has sometimes become more a search for material gains, absolute control and might, and less a quest for the truth. When science fashions a project to serve such agendas, the avowed goal of dominating nature can turn into domination of the human person, and ethical problems of enormous proportions may result. The very essence of humanity stands the risk of being compromised, sometimes irreversibly. In that instance, science might become self-deprecating, with no clue, much less an answer (Okere, 2005).
Indeed, R&D in biomedicine greatly relies on clinical trials. But what may not be so obvious are the dynamics involved; they include, the admixture of scientific, technological, socio-cultural and environmental factors that collide in the process.
The present analysis of a multi-cultural approach to clinical trials is borne out of interests that interlink bioethics, multiculturalism, environmental and global studies. This is exemplified in the attempt to string together seemingly disparate subject matters such as responsibility, clinical trials, and selfhood (African notion of it),1 to make them cohere.2 To some readers, certain questions might arise: What do these have in common? Is there an African philosophy?3 And, an “African self,” what is that?
It suffices to clarify that this topic occupies a tricky terrain at the confluence of research in biomedical attitudes, the discipline of philosophy, and the disciplines of multiculturalism, including sociology and ecology. Evidently, the task is rare, even herculean, but it is desirable to make the connection (between the tripartite themes of responsibility, clinical trials, and selfhood) to provide a complete understanding of the trajectory of this discussion. It is hoped that readers will be willing to stretch their capacities beyond their accustomed bounds in readiness to accommodate the uncommonly offered lines of reasoning that follow.
The aim of this chapter is to prominently position the African philosophical notion of personhood within the clinical trials context (and the larger bioethics project). As opposed to the Euro-American autonomy-based principlism in research ethics, this chapter will propose an ‘other-regarding’ or communalist4 perspective as the preferred alternative model. Hence, this chapter attempts to explore the ethics of public health, specifically, responsibility in clinical trials. It re-conceptualizes responsibility in clinical trials with the insight of the African understanding of the human person. By inference, it strives to complement scholarly literature dealing with cross-cultural biomedical research ethics, and emphasizes the African perspective, which is rare or even non-existent in some cases. This tactic draws further attention to the inadequacy of the principlist approach particularly in multicultural settings. Hence, it aims to stimulate interest, engender a rethink, and present a re-assessment of the failed assumptions of universal ethical principles.