Bioethics North and South: Searching for Common Ground

The lecture held at the School of Public Health was chaired by Dr. Emmanuel Asampong. Dr. Laar introduced the speaker, Prof. Miles, an Emeritus Professor of Medicine at the University of Minnesota. Professor Miles’ visit to Ghana was his first.  The lecture centered on an article that Prof. Miles co-authored with Dr. Laar (forthcoming). Titled “Bioethics North and South: Searching for Common Ground” (forthcoming), this work supports the call for “a global bioethics” – one that is truly global. A bioethics for the global community, the paper contends must substantially turn to focus on public health outcomes in all its work; must embrace human rights; must be one where all bioethics associations and conferences create explicit platforms for resource-poor countries and for marginalized domestic communities such as prisoners or refugees, amongst others.

Providing relevant background to his talk, Professor Miles noted that Bioethics has priorities to developed, and underdeveloped  countries. He noted that although progress in the life sciences hass given human beings the power to improve their life, several ethical problems remain.  He referred to Alexander Capron’s Presidential Address to the International Association of Bioethics in 2007 whence bioethics’ 10/90 problem was disclosed. That reference analogized to the observation that medical research spends 90% of its resources on problems affecting 10% of the world’s population e.g. research into stem cells, transplantation. The question to ask is, what the bioethics issues for Ghana are? One realizes that such things as stem cell research, transplation are largely not relevant or critical for clinical or public health systems in countries like Ghana. Bioethics needs to be applied to local needs and has a planned role to play in solving problems such as child protection, female genital mutilation, community health issues, contraception and illegal abortions in refugee camps, explosion of population in refugee camps among others. These are the issues bioethics, in his view, need to address.

Professor Miles delivering his speech

The focus on bioethics has recently been on high technology. African bioethics articles also focus on the same thing such as articles from Cuba. Few articles have focused on developing countries and the few have mainly concentrated on 1st world issues like intensive care. Some local articles do not focus on some of the gruesome activities that go on such as the killing of prisoners to get body organs for other human beings. This does not however mean that bioethics should not focus on technology in developing countries but should focus on technologies relevant to Ghana for instance. Corruption is for instance a bioethics issue. The Ebola epidemic showed the failure of bioethics in a profound way e.g. untested world 1st drugs for Ebola, WHO never looked at these drugs until a high number of people had died. Ebola is not that contagious and hence the spread must have been related to some cultural practices and hence an early investigation should have been done and the outbreak treated as a culture phenomenon instead of a medical one. Instead of Bioethics addressing these issues they are being addressed by Human rights groups and women groups. How can this be fixed?

There is a need for an African Bioethics within the developing world and must help progress public health. Bioethics has acknowledged that climate change is gradually transforming Africa. Bioethics need to tackle such issues as climate change in relation to humans, the role of the community and the community bio-standards. Bioethics should provide a framework within which community values can be evaluated.
He encouraged the audience to join Bioethics International since membership is free and there is a need for a bioethics conversation in Africa. Bioethicists need to travel more and open themselves up not to only countries that are resource poor but to refugees and prisoners as well. He ended by saying that courage is the form of virtue at every testing point. Bioethics takes courage. Then the floor was opened for questions.

A section of the audience


Steven H. Miles, MD
Professor Emeritus
Department of Medicine, Center for Bioethics
University of Minnesota