Avoiding the missionary position

An intriguing book has just been published by Oxford University Press, edited by Catherine Myser, and entitled Bioethics around the Globe. The book examines, from loosely anthropological or sociological perspectives, variations in how bioethics is conceived and practiced in different parts of the world, as well as attempts to spread 'Western-style' bioethics globally. In regard to the latter, Raymond de Vries and Leslie Rott have written a provocative essay in which bioethics training programs (in the United States, continental Europe and the UK) are compared with old-style missionary work in developing countries. Either bioethics experts are flown into developing countries to spread the 'good word' of bioethics, or the natives are flown to Western centers of bioethics excellence, where they gather and return home with the 'right' bioethics notions and approaches.

If there was only one true way of doing bioethics, that those in the more affluent countries of the north just happened to latch onto, this would be less problematic. But as the rest of the book makes plain, bioethics wherever it is practiced tends to be heavily flavored by local morality, social conditions, and cultural norms. This means that attempts (however well-intentioned) to transfer Western bioethics into non-Western settings is going to be a bit weird at best, and harmful at worst. De Vries and Rott speak of various ills: blindness of Western bioethicists to the shortcomings of their own culture and to the cultural assumptions embedded in conceptions of informed consent and autonomy; the lack of cultural fit between what budding non-Western bioethicists get taught and what is relevant in their own culture. And what might be seen as relevant may arguably be relevant for the wrong sort of reasons. Learning how to set up an IRB might be interesting for those in the developing world hoping to attract funding and resources from research agencies, but that seems to miss the ethical point about protection of human participants in research. In these post-colonial exchanges, much is lost in translation.

How can the missionary trap be avoided? It is no simple thing. The dominant bioethics culture in the world is Anglophone, European-American, and secular with Christian overtones. Developing countries who want to expand their understanding and skills in this area are confronted with that particular world in the 'classic' texts, the most prestigious programs, and high-impact journals. Those interested in bioethics in the developing world need to be encouraged to (critically) tap into the 'Western' style of bioethics while also (critically) engaging with their own local moral traditions for guidance and inspiration. Only in this way will alternative bioethics traditions emerge. Those -- like the author of this blog -- involved in bioethics capacity-building projects in developing countries may still have a delicate role to play as facilitator or catalyst. In any case, the bioethics missionary has to be phased out, and replaced by those willing to listen as much as lecture.