The case for an Indigenous Bioethics
Indigenous
communities in the Americas experience a disproportionate incidence of illness
and disease compared to the general population. They also possess sophisticated
ethical traditions which diverge and not infrequently conflict with Western-oriented
bioethics. This culture gap between patient, provider and ethicist is no small
public health concern—it can foster feelings of alienation and distrust which
compromise the relationship between those in need of care and those able to
offer it. Research ethicists have already made considerable efforts to bring
sensitivity for aboriginal cultural mores into their discipline, but
bioethicists have been slower out of the gate.
This
is the argument made by an article last year in the American Journal of Bioethics. The authors Jaro
Kotalik and Gerry Martin are well-situated to make such claims—Kotalik is a
bioethicist and Martin is an Elder of the Mattagami Nation. The pair attempt to
draw parallels between classical systems of virtue ethics and the Ojibwa narrative
of the Seven Grandfathers, a fable with the central aim of transmitting the
community’s moral compass from one generation to the next. Kotalik & Martin
hope this exercise will show that aboriginal and mainstream bioethical
frameworks are indeed, to quote First Nations intellectual Leroy Little Bear,
“jagged worldviews colliding”. They share parallels, but they are far from
perfect complements. Real work must therefore be done to smooth the contact
point between them.
Kotalik
& Martin make a provocative argument, but they paint a hazy picture of what
this work entails. They doubt the possibility of an “aboriginal bioethics”, but
they do speak of an “ethical framework” for the provision of healthcare in
indigenous communities along the lines of what has been achieved in human research.
What
would this look like? Well, some of the groundwork might already have been laid.
Narrative bioethics, which has gained increasing traction in recent years, finds
common ground with the oral traditions of many indigenous peoples by framing
clinical ethical dilemmas with the devices of story. Communitarianism has also grown
in popularity amongst bioethicists, paralleling the unbroken continuum between
individual and community important to many aboriginal societies.
With
these intellectual currents in place, an indigenous bioethics may or may not be
possible. However, one thing is certain: it is only with the leadership of
aboriginal communities articulating their vision of ethical healing that we’ll
find out.
Gaelen Snell
Labels: communitarianism, First nations, Indigenous bioethics, narrative ethics
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