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In this article, we draw on the thinking about incompleteness and conviviality grounded in Afro-communitarianism ethics from the Global South to argue that adults aged 65 years and above have a prima facie responsibility to vaccinate against influenza. Notably, adults aged 65 years and above have a duty of conviviality to act in ways that limit harm to them and others. This article is intrinsically valuable to promote epistemic justice, thereby contributing towards the decolonisation of the global healthcare system. Moreover, this project has social significance in contributing to mitigation efforts against future public health challenges associated with population ageing in resource-limited developing African nations, wherein the impact of population transition will be felt most., (© 2024 The Author(s). Developing World Bioethics published by John Wiley & Sons Ltd.)

In this article, I interrogate whether the deployment and development of the Metaverse should take into account African values and modes of knowing to foster the uptake of this hyped technology in Africa. Specifically, I draw on the moral norms arising from the components of communal interactions and humanness in Afro-communitarianism to contend that the deployment of the Metaverse and its development ought to reflect core African moral values to foster its uptake in the region. To adequately align the Metaverse with African core values and thus foster its uptake among Africans, significant technological advancement that makes simulating genuine human experiences possible must occur. Additionally, it would be necessary for the developers and deployers to ensure that higher forms of spiritual activities can be had in the Metaverse to foster its uptake in Africa. Finally, I justify why the preceding points do not necessarily imply that the Metaverse will have a higher moral status than real life on the moral scale that can be grounded in Afro-communitarianism., (© 2024. The Author(s).)

The article argues the thesis that institutions have a prima facie obligation to fund the feedback of individual findings in genomic research conducted on the African continent by drawing arguments from an underexplored Afro-communitarian view of distributive justice and rights of researchers to be aided. Whilst some studies have explored how institutions have a duty to support return as a form of ancillary care or additional foreseeable service in research by mostly appealing to dominant principles and theories in the Global North, this mostly normative study explores this question by appealing to underexplored African philosophy. This is a new way of thinking about institutional responsibility to fund feedback and responds to the call to decolonise health research in Africa. Further studies are required to study how this prima facie obligation will interact with social contexts and an institution's extant relationships to find an actual duty. The research community should also work out procedures, policies and governance structures to facilitate feedback. In our opinion, though the impacts of feeding back can inform how institutions think about their actual duty, these do not obliterate the binding duty to fund feedback., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

This manuscript draws on the moral norms arising from the nuanced accounts of epistemic (in)justice and social identity in relational autonomy to normatively assess and articulate the ethical problems associated with using AI in patient care in light of the Black Box problem. The article also describes how black-boxed AI may be used within the healthcare system. The manuscript highlights what needs to happen to align AI with the moral norms it draws on. Deeper thinking - from other backgrounds other than decolonial scholarship and relational autonomy - about the impact of AI on the human experience needs to be done to appreciate any other barriers that may exist. Future studies can take up this task., (© 2024. The Author(s).)

In this paper, we draw on the thinking about solidarity, reciprocity and distributive justice grounded in Afro-communitarian ethics from the Global South to argue for institutions, particularly the South African (SA) government, have a prima facie duty to foster influenza vaccine uptake for adults 65 years and older. Although we focus specifically on the South African government to defend our position, we believe that our argument extends to all governments. Notably, these duties are that the SA government ought to make influenza vaccines freely available for the older adult in both the public and private health facilities, provided financial allocation and their extant relationships allow for this. Further, the SA government has a duty to improve influenza vaccine procurement and availability in the country, preferably through increasing manufacturing capabilities. This paper is intrinsically valuable to promote epistemic justice, thereby contributing toward the decolonization of the global healthcare system. Moreover, this project has social significance in contributing to mitigation efforts against future public health challenges associated with population aging in resource-limited developing African nations, wherein the impact of population transition will be felt most., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Sarangarajan and Ewuoso.)

In July 2020, the H3Africa Ethics and Community Engagement (E&CE) Working Group organised a webinar with ethics committee members and biomedical researchers from various African institutions throughout the Continent to discuss the issue of whether and how biological samples for scientific research may be accessed by commercial entities when broad consents obtained for the samples are silent. 128 people including Research Ethics Committee members (10), H3Africa researchers (46) including members of the E&CE working group, biomedical researchers not associated with H3Africa (27), representatives from the National Institutes of Health (16) and 10 other participants attended the webinar and shared their views. Several major themes emerged during the webinar, with the topics of broad versus explicit informed consent, defining commercial use, legacy samples and benefit sharing prevailing in the discussion. This report describes the consensus concerns and recommendations raised during the meeting and will be informative for future research on ethical considerations for genomic research in the African research context., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

This article draws on the underexplored or novel accounts of inclusion and the moral accounts of decolonization in African health decolonial literature to increase our understanding of how ethics dumping manifests in health research partnerships, and what more ought to be done to eliminate this phenomenon. African decolonial health literature proposes "inclusion that matters" - conceptualized as substantial, respectful and deep engagement with African agency - as a solution to end domination or mitigate the "appearance" of inclusion. Based on this supposition, the harm of ethics dumping - and I demonstrate how - is that it fails to engage the agency of Africans, and listen to or echo their voices in health and health research collaborations on the continent, or research collaborations that have significant implications for them. This account of inclusion can usefully increase our thinking about ethics dumping, which is ultimately and in several ways a failure to practice responsible science. Research is required to increase our understanding of what could reasonably constitute responsible science from a variety of perspectives., (Copyright © 2023 Tehran University of Medical Sciences.)

There are concerns that participation in open science will lead to various forms of exploitation - of researchers and scholars in low-income countries and under-resourced institutions. This article defends a contrary thesis and demonstrates the exact ways the underexplored notions of communal relationships, human dignity and social justice - and the normative principles to which they give rise - grounded in African philosophy can usefully address critical concerns regarding exploitation in the sharing of research resources to facilitate open partnership/collaboration and reuse. Further research is required to study the specific roles different institutions can play in facilitating open practice and contribute towards establishing effective structures that can enhance equity and balance unfavourable power asymmetries., (© 2022 The Authors. Developing World Bioethics published by John Wiley & Sons Ltd.)

Current studies of anti/-natalism have been carried out mainly in the context of western philosophy. In this article, we offer a pro-natalist view based on Confucian and Afro-communitarian philosophy (Sino-African ethics). Grounded in this Sino-African perspective, we uphold that there is, at least, one reason to believe that not only is it morally permissible to procreate, but also that on some occasions, procreating is what morality prescribes. Specifically, we contend that, from a Sino-African perspective, procreating sometimes is the best way to fulfil duties of reciprocity and care towards our parents., (© 2023 John Wiley & Sons Ltd.)

Competing Interests: Competing interests: None declared.

This article draws on reflections about humanness, friendliness and partiality, in the writings of Afro-communitarians to develop principles for thinking critically about why benefit sharing, what may count as benefits within the context of human research in Africa and the limits of the obligation of benefit sharing. Suppose the thinking about humanness, friendliness, and partiality in Afro-communitarianism were the foundation of human genetic research in Africa, then, individuals who have contributed to research or borne its burden would benefit from its rewards. This is even more important if participants have pressing needs that researchers and/or research institutions can help ease. A failure to aid sample contributors and data providers in need when researchers and research institutions can-as well as an indifference to the serious needs of contributors-are failures to exhibit friendliness in the relevant ways. Finally, though providing benefits to contributors can be an important way of showing humanity to them, nonetheless, this obligation is not absolute and may be limited by the stronger obligation of shared experience-to advance science. Studies are still required to inquire how well these norms will work in practice and inform regulatory and legal frameworks., Competing Interests: AS and DK were employed by the company KEMRI Wellcome Trust Research Programme. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ewuoso, Sudoi and Kamuya.)

This article draws on key normative principles grounded in important values - solidarity, partiality and friendliness - in African philosophy to think critically and deeply about the ethical challenges around returning individual genetic research findings in African genomics research. Precisely, we propose that the normative implication of solidarity, partiality and friendliness is that returning findings should be considered as a gesture of goodwill to participants to the extent that it constitutes acting for their well-being. Concretely, the value of friendliness may imply that one ought to return actionable results to participants even when their preferences regarding feedback are unknown. Notwithstanding, returning individual genetic results will have a cost implication. The cost of feeding back is relevant in the context of African genomics research projects, which are often funded by international sponsors and should be researched further., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Competing Interests: Disclosure of interest: The authors completed the ICMJE Unified Competing Interest Form (available upon request from the corresponding author) and disclose no relevant interest.

The response to feeding needs in advanced dementia patients is a subject of ethical inquiry. Advanced dementia is the debilitating result of a range of neurodegenerative diseases. As this terminal illness progresses, patients develop mild to severe dysphagia that can make swallowing difficult. Of the two available options, artificial tube feeding or oral hand feeding, an estimated one-third of these patients will receive artificial tube feeding. However, observational studies have failed to validate the clinical benefits of tube feeding. Ethics of care, the feminist philosophical perspective, and Ubuntu philosophy offer arguments for the choice of oral hand-feeding as a preferrable first option by caregivers as far as possible. These moral theories acknowledge that human beings can be dependent for long periods, mostly early and later years of life. Both views reflect an approach that draws people into a system of interdependent caring relationships. They encourage hand feeding as a way of exhibiting solidarity and respecting human dignity even at the end of life., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Consequentialist life-maximizing approaches to triaging prescribe that everyone ought to have an equal chance of living a typical lifespan, through the saving more life-years (or saving most lives) principle, which emphasizes the youngest-first principle and in some cases a lottery approach, often at the expense of the old and the sick. Although this approach has already been criticized by several bioethicists, this article provides a different kind of criticism to the life-cycle viewpoint, one that has not yet been explored at length; namely, we contend that the life-maximizing approach entails a form of racism without racists in its attitude towards Black people. More specifically, we contend that by neglecting the idea that current societies are not post-racial, it privileges White individuals and disadvantages Black people in the triaging process, curtails equal opportunities for Black people, reinforces white normativity, and neglects African culture. We end the article by pointing towards an Afro-communitarian relational triaging approach that does not face the same difficulties as consequentialist life-maximizing approaches do., (© 2022 John Wiley & Sons Ltd.)

African humanism should be considered more in the theoretical discussion on transhumanism. Using an underexplored humanistic philosophy of Ubuntu, this article shows how the perspective from the global south provides guidelines for pursuing transhumanism without jeopardizing humanism. It argues that heuristics from African (Ubuntu) humanism can serve transhumanist goals. While transhumanism has attracted severe criticisms from bio-conservatives, this article counterargues some salient objections. Drawing on an Ubuntu understanding of humanism, this article posits that the transhumanist vision of the posthuman does not threaten our humanity. Ubuntu humanism is shown to be supportive of transhumanism and can plausibly serve as a guide to protecting transhumanist trajectories from potential abuses. This article concludes that the embedded values of African humanism deserve to be taken seriously in galvanizing global trust in transhuman futures., (© 2021 John Wiley & Sons Ltd.)

Big Data has amplified some challenges in the healthcare context. One significant challenge is how to use healthcare big data (HBD) in ways that honor individual rights to informed consent or privacy. Careful analysis from diverse backgrounds will be vital in contributing ethical guidelines that can adequately address healthcare Big Data's growing complexities globally. Especially, the study argues that an under-explored African philosophy of Ubuntu can usefully influence big data practices in ways that address this challenge without undermining its benefits. Ubuntu emphasizes harmonious relationships. Harmonious relations entail identifying with one another and exhibiting solidarity to each other. One can identify or exhibit solidarity with others through psychological attitudes such as thinking of oneself as part of a "we" and acting in ways that will more likely improve the quality of life of others. The African relational philosophy of Ubuntu deserves to be given an audience not only for epistemic justice but also because the continued absence of African perspective in the discourse on ethical use of HBD science represents a missed opportunity to enrich ethical thinking about HBD from diverse backgrounds. Research is, however, required to provide greater specificity on how Ubuntu values may be integrated into HBD analytic techniques.

Aim: This study is a systematic review that aims to assess how healthcare professionals manage ethical challenges regarding information within the clinical context., Method and Materials: We carried out searches in PubMed, Google Scholar and Embase, using two search strings; searches generated 665 hits. After screening, 47 articles relevant to the study aim were selected for review. Seven articles were identified through snowballing, and 18 others were included following a system update in PubMed, bringing the total number of articles reviewed to 72. We used a Q-sort technique for the analysis of identified articles., Findings: This study reveals that healthcare professionals around the world generally employ (to varying degrees) four broad strategies to manage different types of challenges regarding information, which can be categorized as challenges related to confidentiality, communication, professional duty, and decision-making. The strategies employed for managing these challenges include resolution, consultation, stalling, and disclosure/concealment., Conclusion: There are a variety of strategies which health professionals can adopt to address challenges regarding information management within the clinical context. This insight complements current efforts aimed at enhancing health professional-patient communication. Very few studies have researched the results of employing these various strategies. Future empirical studies are required to address this., Abbreviations: CIOMS: Council of International Organization of Medical Sciences; WHO: World Health Organization; AMA: American Medical Association; WMA: World Medical Association; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analysis; ISCO: International Standard Classification of Occupations; ILO: International Labour Office; SPSS: The Statistical Package for the Social Sciences., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

This paper demonstrates how ubuntu relational philosophy may be used to ground beneficial coercive care without necessarily violating a patient's dignity. Specifically, it argues that ubuntu philosophy is a useful theory for developing necessary conditions for determining a patient's potential dangerousness; setting reasonable limits to the duty to protect; balancing the long-term good of providing unimpeded therapy for patients who need it with the short-term good of protecting at-risk parties; and advancing a framework for future case law and appropriate regulations in the care of psychotherapy patients. Issues regarding the decision to breach medical confidentiality in psychotherapeutic care are ultimately reserved for the courts. Professional assessment might be an important first step in this process, and court rulings govern most aspects of this assessment. However, current case law, especially in the United States, places an unreasonable expectation on psychotherapists to protect all at-risk parties or foresee that a patient intends to follow through on said threats. It has largely failed to guarantee psychotherapy patients unlimited access to care, while potentially inhibiting future honest communication between patients and health professionals and endangering the safety of others. Of these decisions, the two most prominent are the 1976 Tarasoff decision and the 2016 Volk decision. This paper argues for the possibility of grounding good laws in ubuntu African philosophy in a way that protects others from harm and ensures unimpeded access to care without necessarily breaching medical confidentiality., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Competing Interests: Competing interests: The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author) and declare no conflicts of interest.

This study adopts a heuristic technique to argue the thesis that a set of norms rooted in the African philosophy of Ubuntu can usefully supplement current research guidelines for dealing with incidental findings discovered in genomic research. The consensus regarding incidental findings is that there is an ethical obligation to return individual genetic incidental findings that meet the threshold of analytic and clinical validity, have clinical utility, and are actionable, provided that research contributors have not opted out from receiving such information. This study outlines the hurdles that may hinder the integration of this consensus in mainstream clinical practice, and shows how an ethical theory from the global south may be used to address the same. This will advance the field of ethical, legal and social issues of personalized medicine by providing exposure to the under-represented African perspective on the ethical, legal, and social issues of genomics.

This study evaluates the conflict between patient confidentiality and partner notification in sero-discordant relationships, and argues the thesis that based on a theoretical formulation of Ubuntu, a health provider is obliged to facilitate friendly relationships in which individuals are true subjects and/or objects of communal friendship. In serodiscordant relationships, the health professional can fulfil this obligation by notifying "others" (particularly a partner with whom an HIV positive patient has a "present" and "actual relationship") of their spouse's HIV seroconversion, since without such relevant information a partner (subject) of an HIV positive patient cannot "appropriately" care for the patient's condition (object). There is a need to move away from the medical traditional emphasis that has for so long put primacy on doctor-patient confidentiality as is the case with the Health Professions Council of South Africa Guidelines (Booklet 12) which favours patient confidentiality over partner notification. Given empirical evidence to support effectiveness of partner notification amongst sero-discordant couples, there is thus, a need to focus emphasis on latter. This shift is necessary for achieving the United Nations' Sustainable Development of Goal of ending HIV/AIDS epidemic by 2030. I proposed in this study that African ethics, specifically Ubuntu, will do a better job than current ethical frameworks at ensuring that partner notification receives more emphasis in the care of serodiscordant couples. If this framework is integrated into ethical guidelines and codes, it would significantly enhance the care of serodiscordant couples, as well as further boost global effort at ending HIV/AIDS epidemic by 2030., (© 2019 John Wiley & Sons Ltd.)

This study argues the thesis that a set of guidelines - firmly rooted in a particular interpretation of African moral theory, specifically, Ubuntu - will do a better job than current medical ethics frameworks, in addressing ethical challenges around misattributed parentage within the clinical context. Incidental information such as information with significant personal/health implications raises unique challenges for medical professionals. For example, withholding information of misattributed paternity accidentally discovered in clinical interactions may be seen by a patient as a violation of his/her right-to-know. Contrarily, disclosure where a patient has not requested information - or where establishing paternity is not the purpose of clinical visit/interaction - may be taken by the patient as a violation of his/her right 'not-to-know'. Resolving these challenges remain a herculean task. African moral theory contains an under-emphasized value for addressing such ethical challenges around misattributed parentage in the field of transplant. I seek to contribute this knowledge; and enhance clinician-patient relationship. This study builds off three completed systematic reviews, which aimed to answer the following questions: "what are the ethical challenges regarding information health professionals face within the clinical contest?" and "what core aspects (or common themes) of Ubuntu can be identified in existing literature describing the same?" In this present study, I applied the definition of Ubuntu which captures the core aspects of the theory in ethical literature on the same, to address ethical issues around unsought information of misattributed parentage in the field of transplant., (© 2018 John Wiley & Sons Ltd.)

Empirical studies have now established that many patients make clinical decisions based on models other than Anglo American model of truth-telling and patient autonomy. Some scholars also add that current medical ethics frameworks and recent proposals for enhancing communication in health professional-patient relationship have not adequately accommodated these models. In certain clinical contexts where health professional and patients are motivated by significant cultural and religious values, these current frameworks cannot prevent communication breakdown, which can, in turn, jeopardize patient care, cause undue distress to a patient in certain clinical contexts or negatively impact his/her relationship with the community. These empirical studies have now recommended that additional frameworks developed around other models of truth-telling; and which take very seriously significant value-differences which sometimes exist between health professional and patients, as well as patient's cultural/religious values or relational capacities, must be developed. This paper contributes towards the development of one. Specifically, this study proposes a framework for truth-telling developed around African model of truth-telling by drawing insights from the communitarian concept of ootọ́ amongst the Yoruba people of south west Nigeria. I am optimistic that if this model is incorporated into current medical ethics codes and curricula, it will significantly enhance health professional-patient communication., (© 2017 John Wiley & Sons Ltd.)

Information empowerment has been the greatest gain of genomics, yet it also poses serious threat to its survival, especially when the information is incidental. There may be an emerging consensus that actionable incidental findings be returned. But this has not been supported by any systematic review. Future directions are equally missing. These are significant gaps. To fill these gaps, an online search on PubMed and Genetics in Medicine website was conducted between 20th of August to 23rd of October, 2013; combining certain filters and phrases, such as 'return incidental findings'. Nineteen (19) articles were selected from an avalanche of results, and reviewed. The review confirms a majority support for return of clinically actionable findings. The result also shows that the support represents views of Northern Americans. Critical contributions of Africans, Asians and Europeans are missing in this discourse. I recommended studies in this direction.