The Critique of Bioethical Principlism in Contrast to a Black African Approach to Bioethics

THE CRITIQUE OF BIOETHICAL PRINCIPLISM IN CONTRAST TO A BLACK AFRICAN APPROACH TO BIOETHICS by Jude Thaddaeus Buyondo. Wipf 37. 00. ISBN: 9798385217441. *What can African theologians and philosophers teach the world about bioethics? Jude Thaddaeus Buyondo's recent book offers an intriguing opportunity for the advancement of the global perspective and influence of the field of bioethics by putting African bioethical approaches and experiences into conversation with Western bioethical principlism. While this lengthy title with no subtitle points readily to a doctoral dissertation, the maturity of thought and depth of scholarship of this text somewhat exceeds what would be expected from a first post-doctoral published work. The text reviewed here appears to be the first of two books derived from Buyondo's doctoral dissertation. The first book, The Critique, sets the stage for critical conversations between African and Western bioethicists, and the second book, Holistic Bioethics, published the same year but offered as a sequel or companion volume, describes in more detail the specific content and contributions of African bioethics. *Principlism is a framework for making ethical decisions in healthcare. It is based on four principles--respect for autonomy, nonmaleficence, beneficence, and justice--as delineated by Tom Beauchamp and James Childress in their classic text, Principles of Biomedical Ethics, originally published in 1979. Buyondo's overall project entails a comprehensive critical analysis of African responses to Western bioethics, with specific and frequent attention to the thought of Cameroonian bioethicist G. B. Tangwa, author of Elements of African Bioethics in a Western Frame. The first chapter is an introductory overview of the problem under investigation, namely, that universalized Western bioethical principles do not find validation in the context of African local realities. From the outset, Buyondo establishes Tangwa as his key conversation partner. Throughout the book, Buyondo's analysis of bioethical principlism is largely framed, guided, and energized by his response to Tangwa's critique of Western bioethics and view of African moral thought. *The remaining five chapters of The Critique are divided into two parts: Part I: "Critique of Bioethical Principlism in an African Context, " and Part II: "African Moral Thought: An African Interpretation of Bioethics. " Chapter 2 offers a brief general critique of bioethical principlism, with attention to the influence of four underlying moral theories: rights, virtue, Kantianism, and utilitarianism (consequentialism). In chapter 3, again following Tangwa, Buyondo presents case studies and examples of the shortcomings of bioethical principlism in Sub-Saharan Africa. His descriptions of HIV/AIDS and Ebola vaccine research, male circumcision, and other biomedical interventions provide convincing illustrations of the ineptitude of consequentialist utilitarianism in Black African contexts. *In the first instance, HIV vaccine research, based on African traditional practices of medicine using local herbs, progressed in clinical trials but failed to find global reception because of western resistance to collaboration. In the second case, male circumcision was generally practiced in Africa prior to the arrival of European missionaries, who denounced these practices as barbaric and incompatible with Christianity. But the World Health Organization (WHO) and Joint United Nations Programme on HIV/AIDS (UNAIDS) sponsored a campaign to circumcise millions of poor African men, with mixed results. Local communities and leaders were not given a central decision-making role in planning these campaigns. Studies from the global South did not confirm the prophylactic effectiveness of circumcision in reducing HIV infection. Tangwa condemns circumcision as the "New Tuskegee, " with reference to 20th-century experimentation upon poor Black men in Alabama to study the effects of untreated sexually transmitted diseases. *Part II is much longer than Part I, mainly because Buyondo devotes much more attention to African critiques of principlism than to any discussion of principlism on its own terms. Chapter 4, "An African Interpretation of Bioethics, " is a substantive summary of the moral thought and bioethical practices of the Bantu of Sub-Saharan Africa, which further illustrates the contrast and conflict between the Global North and Global South in philosophical terms. In essence, western approaches to bioethics are highly individualistic and anthropomorphic. By contrast, African bioethical perspectives emphasize relationality in the three-dimensional community of the living, the dead (including the "living-dead" victimized ancestors of history) and those not yet born. *Chapter 5 describes an African ethical system that features non-dualistic thinking, relational social reality, and communitarian bioethics and theories of justice. The concluding chapter reiterates the centrality of Tangwa's studies as a guide to orchestrating an integral approach to enriching the bioethical principlism of Beauchamp and Childress with decolonized articulations of African moral thought. The Critique puts two comprehensively distinctive ways of thinking about bioethics on equal footing for dialogue in pursuit of an authentically global bioethics. This ultimate goal of a global bioethics is achieved by adding a fifth life principle of the sacred interconnectedness of all creation. Buyondo argues for a more comprehensive and holistic normative sense of solidarity extending ethically to all systems of life, institutions and nations, biodiversity, and ecology. This platform offers a firm foothold for addressing the morally challenging episodes and patterns of exploitation that historically characterized relations between Africa and the West. *There are not many books that address bioethical principlism from an African perspective, but a recently published text offers an interesting comparison and informative insights into Buyondo's work: Womanist Bioethics: Social Justice, Spirituality, and Black Women's Health (2025) by Wylin D. Wilson, an African American bioethicist. Her study of bioethics from the perspective of Black women in the U. S. , especially in the rural South, begins with the experience and harm of slavery. The Black church is a key context for her analysis of Black women's lives and beliefs. Buyondo's study makes no reference to African American thought, culture, or religion with respect to bioethics; Wilson makes no reference to African thought, culture, or history in hers. What the two have in common is the critique of the inadequacy of the bioethical principles set forth by Beauchamp and Childress in the context of Black existence. Yet, their analytical approaches are distinctive: Buyondo grants equal footing to Western and African approaches to bioethics as a mutually enriching dialogue, whereas Wilson's project is a focused augmentation of bioethics with womanist (or Black feminist) principles. In both cases, their analyses are centered on Black communal life and concerned with Black suffering, especially experienced as a consequence of bioethical indifference to the violation of Black personhood and the vulnerabilities of Black people in the delivery of healthcare. *Buyondo provides an extensive bibliography, but there is no index. His text would have benefitted from more careful editing for grammar and syntax in order to make his rather lengthy sentences more readable. The title of the book as printed on the title and copyright pages is The Critique of Bioethical Principlism in Contrast to a Black African Approach to Bioethics. However, a different version of the title appears on the book's cover: The Critique of Bioethical Principlism in Contrast to an African Approach to Bioethics. The word "Black" is omitted; this is a serious inconsistency that needs to be corrected one way or the other. *Although Buyondo's training in Catholic moral theology is evident in an occasional footnote or sentence in the book citing Catholic theologians, Christian faith is not a major theme in his critique of bioethical principlism, nor does his comprehensive treatment of African moral thought, beliefs, and bioethical practices seem to be informed by any investment in Christian faith or tradition. However, this text would be of great interest to readers who seek deeper appreciation of the influence of culture on the relevance of bioethical principles and practices. *Reviewed by Cheryl Sanders, professor of Christian ethics, Howard University School of Divinity, Washington, DC 20008.