Teaching global bioethics

Bioethics. 2003 Oct;17(5-6):432-46. doi: 10.1111/1467-8519.00359.


We live in a world with enormous disparities in health. The life expectancy in Japan is 80 years; in Malawi, 40 years. The under-five mortality in Norway is 4/1000; in Sierra Leone, 316/1000. The situation is actually worse than these figures suggest because average rates tend to mask inequalities within a country. Several presidents of the IAB have urged bioethicists to attend to global disparities and to broaden the scope of bioethics. For the last six years I have tried to do just that. In this paper, I report and reflect on my attempts to teach bioethics in ways that address global health and justice. I then discuss ways to address key ethical issues in global health: the problem of inequalities; the nature of the duty to assist; the importance of the duty not to harm; the difference between a cosmopolitan and a political view of justice. I also discuss how teaching about global health may help to shift the emphasis in bioethics--from sensational cases to everyday matters, from autonomy and justice, and from access to healthcare to the social determinants of health. At the end of my paper, I reflect on questions that I have not resolved: how to delineate the scope of bioethics, whether my approach over-politicises bioethics, and how to understand the responsibilities of bioethicists.

MeSH terms

  • Bioethical Issues*
  • Bioethics / education*
  • Cultural Diversity
  • Developing Countries
  • Ethicists
  • Global Health*
  • Health Status
  • Humans
  • Internationality*
  • Politics
  • Resource Allocation / ethics*
  • Social Justice / economics*
  • Social Justice / ethics*
  • Social Responsibility
  • Socioeconomic Factors
  • Teaching* / methods
  • Warfare