The failure of the UN Security Council to adequately and effectively address the Syrian crisis has brought renewed scrutiny to the veto and its capricious use during mass atrocity situations. In response to these concerns, the idea of a code of conduct to regulate the exercise of the veto during humanitarian situations is now being increasingly advanced by several states, including France and the United Kingdom. This paper disputes the utility of such a code and argues that it would not (...) make any significant difference to the way mass atrocity crimes are addressed. I examine three core arguments often extended to justify the merit and the utility of the norm: the circumvention argument, the naming and shaming argument, and the Charter reform argument. I show how each of these arguments is undermined by mistaken notions about the norm's procedural effectiveness, and the role the veto plays in cases of what Simon Chesterman calls “inhumanitarian noninterventions.” Additionally, drawing on interviews conducted with diplomats at the United Nations in New York, I present evidence that resistance to a code of conduct comes not only from the permanent five members of the Council but also from the nonpermanent members, further imperiling the idea's capacity to effect change. Ultimately, I contend that the current global effort to curtail the influence of the veto is nothing more than a journey down the rabbit hole: exciting, but ultimately distracting. (shrink)

This book presents the first critical examination of the overlapping ethical, sociocultural, and policy-related issues surrounding disasters, global bioethics, and public health ethics. These issues are elucidated under the conceptual rubric: Public health disasters. The book defines PHDs as public health issues with devastating social consequences, the attendant public health impacts of natural or man-made disasters, and latent or low prevalence public health issues with the potential to rapidly acquire pandemic capacities. This notion is illustrated using Ebola and pandemic influenza (...) outbreaks, atypical drug-resistant tuberculosis, and the health emergencies of earthquakes as focal points. Drawing on an approach that reckons with microbial, existential, and anthropological realities; the book develops a relational-based global ethical framework that can help address the local, anthropological, ecological, and transnational dynamics of the ethical issues engendered by public health disasters. The book also charts some of the critical roles that relevant local and transnational stakeholders may play in translating the proposed global ethical framework from the sphere of concept to the arena of action. This title is of immense benefit to bioethics scholars, public and global health policy experts, as well as graduate students working in the area of global health, public health ethics, and disaster bioethics. (shrink)

The introduction of Western healthcare, via colonialism, into Africa facilitated a confrontation of indigenous and exogenous “medical” knowledge as well as the attendant praxis. Although colonialism has been expunged from the shores of Africa, the epistemic and ideological frictions it introduced into the sphere of healthcare linger and raise different dilemmas. Against this background, this paper explores pragmatic and ethical approaches that may help engage these tensions in the context of drug development based on validated traditional phytomedicines.

Many drugs used in paediatric medicine are off-label. There is a rising call for the use of adaptive clinical trial designs in responding to the need for safe and effective drugs given their potential to offer efficiency and cost-effective benefits compared with traditional clinical trials. ADs have a strong appeal in paediatric clinical trials given the small number of available participants, limited understanding of age-related variability and the desire to limit exposure to futile or unsafe interventions. Although the ethical value (...) of adaptive trials has increasingly come under scrutiny, there is a paucity of literature on the ethical dilemmas that may be associated with paediatric adaptive designs. This paper highlights some of these ethical concerns around safety, scientific/social value and caregiver/guardian comprehension of the trial design. Against this background, the paper develops a non-static conceptual lens for understanding PADs. It shows that ADs are epistemically open and reduce some of the knowledge-associated uncertainties inherent in clinical trials as well as fast-track the time to draw conclusions about the value of evaluated drugs/treatments. On this note, the authors argue that PADs are ethically justifiable given they have multiple layers of safety, exposing enrolled children to lesser potential risks, create social/scientific value generally and for paediatric populations in particular, specifically foster the flourishing of paediatric populations and can significantly improve paediatric trial efficiency when properly designed and implemented. However, because PADs are relatively new and their regulatory, ethical and logistical characteristics are yet to be clarified in some jurisdictions, the cooperation of various public and private stakeholders is required to ensure that the interests of children, their caregivers and parents/guardians are best served while exposing paediatric research subjects to the most minimal of risks when they are enrolled in paediatric trials that use ADs. Data sharing not applicable as no datasets generated and/or analysed for this study. Not applicable. (shrink)

Pragmatic clinical trials (PCTs) seek to show the effectiveness of treatments in routine, clinical practice (MacPherson 2004). However, a number of ethical challenges come to the fore when collater...

The power of the scientific enterprise presents multiple avenues for harnessing and increasingly controlling biological phenomena and instituting interventions in different areas of biomedicine (Af...

Volume 19, Issue 7, July 2019, Page 53-55.

A large and important part of social relations is gender relations between men and women. Over time, the manifestation of such relations has often been one of violence, particularly violence against women. Different approaches have been deployed to deal with the experience of gender-based violence (GBV). One popular approach is the human rights framework that suggest that GBV can be addressed by granting certain rights to women. We argue that while a human rights framework holds some promise in resolving GBV, (...) it is limited in some ways because it does not take the cultural perceptions of gender relations that envision gender duties into account. As part of our argument, we show that social relations in African communities ought to be primarily based on the principle of duty to the other, rather than an emphasis on rights. We conclude that there is a need to complement the rights-based approach with a duty-based approach to effectively address GBV. (shrink)

Funding broadly connotes the notion of an institution and/or institutions making money and other resources available to individual researchers and organizations to accomplish specific projects. Whi...

COVID‐19, caused by a novel coronavirus named SARS‐CoV‐2, was identified in December 2019, in Wuhan, China. It was first confirmed in sub‐Saharan Africa in Nigeria on 27 February 2020 and has since spread quickly to all sub‐Saharan African countries, causing more than 111,309 confirmed cases and 2,498 deaths as of 03 June 2020. The lessons learned during the recent Ebola virus disease (EVD) outbreaks in some sub‐Saharan African countries were expected to shape and influence the region’s responses to COVID‐19 pandemic. (...) However, some of the challenges associated with the management of the EVD outbreaks persist and create obstacles for the effective management of the COVID‐19 pandemic. This article describes the commonalities between the EVD epidemics and COVID‐19 pandemic, with a view to draw on lessons learned to effectively tackle the ongoing pandemic. Key successes, failures and lessons learned from previous EVD outbreaks are discussed. Recommendations on how these lessons can be translated to strengthen the COVID‐19 response in sub‐Saharan Africa are provided. (shrink)

I read with great bewilderment the unconvincing arguments of Peter F. Omonzejele in his article “Ethical Challenges Posed by the Ebola Virus Epidemic in West Africa” published in the 11 issue of the Journal of Bioethical Inquiry. While the author glaringly mixed up anthropological issues concerning the hygiene of hand-washing and safe burials in an article with a title clearly focused on ethical challenges, he failed to establish how the current Ebola epidemic ravaging some West Africa countries made these human (...) practices ethical challenges. Anecdotal examples cited in the article fit entirely into the realm of anthropological and sociological issues fuelling the spread of Ebola but are not in any way related to ethical challenges. The title was either misleading or the author deliberately discussed anthropological/sociological issues tangentially in an article supposedly written on ethical issues.The author also contradicted himself, having categorized as a compelling need t .. (shrink)

Contexts where the same clinician with an ongoing physician-patient relationship seeks to enroll his or her own patient(s) into a clinical research are ethically tricky due to the associated role c...

One of the central characteristics of public health disasters is the rapid overlapping of different needs and priorities that require making critical choices that inevitably elicit conflicti...

Volume 20, Issue 2, February 2020, Page 38-41.

Psychological assessment has long been reported as a key component of clinical psychology. This paper examined and shed light on the complexities surrounding the clinical significance of therapeutic approach to treatment Planning. To achieve this objective, the paper searched and used the PsycINFO and PubMed databases and the reference sections of chapters and journal articles to analysed the underlying themes: 1) a strong basis for the usage of therapeutic approach to psychological assessment in treatment plans, 2) explained the conceptual meaning (...) of clinical significant change in therapeutic assessment, 3) used initial theory to explain the therapeutic mechanisms of change in clinical practice, 4) analysed the empirically documenting clinically significant change in therapeutic assessment. Finally, the study suggested that though therapeutic assessment is not sufficient for the systematic study of psychotherapy outcome and process, it is still consistent with both the lay-man and professional expectations regarding treatment outcome and also provides a precise method for classifying clients as “changed” or “unchanged” on the basis of clinical significance criteria. (shrink)

Nigeria agriculture, food security and dietary intake have not been exempted from the disruptions in countless sectors around the world due to the outbreak of COVID-19. The country first experienced the outbreak on February 27, 2020, and the experience since then has shown negative effects not only on the socioeconomic conditions but also on agriculture, food security and dietary intake. Long term in-depth analysis of the effects of this pandemic on food security and dietary intake using quantitative data is still (...) very difficult due to paucity of data and the great level of the improbability of the trajectory of the spread of the Virus. This study is a rapid assessment of the short and long-term potential effects of the disease. It relied on a review of situation reports especially by the Nigeria Centre of Disease Control and other reports around the world on COVID-19, personal observations, and public opinion via mobile telephone survey of Lagos and Oyo States, Nigeria. Findings show that food demand and supply shocks caused by COVID-19 outbreak affect agriculture, food and dietary intake negatively through COVID-19 policies. It leads to a reduction in household income coupled with hike in food prices. Owing to the Nigeria’s crude farming practice, there was a scarcity of hired labour required for production process during 2020 farming season. This implies a high likelihood of low output and further surge in food prices in the future. Food access was also compromised with the accumulation of unsold fresh produce by the smallholder farmers and the low salary earners during movement restrictions and of loss income as a result of international border closure. Food and dietary intake is affected as people are shifting diets to more affordable and low quality foods, while food stability is not guaranteed due to market insecurity, prompting an extraordinary level of indecision. The study concludes that the shock of COVID-19 is not only a demand management problem but a multidimensional crisis requiring monetary, fiscal, and health policy responses with global collaboration and cooperation. (shrink)

Community engagement in research, including public health related research, is acknowledged as an ethical imperative. While medical care and public health action take priority over research during infectious disease outbreaks, research is still required in order to learn from epidemic responses. The World Health Organisation developed a guide for community engagement during infectious disease epidemics called the Good Participatory Practice for Trials of Emerging (and Re‐emerging) Pathogens that are Likely to Cause Severe Outbreaks in the Near Future and for which (...) Few or No Medical Counter‐Measures Exist (GPP‐EP). This paper identified priorities for community engagement for research conducted during infectious disease outbreaks drawing on discussions held with a purposive sample of bioethicists, social scientists, researchers, policy makers and laypersons who work with ethics committees in West Africa. These perspectives were considered in the light of the GPP‐EP, which adds further depth and dimension to discussions on community engagement frameworks. It concludes that there is no presumptive justification for the exclusion of communities in the design, implementation and monitoring of clinical trials conducted during an infectious disease outbreak. Engagement that facilitates collaboration rather than partnership between researchers and the community during epidemics is acceptable. (shrink)

This paper explores the implications of mass migration and the conditions of hybridization for early 21st century Western societies in texts dealing with migrantexperiences. The novel Goodbye Lucille (2007) by the Afro-cosmopolitan writer Segun Afolabi will be explored with respect to the crucial problem of an ethics and politics of belonging, related to the recent controversies surrounding multiculturalism and issues of migration. This text deals with the “in-between world” of migrants and negotiates questions of identity, alienation and belonging in (...) a so-called transcultural/transnational context. The issues raised in Segun Afolabi's fiction are addressed by employing the ways of thinking developed in political philosophy, including recent phenomenological attempts to theorize the notion of “home” and “belonging” (e.g., by Karen Joisten, but also Martin Heidegger) in order to deal with the complexities of the issue. The question, “What constitutes the good life for the individual and the political community?”, needs to be considered by taking into account the current plurality of approaches to forging identitiesin the political sphere as well. The subtlety of literary accounts of this phenomenon – literature may indeed be one of the best diagnostic instrument for studying a society – sheds light, I suggest, on the conditions of politically relevant identity formations. A close reading of literary texts such as those by Afolabi offers an important contribution to a realistic, and therefore complex and complicating, account of our overall situation in the Western world with respect to the politics of belonging. (shrink)