Dental caries is the main oral health challenge for children in Nigeria. Concern about its negative impact makes screening for caries in children an attractive public health strategy. The ability to detect the preclinical phase of caries, the availability of screening tools with high accuracy, and the possibility of treatment before onset of clinical symptoms with significant cost and health benefits, makes it appropriate for screening. However in Nigeria, the poor availability of highly specific and sensitive screening tools, poor access (...) to oral health care and concerns with pre-screening consent, raise the question of the appropriateness of conducting screening programmes for children. We argue that a number of structural challenges associated with poor uptake of oral health care services need to be addressed before screening for caries can be considered ethically appropriate. These include facilitating access of children to quality oral health care and a systematic national approach to oral health impl... (shrink)

Background Inadequate knowledge among health care providers (HCPs) and parents of affected children limits the understanding and utility of secondary genetic findings (SFs) in under-represented populations in genomics research. SFs arise from deep DNA sequencing done for research or diagnostic purposes and may burden patients and their families despite their potential health importance. This study aims to evaluate the perspective of both groups regarding SFs and their choices in the return of results from genetic testing in the context of orofacial (...) clefts.Methods Using an online survey, we evaluated the experiences of 252 HCPs and 197 parents across participating cleft clinics in Ghana and Nigeria toward the return of SFs across several domains.Results Only 1.6% of the HCPs felt they had an expert understanding of when and how to incorporate genomic medicine into practice, while 50.0% agreed that all SFs should be returned to patients. About 95.4% of parents were willing to receive all the information from genetic testing (including SFs), while the majority cited physicians as their primary information source (64%).Conclusions Overall, parents and providers were aware that genetic testing could help in the clinical management of diseases. However, they cited a lack of knowledge about genomic medicine, uncertain clinical utility, and lack of available learning resources as barriers. The knowledge gained from this study will assist with developing guidelines and policies to guide providers on the return of SFs in sub-Saharan Africa and across the continent. (shrink)

Racism and Its Presuppositions: Towards a Pragmatic Ethics of Social Change Racism has been described as a litmus test or a barium meal which reveals other disorders and injustices within the body politic. It presupposes the legitimacy of racial classifications and the metaphysical reality of races and therefore provides a vital area of scrutiny for philosophical traditions. This paper examines racism and its anti-social effects both on the individual and the society at large. It argues that racism is generally driven (...) by fear and hatred hence all forms of racism are dangerous, socially harmful and morally wrong in practice. The paper recommends ways of overcoming the evil of racism by emphasizing social intelligence and self-realization as moral ideals drawing on John Dewey's pragmatism in ethics. It concludes by stressing Dewey's moral pragmatism as a potent instrument of social change. (shrink)

The aim of the study was to determine the acceptance and perception of Nigerian patients to medical photography. A self-administered questionnaire was distributed among Nigerian patients attending oral and maxillofacial surgery and plastic surgery clinics of 3 tertiary health institutions. Information requested included patients' opinion about consent process, capturing equipment, distribution and accessibility of medical photographs. The use of non-identifiable medical photographs was more acceptable than identifiable to respondents for all purposes (P = 0.003). Most respondents were favourably disposed to (...) photographs being taken for inclusion in the case note, but opposed to identifiable photographs being used for other purposes most especially in medical websites and medical journals. Female respondents preferred non-identifiable medical photographs to identifiable ones (P = 0.001). Most respondents (78%) indicated that their consent be sought for each of the outline needs for medical photography. Half of the respondents indicated that identifiable photographs may have a negative effect on their persons; and the most commonly mentioned effects were social stigmatization, bad publicity and emotional/psychological effects. Most of the respondents preferred the use of hospital-owned camera to personal camera/personal camera-phone for their medical photographs. Most respondents (67.8%) indicated that they would like to be informed about the use of their photographs on every occasion, and 74% indicated that they would like to be informed of the specific journal in which their medical photographs are to be published. In conclusion, non-identifiable rather than identifiable medical photography is acceptable to most patients in the studied Nigerian environment. The use of personal camera/personal camera-phone should be discouraged as its acceptance by respondents is very low. Judicious use of medical photography is therefore advocated to avoid breach of principle of privacy and confidentiality in medical practice. (shrink)

The first annual Alchemy Lecture brings four deep and agile writers from different geographies and disciplines into vibrant conversation on a topic of urgent relevance: humans and borders. Borders, Human Itineraries, and All Our Relation captures and expands those conversations in insightful, passionate ways. Architect, artist, and urban theorist Dele Adeyemo (UK/Nigeria) calls attention to the complexity of Black infrastructures, questioning how "the environments that surround us condition the possibility of our being." Poet Natalie Diaz (US/Mojave/Akimel O'otham) writes: "Like (...) story, migration is the sensual movement of knowledge," and asks, "What is the language we need to live right now?" Philosopher Nadia Yala Kisukidi (France) suggests there is no diasporic life "without the dynamics of fabulation, where we pass down, from generation to generation, the stories of our ancestors who walked barefoot for many months." And cultural theorist Rinaldo Walcott (Canada) asks us to consider inheritances beyond white supremacist logics: "What might it mean to live a life, if we can't risk desiring and working towards utopia?" As each Alchemist considers the legacies of anticolonial struggle, the future of the planet, and the textures of Black and Indigenous life, their essays speak to each other in multiple ways, creating something startling and revelatory: a vision of the world as it is, and as it could be. (shrink)

Recent developments in Western bioethics and biomedicine have called for the need to be culture-sensitive in handling certain bioethical issues. As a result of this anthropological turn in bioethics and biomedicine, there are cultural differences in moral attitudes such as disclosure of terminal illnesses, reproductive technologies, stem cell research, prenatal screening, genetic screening, therapeutic cloning, organ transplant, brain death, physician assisted suicide and so on.This paper offers an examination of the socio-culturally framed ways of dealing with Western and African bioethics (...) particularly as it relates to assisted reproductive technology. It focuses on the ethical issues surrounding assisted reproductive technology from an African perspective making special reference to their religious beliefs by drawing on the Christian and Islamic culture. Effort is made to distinguish between Western and African approaches to assisted reproduction stressing the fact of cultural diversity in issues relating to these reproductive techniques. It argues for the need to take social and cultural meanings embedded in various bioethical issues into consideration in arriving at different conclusions about issues in assisted reproduction in order to give room for adequate understanding.The paper concludes by emphasizing the need to acknowledge cultural diversity in bioethics giving reasons why this diversity is crucial and suggesting ways of handling this diversity. (shrink)

Current developments in feminist epistemology stem from the recognition that knowledge is socially constructed and therefore, must be seen in the context of the social relations in which its production occurs. This version of epistemology stresses the view that individual experiences and knowledge claims are possible only within a community.The concern of this paper is to examine the empiricist account of knowledge. It questions the adequacy of the empiricist attempt to base knowledge on perceptual experience, pointing out that experience has (...) a wider focus than what empiricists allow.Feminist epistemology takes off as a critique of empiricist epistemology on the grounds that the empiricist conception of knowledge fails to acknowledge the fact that knowledge operates in sociohistorical contexts. This accounts for a major limitation in the empiricist conception of knowledge. In order to underscore the thesis of feminist epistemology, the Yoruba women's experience is used, drawing on such factors as women's reproductive experiences and how these experiences can bear upon epistemological inquiry. (shrink)

Nigeria is developing country where the practice of euthanasia is not legalized. But a look at the socio-economic conditions of Nigeria calls for the need to legalize the practice in this country. This paper examines the features of this country such as poverty, endemic diseases and a low level of investment in healthcare systems . It argues for the need to legalize euthanasia by justifying it as a policy and practice and identifying factors which are to be taken into account. (...) They include poor standard of living which reduces the life span of many and limited health care resources which prevents access to health care. The paper justifies legalizing euthanasia in Nigeria by responding to some arguments against euthanasia raised by critics emphasizing at the same time ethical issues such as autonomy, dignity and quality of life for euthanasia debate. It concludes by stressing that in Nigeria, a competent person who is terminally ill and undergoing severe pain should be able to determine how and when to end his life; the possibility of this will only depend on the legalization of euthanasia in this country. (shrink)

Xenophobia, a form of discrimination practiced in countries, particularly in South Africa, is one of the major challenges confronting the modern day society. This paper examines xenophobia as a menace showing at the same time that this discriminatory practice bifurcates societies by creating a dichotomy amidst the various occupants of the society, thereby giving room for “otherness” rather than “orderliness”. The paper also highlights the philosophical implications of this societal bifurcation, particularly to the human community. Seeking a plausible way of (...) addressing this challenge, the paper concludes by emphasizing the relevance of the value of tolerance in curbing xenophobia. Keywords : Xenophobia, Social discrimination, Tolerance, order and other, Africa. (shrink)

Xenophobia, a form of discrimination practiced in countries, particularly in South Africa, is one of the major challenges confronting the modern day society. This paper examines xenophobia as a menace showing at the same time that this discriminatory practice bifurcates societies by creating a dichotomy amidst the various occupants of the society, thereby giving room for “otherness” rather than “orderliness”. The paper also highlights the philosophical implications of this societal bifurcation, particularly to the human community. Seeking a plausible way of (...) addressing this challenge, the paper concludes by emphasizing the relevance of the value of tolerance in curbing xenophobia. (shrink)

PurposeThe purpose of this paper is to examine the risk arising from technological devices, such as closed circuit television and nuclear power plants and the consequent effect on the rights to privacy and security of individuals.Design/methodology/approachThe paper presents critical and conceptual analyses of CCTV, nuclear power plants and the rights of individuals. It also analyses how communitarianism and liberal individualism would respond to right‐infringements and risk‐imposition. It draws on W.D. Ross's prima facie and actual duties to explain the pre‐eminence of (...) duty when certain duties conflict in a bid to improve technology.FindingsThe paper discovers the importance of rights to individuals, particularly the rights to privacy and security. It shows that, in some situations, government's duty to respect the right to the privacy of individuals conflicts with the duty to provide public goods, such as CCTV. The paper, therefore, stresses that one duty has greater moral force than the other. In essence, the more incumbent duty can be employed by government in justifying right‐infringement and risk‐imposition, though this does not disvalue the rights of individuals.Originality/valueThe paper offers insight into ways of addressing questions such as: when is it morally acceptable or justifiable to expose others to risk? When is infringement on people's rights permissible? Also, the paper is relevant to those in the areas of ethics and technology because it offers an ethical analysis of risk‐imposition and right‐infringement by examining how ethical theories, such as communitarianism and liberal individualism, would assess risks resulting from CCTV and nuclear energy. It argues that consent is not enough to justify risk‐imposition and right‐infringement. It concludes by drawing on W.D. Ross's prima facie and actual duties as a means of justifying risk‐imposition and right‐infringement by government. (shrink)

Background Currently there is increasing recognition of the need for research in developing countries where disease burden is high. Understanding the role of local factors is important for undertaking ethical research in developing countries. We explored factors relating to information and communication during the process of informed consent, and the approach that should be followed for gaining consent. The study was conducted prior to a family-based genetic study among people with podoconiosis (non-filarial elephantiasis) in southern Ethiopia. Methodology/Principal Findings We adapted (...) a method of rapid assessment validated in The Gambia. The methodology was entirely qualitative, involving focus-group discussions and in-depth interviews. Discussions were conducted with podoconiosis patients and non-patients in the community, fieldworkers, researchers, staff of the local non-governmental organisation (NGO) working on prevention and treatment of podoconiosis, and community leaders. We found that the extent of use of everyday language, the degree to which expectations of potential participants were addressed, and the techniques of presentation of information had considerable impact on comprehension of information provided about research. Approaching podoconiosis patients via locally trusted individuals and preceding individual consent with community sensitization were considered the optimal means of communication. Prevailing poverty among podoconiosis patients, the absence of alternative treatment facilities, and participants' trust in the local NGO were identified as potential barriers for obtaining genuine informed consent. Conclusions Researchers should evaluate the effectiveness of consent processes in providing appropriate information in a comprehensible manner and in supporting voluntary decision-making on a study-by-study basis. (shrink)

Rapid advances in high throughput genomic technologies and next generation sequencing are making medical genomic research more readily accessible and affordable, including the sequencing of patient and control whole genomes and exomes in order to elucidate genetic factors underlying disease. Over the next five years, the Human Heredity and Health in Africa (H3Africa) Initiative, funded by the Wellcome Trust (United Kingdom) and the National Institutes of Health (United States of America), will contribute greatly towards sequencing of numerous African samples for (...) biomedical research. (shrink)

Studies on informed consent to medical research conducted in low or middle-income settings have increased, including empirical investigations of consent to genetic research. We investigated voluntary participation and comprehension of informed consent among women involved in a genetic epidemiological study on breast cancer in an urban setting of Nigeria comparing women in the case and control groups.

BackgroundThe consent process for a genetic study is challenging when the research is conducted in a group stigmatized because of beliefs that the disease is familial. Podoconiosis, also known as 'mossy foot', is an example of such a disease. It is a condition resulting in swelling of the lower legs among people exposed to red clay soil. It is a very stigmatizing problem in endemic areas of Ethiopia because of the widely held opinion that the disease runs in families and (...) is untreatable. The aim of this study was to explore the impact of social stigma on the process of obtaining consent for a study on the genetics of podoconiosis in Southern Ethiopia.MethodsWe adapted a rapid assessment tool validated in The Gambia. The methodology was qualitative involving focus-group discussions (n = 4) and in-depth interviews (n = 25) with community members, fieldworkers, researchers and staff of the Mossy Foot Treatment and Prevention Association (MFTPA) working on prevention and treatment of podoconiosis.ResultsWe found that patients were afraid of participation in a genetic study for fear the study might aggravate stigmatization by publicizing the familial nature of the disease. The MFTPA was also concerned that discussion about the familial nature of podoconiosis would disappoint patients and would threaten the trust they have in the organization. In addition, participants of the rapid assessment stressed that the genetic study should be approved at family level before prospective participants are approached for consent. Based on this feedback, we developed and implemented a consent process involving community consensus and education of fieldworkers, community members and health workers. In addition, we utilized the experience and established trust of the MFTPA to diminish the perceived risk.ConclusionThe study showed that the consent process developed based on issues highlighted in the rapid assessment facilitated recruitment of participants and increased their confidence that the genetic research would not fuel stigma. Therefore, investigators must seek to assess and address risks of research from prospective participants' perspectives. This involves understanding the issues in the society, the culture, community dialogues and developing a consent process that takes all these into consideration. (shrink)

Research is a global enterprise requiring participation of both genders for generalizable knowledge; advancement of science and evidence based medical treatment. Participation of women in research is necessary to reduce the current bias that most empirical evidence is obtained from studies with men to inform health care and related policy interventions. Various factors are assumed to limit autonomy amongst the Yoruba women of western Nigeria. This paper seeks to explore the experience and understanding of autonomy by the Yoruba women in (...) relation to research participation. Focus is on factors that affect women's autonomous decision making in research participation. An exploratory qualitative approach comprising four focus group discussions, 42 in-depth interviews and 14 key informant interviews was used. The study permits a significant amount of triangulation, as opinions of husbands and religious leaders are also explored. Interviews and discussions were audiotaped and transcribed verbatim. Content analysis was employed for data analysis. Findings show that concepts of autonomy varied amongst the Yoruba women. Patriarchy, religion and culture are conceived to have negative impact on the autonomy of women in respect to research participation. Among the important findings are: 1) male dominance is strongly emphasized by religious leaders who should teach equality, 2) while men feel that by making decisions for women, they are protecting them, the women on the other hand see this protection as a way of limiting their autonomy. We recommend further studies to develop culturally appropriate and workable recruitment methods to increase women's participation in research. (shrink)