Comparing Western and African Bioethics: Reflections through Art, Teaching, and Philosophy
- Julie Botticello
- Feb 23
- 12 min read
Introduction
Western thought can be pervasive. It has spread from Europe outwards, often to the detriment of other ways of knowing, supplanting preexisting bases. Some post-colonial authors have explored these cultural encounters and clashes through literature and critical theory. In his Globalectics, Ngũgĩ explored how, in the period prior to the colonial encounter, autochthonous thought and knowledge existed and thrived.[1] This is in contradiction to the dominant Western view, which holds that thought and philosophy arose through contact with Western ‘civilizations’: that the colonies only came to exist, epistemologically, because of this contact. Ngũgĩ argues that colonial knowledge aimed to construct a particular perception of reality that sought to erase colonized peoples prior to their ‘discovery’ through conquest.[2]
My eureka moments around whose knowledge matters arrived through formal education. In high school my class took a fieldtrip to New York and the Metropolitan Museum of Art, where I was introduced to high art and culture. The experience was transformational. The majesty of the museums, the scale of the art works, and their colours and forms, not to forget their setting in a global city, represented the sheer possibilities of life and I was drawn in. After moving to the UK, I again engaged with Western art works and representational culture in museums as an undergraduate, but this time was curious about art from outside the Western canon.
In particular, ethnographic artefacts created within the context of daily life were represented differently from the art market driven value of museums and gallery pieces. Yet ethnographic artefacts were also traded and valued for their aesthetic and artistic qualities, as Steiner documents.[3] These works were predominantly from former European colonies in Africa and included performance masks and Nkisi medicinal figures (fig 1). Among them high art existed, as seen in the Benin Plaques (from current day Edo State, Nigeria) made using the lost wax technique that pre-dated colonial contact (fig 2). Post-contact, European artefacts such as manilla, crescent-shaped metal rings made in Europe and used by the Edo people as currency, were incorporated into some representations, documenting intercultural exchange. Western artists like Picasso incorporated African sculpture into their works. While also documenting intercultural exchange, underpinning the juxtaposition was the difference between simple representational art and complex conceptual art. Despite being included by Western artists, artworks produced in service of the everyday tended to remain outside the high art canon, as something ‘other’, located in ethnographic museums, with anonymous works categorised regionally as representative of specific cultures and periods.
Later, as an academic instructing higher education students, I have again experienced how knowledge and experiences are differentially represented, whether from the global Western view or from a local African one. During a film screening about international development and reconciliation between the Hutus and the Tutsis in Rwanda, in which Paul Kagame was presented as a champion for peace and unity, one student from the Democratic Republic of Congo (DRC) walked out. Later, she explained that Kagame was responsible for perpetuating the genocide, especially in the DRC, and that his perceived character among Western audiences should not be the only interpretation.
Western interpretations and validations can undermine and obfuscate alternative ways of knowing and being. In this article, the focus shifts to bioethics and its attendant notions of personhood, comparing Western and African conceptualisations. This aims not only to better understand their similarities and differences, but also to amplify an African alternative for consideration within the Western canon.
What is Bioethics?
Questions about the beginning of life, through IVF, stem cell research, or abortion, and end of life, such as advance directives or assisted dying, are the concern of bioethics. Bioethics is an applied form of ethics, a branch of moral philosophy, which strives to provide guidance for life and death decision making. It centres on the norms by which we live our lives and tends to sit outside of more abstract contemplations of existence or being, as explored through metaphysics and ontology. Bioethics can also extend to other living entities, such as animals and the natural environment, being worthy of care, respect, and consideration.[4] It fundamentally draws on our societally internalised morality[5] as bioethical values underpin our everyday thoughts and actions.
Bioethics, as it is generally practiced, has Western origins, arising in the twentieth century in response to some of the most egregious violations against persons and their autonomy or ability to self-determine. In response to these atrocities, codes were developed, such as the Nuremberg Code (1949), the Belmont Report (1979), and Principlism,[6] each of which underpins informed consent as the practical manifestation of autonomy. These ethical guidelines clearly enunciate that individuals hold the authority to self-determine and define under which conditions their autonomy would be violated. Duties between healthcare practitioners and patients date back to the Hippocratic Oath and the Code of Hammurabi, both of which existed before the common era.
Ethics and moral guidelines were also present in precolonial societies. Akan (Ghanaian) proverbs attempted to address common assumptions and beliefs about human experience through a ‘synthetic’ or unified interpretation.[7] Proverbs provided insight and guidance on how to live, for oneself and as part of a community. An individual’s identity is therefore connected to and defined by engagement with others.[8] Bioethics in Africa is rooted in these communitarian systems of ‘collective responsibility, community participation, and engagement’ that underpin society.[9] The ethical norm lies in the individual obligation to fulfil their share of that collective responsibility.
Individuals exist in both Western and African contexts. In the former, individuals hold inviolable ‘natural’ autonomy; in the latter, individuals are ‘natural’ members of a society, who require society to realise their potential.[10] Ajei and Myles review autonomy and contest informed consent as it is currently framed within Western logics, questioning to what degree a Western person is exerting their autonomy in any given situation when having to rely on the knowledge of others to make their decision. That is, how can a cancer sufferer be said to make an informed decision about treatment when they understand so much less about cancer or treatment outcomes than their doctor? This questioning is not limited to African bioethicists but also includes legal scholars who question the degree of being ‘informed’ in the informed consent giving process.[11] Ajei and Myles also extend notions of relationality to Western thought, where healthcare practitioners, again, are rooted in beliefs about doing good and not harming and would therefore see compliance with their recommendations as the right thing to do—the only thing to do.[12] This suggests that consent and autonomy, even in individualised Western contexts, are not as independently generated as the concept implies.
When teaching students whose traditions and history align more with communitarian ethics than individualist ones, to presume Western individualist bioethics as the baseline for ethical values would be a further injustice of erasure and silencing of alternative systems of knowing; it would also exclude recognition of the power and knowledge differentials in any decision-making processes. Delving deeper, it is necessary to understand what makes a human being a person in each context, Western or African, and how this informs autonomy.
Personhood—Patient or Agent
Western and African bioethics each draw a distinction between being a human being and being a person, and what moral status each holds. Moral status can be seen as a duality, where a recipient (patient) experiences the effects caused by an actor (agent).[13] Broadly speaking, patient-centred ethics is relevant to Western philosophy and agent-centred ethics is relevant to African philosophy.[14] In the west, the patient-centred approach suggests that the patient is like an object who possesses attributes (ie humanity, consciousness, or rationality) which indicate personhood. This idea of a possessor of properties aligns with the concept of ‘Western possessive individualism’, often associated with people surrounding themselves with material possessions, whether through seventeenth-century cabinets of curiosities (fig 3) or contemporary collections named for the benefactor (such as the Tate or Guggenheim), and the status this confers.[15] In a Western bioethical context, the focus is on the object of morality, the patient and the attributes they possess, and not the subject of morality, the agent and what they do.[16] In the Western view, there are arguments over which attributes determine personhood status. For some, foetuses or individuals who are braindead constitute persons, due to being human beings. For others, those same entities would not be persons.[17] The deciding factor is whether the patient possesses certain qualities that constitutes personhood.
Conversely, in African traditions, the action that someone undertakes is also factored in when ascribing personhood. Achebe notes that for the Igbo of Nigeria, ‘every generation will receive its own impulse and kinesis of creation’, such that overemphasizing the product undermines each generation’s (or person’s) development through the process.[18] The fetishization of possession undermines the character development in striving for moral perfection.[19] Tangwa locates actions as the source of morality, arguing that ‘human persons are not morally special [as patients], they are morally liable [as agents]’.[20] The Western version is the ‘minimal definition’ of personhood (based on characteristics possessed), whereas the African version proposes the ‘maximal definition’ of personhood, based on the measure of the excellence of the moral agent.[21] As such, a human being must work to attain personhood through their actions and intentions to continually better themselves for the purpose of bettering their community. Achieving one’s potential is therefore not a self-serving end. Persons become so through caring for one another in a shared way of life.[22]
For some African philosophers, the community overshadows the individual. For others, it does not. Ghanaian philosopher Gyekye questions the personhood of a robotic automaton who unthinkingly abides by the group will.[23] Although a person is dependent upon social relations, such dependence does not ‘dissolve her individuality within a broader notion of community’.[24] This is because a person’s individuality remains. While an individual is a member of a community and that community aims to help that individual achieve moral virtue, it still comes down to the individual to act.[25] The deciding factor is how much the individual did the moral work to become a person. A person is at once both free and not free, due to their individuality and the pressure imposed upon them from the community.[26]
Yet the attainment of personhood by these standards could suggest that if society does not deem one to have worked for the welfare for others, they could be denied personhood. This would have material and existential implications, such as death sentences for being LGBTQI+, healthcare denial for abortion, or refusal to approve of stem-cell research.[27] Atuire aims to reconcile these contemporary bioethical dilemmas besetting Africa through an alternative yet still indigenous view of personhood. He maintains the African theorisation of personhood as underpinned by the patient/agent duality which confers both privileges and duties: what is owed to an object (patient) and what a subject (agent) owes to others. Differing from some African bioethicists, however, Atuire asserts that object moral status is a condition of all human beings, irrespective of any specific capacities they hold. Being human is inherently relational and this fact alone confers object moral status. To this he adds subject moral status, for which individual actions toward collective human flourishing are accounted. Full moral status, ie full personhood, is accorded only to those beings with both object and subject moral statuses.
Atuire acknowledges traditional African philosophers’ wish to eschew what is seen as the reach of Western influence and its technological advance; however, he questions their complete refutation as a false ideological bid to return to ‘precolonial culture’ and its ‘uncontaminated reality’,[28] stating that these issues are concrete challenges in Africa, in need of ethical and practical attention. Instead of ‘dislodging’[29] or ‘exorcising’[30] Western influence, in a bid to return to an imagined pre-colonial past, he recommends active engagement with these contemporary concerns toward the development of practical and locally relevant solutions.[31]
With these moral statuses explained, Atuire focusses his attention on the question of abortion, something which impacts millions of women in Africa while garnering divergent ethical views. An embryo or foetus would be accorded object moral status as part of the human species. Object moral status denotes vulnerability and a need for heightened societal protection. Rather than spurning the pregnant person who seeks an abortion as someone rupturing traditional African values by not contributing to human flourishing through taking the birth to full term, Atuire extends the notion of vulnerability to them, as patients owed care. In doing so, he recognises their distress in having an unwanted pregnancy, the stigma and long-term social harm of bearing an ill-conceived child, and the potential death faced through unsafe abortions outside of the community’s sight.
Subject moral status comes from acting for one’s community. Therefore, Atuire argues, to abandon a pregnant person to their plight of an unwanted pregnancy would not be serving humanity, nor would it be exhibiting communal humanism on the part of other members of the community. His argument rests on a reconsideration of whose vulnerability matters. He cites the traditional African ethicists’ attention to an agent’s sympathy—of having ‘sympathetic identification with the interests of others, even at the cost of a possible abridgement of one’s own interests’[32]—through which they fulfil their duty to the community and exercise social virtue. By reframing vulnerability to include the pregnant person as a patient, his proposal demonstrates how traditional African ethical frameworks can account for and incorporate contemporary bioethical challenges besetting African societies, while remaining congruent to a communitarian ethic. His argument to sympathise with the patient could also reframe the rights-based approach to abortion within Western contexts, to one that aligns within patient-centred ethics.
Moving forward
This article seeks to advocate for an alternative to Western ways of knowing and being through a comparison to African perspectives in art and ethics. In so doing, it attempts to broker a dialogue between Western and African viewpoints, and to suggest that their values, while different, are not opposed. It also hopes to suggest that there is more to be gained from engaging with each another than there is in remaining apart.
Western perspectives tend to revolve around attributes possessed by individuals, whereas African perspectives tend to value processes and actions taken for the benefit of communities. This can be seen in the art collections amassed by individuals versus the qualities of forging both objects and character, through actions undertaken. That said, gaps appeared on both sides. In Western contexts, this centred around the concept of autonomy, where the precept of self-direction is tempered by acquiescence to medical authority. Similarly, in African contexts, self-subsummation to the will of the community was refuted, as automatons could not also be moral agents taking action for the betterment of the group.
These examples demonstrate that in the fields of art or ethics, once aware of our own restrictions, a space emerges for wider reconsideration. Dialogue between Western philosophy and African philosophy could offer Westerners moral tools through which to consider contemporary challenges.[33] At the same time, such dialogue could address current and emerging bioethical issues in Africa, by engendering theory that aligns with African sensibilities.[34] This dialogic approach would better serve international classrooms by shifting entrenched philosophical divisions and opening pathways for change. In global contexts, it is this reckoning with both indigenous and imported values that gives rise to informed, inclusive, and relevant information necessary to address contemporary concerns. Each side alone is insufficient as important aspects remain unresolved. Recognising commonalities amid philosophical differences can enrich all engaged.
Julie Botticello
Dr Julie Botticello is an anthropologist, who has worked in academia since completing her PhD in 2009 on Yoruba-Nigerians and their aspirations for wellbeing in the post-colonial context. Post-doctorate, her research interests have remained focussed on post-colonial migrants and other marginalised communities, whether in relation to health, work, or education, to affirm alternative knowledge bases in our interconnected, yet heterogenous, globalised world. Critically, Dr Botticello’s research questions how technological advances in reproductive health reshape ethical frameworks, especially in settings marked by historical and epistemic inequalities. Specifically, this research pathway explores the confluences of African and Western perspectives on bioethics and biotechnology in reproduction, considering how the advancement of technology, combined with epistemic transnationalism, challenges accepted norms.
Currently, Dr Botticello serves as the Program Director for the BSc in Health Sciences and a Senior Lecturer at the University of New Haven (UNH), in Connecticut, USA. In 2024/25, she held a Faculty Fellowship with the Center for Teaching Excellence on inclusive pedagogy, and as part of the Yale Prison Education Initiative, expanded higher education access to incarcerated women in a Federal Prison. Previously, she was the Course Leader for the Public Health BSc degree, led the Athena Swan Gender Equality self-assessment team, and served as a Senior Lecturer for the School of Health, Sport and Bioscience, at the University of East London, UK.
[1] Ngũgĩ wa Thiong'o, Globalectics: Theory and the Politics of Knowing (Cambridge University Press 2012).
[2] ibid 30.
[3] Christopher Steiner, African Art in Transit (Cambridge University Press 1994).
[4] Caesar Atuire, ‘African Perspectives of Moral Status: A Framework for Evaluating Global Bioethical Issues’ (2022) 48(2) Medical Humanities 238-245.
[5] Godfrey Tangwa, ‘The Traditional African Perception of a Person: Some Implications for Bioethics’ (2000) 50(5) Hastings Center Report 39-43.
[6] See Tom Beauchamp and James Childress, Principles of Biomedical Ethics (8th edn, Oxford University Press 2019).
[7] Kwame Gyekye, An Essay on African Philosophical Thought: The Akan Conceptual Scheme (Temple University Press 1995) 21.
[8] Oche Onazi, Human Rights from the Community (Edinburgh University Press 2013) 38.
[9] Yaw Frimpong-Mansoh, ‘Bioethics: Traditional African Perspective’ in Yaw Frimpong-Mansoh and Caesar Atuire (eds), Bioethics in Africa, Theories and Praxis (Vernon Press 2019) 49.
[10] Martin Ajei and Nancy Myles, ‘Personhood, autonomy and informed consent’ in Frimpong-Mansoh and Atuire (n 9) 77-94.
[11] Radhika Rao, ‘Informed Consent, Body Property, and Self-Sovereignty’ (2016) 44 Journal of Law, Medicine and Ethics 438.
[12] Ajei and Myles (n 10).
[13] Kurt Grey and David Wegner, ‘Moral Typecasting: Divergent Perceptions of Moral Agents and Moral Patients’ (2009) 96 Journal of Personality and Social Psychology 505.
[14] Kevin Behrens, ‘Two “Normative” Conceptions of Personhood’ (2011) 25 Quest: An African Journal of Philosophy 103-118.
[15] James Clifford, ‘Objects and Others’ in George Stocking (ed), Objects and Others: Essays on Museums and Material Culture (University of Wisconsin Press 1985).
[16] Tangwa (n 5) 40.
[17] Peter Singer, Practical Ethics (3rd edn, Cambridge University Press 2011).
[18] Chinua Achebe, ‘Foreword’, in Herbert Cole and Chike Aniakor (eds), Igbo Arts: Community and Cosmos (University of California Press 1984).
[19] Motsamai Molefe, An African Ethics of Personhood and Bioethics: A Reflection on Abortion and Euthanasia (Palgrave MacMillian 2020).
[20] Tangwa (n 5) 40.
[21] Ifeanyia Menkiti, ‘Person and Community in African Traditional Thought’ in RL Wright (ed), African Philosophy: An Introduction (University Press of America 1984) 132.
[22] Thaddeus Metz, ‘An African Theory of Moral Status: A Relational Alternative to Individualism and Holism’ (2012) 15 Ethical Theory and Moral Practice 387-402.
[23] Kwame Gyekye, Tradition and Modernity: Philosophical Reflections on the African Experience (Oxford University Press 1997).
[24] Ajei and Myles (n 10) 87.
[25] Molefe (n 19) 36
[26] Ajei and Myles (n 10)
[27] Caesar Atuire, ‘A Prolegomenon to Bioethics in Africa: Issues, Challenges and Commonsensical Recommendations’ in Frimpong-Mansoh and Atuire (n 9).
[28] Atuire (n 4) 244.
[29] Molefe (n 19) 10
[30] Kwasi Wiredu, ‘An Oral Philosophy of Personhood: Comments on Philosophy and Orality’ (2009) 40(1) Research in African Literatures 8-18.
[31] Atuire (n 4) 238.
[32] Kwasi Wiredu and Kwame Gyekye, Person and Community (Council for Research in Values and Philosophy 1992) 194.
[33] Tangwa (n 5).
[34] Atuire (n 4) 238.
