Our April 2022 issue is a showcase of diversity of experience and perspective in bioethics across the Asian region. The geographical reach of this issue is particularly extensive, as is the range of types of scholarship, covering theoretical work, empirical analysis, and case studies all involving the lived experience of ‘doing’ bioethics within – or with a focus on – Asia.
While it is trite to observe that different groups are adversely affected by the COVID-19 pandemic, some groups are easier to ignore than others. This is particularly true of refugees and migrant workers who can all too easily slip below the radar of governments’ attention and the operation of public health policies. We are very pleased to support the work of Shu Hui Ng who has contributed a paper as a Student Article. Capacity building is a very important part of the strategic objectives of the Asian Bioethics Review, and this paper by Shu Hui Ng on the situation in Malaysia is a very good example of the kind of work that the editorial team is keen to support.
As a counterpoint to this perspective, Yusuke Seino, Yayoi Aizawa, Atsushi Kogetsu, and Kazuto Kato examine the experiences of Japanese healthcare providers working in intensive care units in the early stages of the COVID-19 pandemic. The research reveals not only a detailed picture of the range of ethical and social issues to arise while working under such conditions but also, most revealingly, the moral distress experienced by the professionals during these times.
The theme of decision-making in Japan is continued by Atsushi Asai, Taketoshi Okita, and Seiji Bito, who adopt a psychocultural-social perspective that reveals five tendencies in thinking and action that are said to be characteristic of many Japanese people living in contemporary Japan. The argument is made that such tendencies can militate against shared decision-making (SDM) between healthcare professionals and patients. To the extent that SDM can be cast as a universal ethical ‘ideal’, this paper has important implications for the training of healthcare professionals and their future relationships with patients in promoting full respect for patient autonomy.
The experiences of Pakistan when faced with the globalisation of clinical research is the focus of the paper by Asma Fazal. While it is well-recognised that the conduct of clinical trials in lower income countries gives rise to a plethora of ethical issues, the added value of this article to the debate is in its efforts to reveal the particular ways in which the population of Pakistan is made vulnerable by such practices. The paper also offers an important set of recommendations that seeks to align good research conduct with an understanding of local cultural practices, experiences and expectations. In this way, the article is a good example of ethics in action.
Vorathep Sachdev makes a plea to take the perspective of developing countries seriously in on-going debates about human enhancement. This piece argues that current debates are framed too much in the neoliberal tradition and that, accordingly, much is lost as a result. More practically, however, using the example of Thailand as a developing country, the author seeks to demonstrate concrete ways in which such a country could benefit from certain types of human enhancement, as well as revealing specific ways in which risks or harms might be exacerbated.
In his paper, Vijayaprasad Gopichandran tackles the global phenomenon of antimicrobial resistance through an argument that requires us to consider the role and impact of up-stream social determinants of health (SDH). As with many other papers in this issue, the central point is that context is key; self-evidently, and by definition, contexts are diverse and varied. In particular, SDHs can have ethical implications on effective antimicrobial stewardship in practice. Only by taking a holistic approach can stewardship from the global to the local have any real hope of success.
Thinley Dorji, Nidup Dorji, Kinley Yangdon, Dorji Gyeltshen, and Langa Tenzin offer profound insights into social attitudes and values in Bhutan towards dying. Just as there has been socio-economic growth in the country, so too the focus of death and dying has shifted from the home to the hospital. But as with all other countries, socio-economic development brings its own host of issues for healthcare, including a rise in certain kinds of diseases and a population that is increasingly more aged. Against this backdrop, the authors reflect on their own observations and anecdotal evidence of how these social and cultural shifts have impacted on perspectives on death in Bhutan.
The idea of the lived experience of bioethics permeates this issue. This is continued in the paper by Lily Beth Lumagbas who writes on ‘Exploring the Ethics of Space in Slum Research during COVID-19 through the Lens of Merleau-Ponty’. Building on the foundations of Merleau-Ponty’s phenomenology of perception, Lumagbas explores the diverse ways in which human experiences of, and perceptions of, space have been altered during the extreme lockdown moments of the COVID-19 pandemic; and goes on to make a normative point about the increased role of the virtual space as a place where humans can enjoy different experiences away from the physical and can also enjoy the opportunity to make their own place.
Our final paper comes from Yumal Kuruppu, Thrangani Rupasinghe, and Saroj Jayasinghe in Sri Lanka, on the theme of racism, with respect to medical images in teaching materials, newspapers and health-related websites. The research reveals a significant preponderance of white Caucasian images that in turn gives rise to at least two sets of concern: (i) it could re-enforce a false view that the legitimacy of medical knowledge is to be found predominantly in the West, and (ii) it may affect healthcare professional skills in visual diagnosis for individual patients. It is a source of considerable concern that the theme of diversity is not continued into more areas of life.
Our publisher Springer Nature allows you to read all articles online for free, even if you do not have a subscription to ABR – simply click on the title. Additionally:
- Free2Read articles can be downloaded and printed as well, if you have a subscription.
- Free or Open Access articles can be downloaded and printed, even without a subscription.
- Our articles since 2018 are also accessible via PubMed Central (PMC), where they become Free Access after 12 months.
The copyright of Free2Read and Free Access articles is shared by Springer Nature and the National University of Singapore. The copyright of Open Access articles remains with the respective authors.
Editorial – Free Access
Diversity of Experience and Perspective in Bioethics
Graeme T. Laurie
April 2022 – 14(2): 103-105 – doi: 10.1007/s41649-022-00204-7
Student Article – Open Access
Health Inequalities amongst Refugees and Migrant Workers in the Midst of the COVID-19 Pandemic: A Report of Two Cases
Shu Hui Ng
April 2022 – 14(2): 107-114 – doi: 10.1007/s41649-021-00198-8
Original Article – Open Access
Ethical and social issues for healthcare providers in the intensive care unit during the early stages of the COVID-19 pandemic in Japan: A questionnaire survey
Yusuke Seino, Yayoi Aizawa, Atsushi Kogetsu, and Kazuto Kato
April 2022 – 14(2): 115-131 – doi: 10.1007/s41649-021-00194-y
Original Article – Free Access
Discussions on the risk of transformation of the shared decision-making process in Japan
Atsushi Asai, Taketoshi Okita, and Seiji Bitoe
April 2022 – 14(2): 133-150 – doi: 10.1007/s41649-021-00201-2
Original Article – Free2Read
Ethical issues in conducting research in third world countries: A Pakistani perspective
Asma Fazal
April 2022 – 14(2): 151-168 – doi: 10.1007/s41649-021-00196-w
Free Access from 1 April 2023 via PMC8986905
Original Article – Open Access
‘Beyond’ Human Enhancement – Taking the developing country’s perspective seriously
Vorathep Sachdev
April 2022 – 14(2): 169-182 – doi: 10.1007/s41649-021-00193-z
Perspective Article – Free2Read
Reducing the Ethical Burdens of Antimicrobial Stewardship using a Social Determinants Approach
Vijayaprasad Gopichandran
April 2022 – 14(2): 183-190 – doi: 10.1007/s41649-022-00202-9
Free Access from 1 April 2023 via PMC8986926
Perspective Article – Free2Read
Exploring the Ethical Dilemmas in End of Life Care and the Concept of a Good Death in Bhutan
Thinley Dorji, Nidup Dorji, Kinley Yangdon, Dorji Gyeltshen, and Langa Tenzin
April 2022 – 14(2): 191-197 – doi: 10.1007/s41649-021-00199-7
Free Access from 1 April 2023 via PMC8986937
Perspective Article – Free Access
Exploring the Ethics of Space in Slum Research during COVID-19 through the Lens of Merleau-Ponty
Lily Beth Lumagbas
April 2022 – 14(2): 199-206 – doi: 10.1007/s41649-021-00187-x
Perspective Article – Free2Read
Images in health-related communications from Sri Lanka: Is there a racial bias?
Yumal Kuruppu, Thrangani Rupasinghe, and Saroj Jayasinghe
April 2022 – 14(2): 207-212 – doi: 10.1007/s41649-021-00195-x
Free Access from 1 April 2023 via PMC8986920
Asian Bioethics Review 