Saturday, March 23, 2013

Are Bioethics and Developing World Bioethics institutionally racist?

The answer appears to be 'yes' if you believe a Letter to the Editor published recently by our colleagues at the Journal of Bioethical Inquiry. Three authors (one from India the other two from the USA and the Netherlands respectively -  ie two thirds from the global north, I'll get back to that!) decided one way to ascertain whether there's institutional bias toward the rich world's problems in bioethics journals would be to investigate the country location provided for the journals' editors as well as their editorial board members. They picked 14 journals, looked at their overall number of editorial board members and divided them into groups based on the Human Development Index into Very High and High, Medium and Low. To no one's surprise they discovered that the vast majority of Editorial Board members hail from Very High and High HDI countries. You might wish to note that High HDI includes countries such as Jamaica, Malaysia, Grenada, Brazil, Iran and so on and so forth. The current list is here. So, by lumping countries such as Germany and Jamaica into one category (ie by lumping together Very High and High HDI) the authors of the letter have arguably created the particular outcome they needed to mount their criticism, namely the underrepresentation of bioethicists from developing countries on bioethics journals editorial boards. They discovered that 95% of editorial board members hail from these countries. These countries, of course, include countries as far apart in terms of development as are Germany and Libya.

Surprisingly this question begging bean counting activity must have passed peer review at the Journal of Bioethics Inquiry. Well, or it passed the editorial judgment of whoever is currently in charge at that journal. 

Now, fair enough, it is reasonable to be concerned about bioethics focus on the - often times decadent - problems of folks in the global north while ignoring more serious issues confronting people in the global south. I certainly feel passionately about this and have done my best during my years as one of the Editors of Bioethics and as one of the Founding Editors of Developing World Bioethics to remedy this situation. Let me show you how this pans out in the Letter writers analysis. I mentioned already that they're lumping - unreasonably - together folks from Germany and Jamaica or Australia and Dominica to generate the scandal they are keen on exposing. Bioethics is listed here as a journal with zero representatives from medium and low HDI. Brilliant insight. Here is the context the Letter writers ignored - were too busy investigating. 

On my initiative, more than a decade ago, while I was working full-time as an academic in South Africa, we made a considered decision to 'sacrifice' some of the Bioethics print real estate (ie the number of print issues we could produce in a given year) by starting a companion journal dedicated exclusively to developing world issues, and so Developing World Bioethics was born. Its distribution is identical to that of Bioethics, so wherever Bioethics is available in a personal or institutional subscription, there is also Developing World Bioethics. You could argue now that that surely was just a means to shunt aside issues affecting the global south, but incidentally the success of Developing World Bioethics in competitive journal impact rankings (where it does better than many mainstream bioethics journals) suggests otherwise. Criticizing Bioethics then for not having editorial board members from medium to low-income HDI countries completely misses the point of this arrangement. It constitutes unfair and uninformed criticism. Incidentally, 2/3rds of the Letter's authors hail from countries of the global north. Their own logic applied to their own letter would suggest that that somehow isn't a good thing. 

A more serious omission by the authors is their decision not to undertake actual serious qualitative research.  After all, the Letter writers have not even bothered to undertake an actual content analysis to investigate (and demonstrate) that the problem they are concerned about exists. Instead they say this, 'Scanning 4,029 research articles in nine bioethics journals, Borry, Schotsmans, and Dierickx (2005) found that developing country scholars contributed fewer than 4 percent of publications (the other 96 percent coming from authors working in developed countries). It is no surprise, then, that bioethics pays more attention to esoteric ethical problems facing wealthy nations than it does to issues such as poverty, hunger, and health inequities that are global in nature.'

You might wish to note that the study they cite ignored Developing World Bioethics. There's something amusing about scholars trying really hard to show how badly the global south is done by by mainstream bioethics, yet they have to resort to unnecessary acts of omissions, such as ignoring journals dedicated exclusively to this issue. They also ignore something else: many journals focusing strongly on these issues (in China, in Brazil, in Iran and so on and so fourth) do not feature on their list.  Why should non-English speaking academics working in the global south submit content to English language journals that are not widely read in their home countries? Are they doing wrong, in the eyes of our Letter writers, when they focus on journals in their mother tongue that are actually locally read by their fellow country men and women? 

My bone of contention with the authors of this Letter (and the Editors of the journal that published it) is that the research that it is based on is shoddy at best; that even if it wasn't as shoddy as it is it would still not have been able to show what needs to be shown, namely that the absence of editorial board members from the countries in question is the cause of bioethics lack of focus on issues the Letter writers are rightly concerned about.

Arguably today more content than ever before is produced by bioethicists on these issues. Perhaps not enough, but since Developing World Bioethics has come into being a lot has changed for the better. Journals such as the Journal of Global Ethics, Metaphilosophy, Public Health Ethics and others continue to produce high-quality outputs on the issues the Letter writers are concerned about. 

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