Wathuta Jane
Dev World Bioeth. 2018 Jun;18(2):109-118. doi: 10.1111/dewb.12139. Epub 2016 Dec 28.
This paper seeks to highlight the benefits of prioritizing moderate African communitarian principles as partly demonstrated in the HIV prevention strategies implemented in Uganda in the late 1980s. Pertinent lessons could be drawn so as to achieve the HIV prevention targets envisioned in the post-2015 development era. Communitarianism emphasizes the importance of communities as part of healthy human existence. Its core ethical values include the virtues of generosity, compassion, and solidarity. Persuasion through communication, consensus through dialogue, and the awareness and commitment to responsibilities towards other members of the community, are chief practices relied upon to achieve appropriate social behaviour. All these elements signify individual rootedness in communities and contribute to the healthy existence of its members. Communitarianism is usually classified as either authoritarian/radical or responsive/moderate, depending on the primacy given to either community interests or the individual will and rights. Moderate communitarianism recognizes the individual's capacity for moral reasoning, virtue and free choice. The ensuing form of society is deemed more ethical as it relies on education in the virtues, moral persuasion and informal social controls, without stifling individual identity, agency, and capacity for self-determination. If moderate African communitarianism, in particular, can to a certain extent be associated with the significant aspects of Uganda's HIV prevention strategies in the stated period, then its present-day relevance for HIV prevention and other public health interventions may be emphasized accordingly. This applies especially in view of the ongoing efforts to achieve a balance between individual and collective interests in bioethics.
本文旨在强调优先考虑温和的非洲社群主义原则的益处,这在20世纪80年代末乌干达实施的艾滋病预防策略中已有所体现。可以从中吸取相关经验教训,以实现2015年后发展时代所设想的艾滋病预防目标。社群主义强调社区作为健康人类生存一部分的重要性。其核心伦理价值观包括慷慨、同情和团结等美德。通过沟通进行说服、通过对话达成共识,以及对社区其他成员的责任意识和承诺,是实现适当社会行为所依赖的主要做法。所有这些要素都表明个人扎根于社区,并有助于其成员的健康生存。社群主义通常根据对社区利益或个人意志及权利的优先考虑程度,分为专制/激进型或响应/温和型。温和的社群主义承认个人的道德推理、美德和自由选择能力。由此产生的社会形式被认为更具道德性,因为它依赖于美德教育、道德说服和非正式的社会控制,而不会扼杀个人身份、能动性和自我决定能力。特别是,如果温和的非洲社群主义在一定程度上可以与上述时期乌干达艾滋病预防策略的重要方面联系起来,那么可以相应地强调其在当今艾滋病预防和其他公共卫生干预措施中的相关性。鉴于目前在生物伦理学中努力在个人利益和集体利益之间取得平衡,这一点尤其适用。