African approaches to an enriched ethics of person-centred health practice

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Werdie van Staden


‘Person-centred ethics’, containing ‘person’ in the singular, may suggest a commitment to individualism. This paper, however, argues that a person-centred ethic need not be trapped in an a priori commitment to liberal individualism or communitarianism, should one draw on two related core African insights on 1) putting people first and 2) respect for diversity. “Batho pele” is a Sesotho expression that means “people first”. It is closely connected to the rich concept of “ubuntu”, translated incompletely as “in existence with and through others”. It champions both the person and groups of persons by virtue of an interconnectedness expressed, for example, in the isiZulu maxim “Unmuntu Ngumuntu Ngabantu”, translated as “I am because you are, and you are because we are”.Putting people first in the ethics of health care has to account for diversity, for diversity is an inevitable characteristic both among individual persons and groups of people.  To account for diversity in not merely a general way, the diversity specific to both particular persons and between groups of people in a particular situation and context needs to be taken seriously. Accounting for diversity in this way guided by the ethics “people first” and “ubuntu”, requires a process of shared decision making in which all relevant values, including potential individualist and communitarian values, are taken up in a substantive communicative process that creates in partnership person and people-specific decisions for that very situation, context, and time – a process captured in the African concept of an “indaba”.

Article Details

Third Geneva Conference on Person-Centered Medicine: Conceptual Perspectives
Author Biography

Werdie van Staden, University of Pretoria

Werdie (C.W.) van Staden is Professor of philosophy and psychiatry and head of the Division of Philosophy & Ethics of Mental Health at the University of Pretoria. He has been the first appointee of this kind outside Europe. He directs an MPhil-degree programme and supervises doctoral research in this field. His clinical attachment is as honorary consultant psychiatrist at Weskoppies Hospital, Pretoria, South Africa.            Following his training as physician and specialisation in psychiatry at the University of Pretoria, he continued his clinical training and his study in philosophy in the United Kingdom where the University of Warwick awarded him a doctorate of medicine in philosophy. He is a fellow of the College of Psychiatrists of the South African Colleges of Medicine, and also holds qualifications in music at master’s degree level from the University of London (UK) and the University of South Africa.He published several papers and chapters in medical and philosophy journals and books. His core interests are in respectively values in health, incapacity, the philosophy of Gottlob Frege, and the symptomatology of schizophrenia. He considers his most profound philosophical work, captured in the journal Philosophy, Psychiatry & Psychology under the title “Linguistic markers of recovery: theoretical underpinnings of first person pronoun usage and semantic positions of patients”.He is the editor of the South African Journal of Psychiatry, serves on the editorial boards of a number of international journals, including Philosophy, Psychiatry & Psychology and is managing editor of Philosophy, Ethics & Humanities in Medicine. He serves on the Steering Committee of the International Network for Philosophy & Psychiatry consisting of more than 40 national associations.He has served on several scientific committees of international and national conferences, and chaired the organising and scientific committees of the 10th International Conference for Philosophy, Psychiatry and Psychology held in 2007 in South Africa. In 2006, he convened the national Congress of the South African Society of Psychiatrists (SASOP). He is the founder and chair of the Philosophy of Psychiatry Special Interest Group of SASOP, and serves on the National Advisory Board of SASOP.He is member of various executive committees of the University of Pretoria including being the Chairperson of the Research Ethics Committee (IRB) of the Faculty of Health Sciences, and several management and policy committees of the School of Medicine. He directs the health ethics training in the School of Medicine; chairs the postgraduate training committee of the department of psychiatry; provides clinical training and supervision in general adult psychiatry for medical students and registrars in psychiatry; leads the clinical and theoretical training programme in psychotherapy for registrars in psychiatry; chairs a major module of 2nd year medical and dental students; and leads an inter-disciplinary clinical team at Weskoppies Hospital.