I am delighted to announce a special seminar by Dr John Barugahare 
(Makere, visiting Cambridge) on 11th June at 1pm, in Seminar Room 1 in 
HPS. More details on the talk and speaker below

Best wishes

Stephen

Abstract

Introduction: 'How rigorous should the consenting process be for the 
resulting consent to be valid in medical and health research?' This is 
the precise question informing all current discussions on consent in 
medical and health research. Discussion: The argument of this paper is 
that this and related questions cannot be fully answered in abstract by 
using hypothetical cases to arrive at pre-determined ethical rules for 
research. Rather, precise answers can be arrived at in specific concrete 
situations. Hence, the current frustration resulting from the 
insufficiency of official guidelines for obtaining valid consent is a 
result of two weaknesses: i) failure to appreciate the unavoidable gap 
between general rules/guidelines and their application in specific 
cases; ii) reluctance to identify and emphasize the sort of cognitive 
skills and attitudes needed to close that gap. To demonstrate this 
point, this paper proposes conceptual tools to guide the understanding 
and overcoming stubborn difficulties encountered in answering the 
question at issue. The conceptual tools being proposed are five: 
Fact-skepticism, Rule-skepticism, Hypothetical guidelines, Real 
guidelines and ultimately Bioethical reflexivity. The argument is that 
whereas pre-determined ethical rules/guidelines are supposed to apply to 
specific facts of individual studies, we can never be certain about all 
the facts of all future studies (fact-skepticism) to the extent that we 
design guidelines to sufficiently address every detail of such studies 
(rule-skepticism). Further, given that the guidelines we have are based 
on hypothetical facts, then such guidelines can be understood as 
hypothetical guidelines. Hence, real guidelines as opposed to 
hypothetical ones, are the final decisions the ethical design of 
particular studies, and in this specific case, how the processes of 
consent ought to proceed. Effectiveness at deriving real guidelines 
requires a reflexive disposition and related skills, hence bioethical 
reflexivity. Conclusion: The problem with existing bioethics is not that 
existing guidelines in many cases fail to provide answers to specific 
and unique questions in the field. The problem is lack of reflexive 
mindset and the relevant skills needed to close the natural gap between 
general rules and their application in specific cases.


Bio-

Dr. John Barugahare (PhD) is a visiting Scholar at HPS under the 
Cambridge African Partnership for Research Excellence (CAPREx). He is a 
lecturer at Makerere University – Kampala in the Department of 
Philosophy. He also teaches bioethics in the School of Health Sciences 
at the same institution. His backgrounds is in Philosophy with special 
interest in applied moral philosophy in medicine and health generally. 
His current research is in bioethics, specifically the ethics of 
International Collaborative Medical and Health Research. He will be 
presenting one of the manuscripts he has drafted and completed while 
here at here at HPS. The title of his talk is­: 'Bioethical Reflexivity' 
and requirements of valid consent: Conceptual tools.

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