Can Bioethics Be Global and Local, or Must It Be Both?

Abstract

This article contributes to ethnography of bioethical practices in a developing nation by examining how doctors perceive and use them in Mexico. We ask whether principle-based bioethics can transplant to a developing nation. An analysis reveals the bioethical approaches in different hospital settings, the local nature of bioethical understanding, and a universal requirement for ethical distribution of health care. After an overview of U.S. bioethics development and of Mexican biomedical institutions, the article presents field research done on bioethical conceptualizations and practices in two Mexican government hospitals. An analysis of the bioethical dilemmas physicians face and the approaches taken within the society in different institutional venues uncovers the local character of bioethics and the universal bioethical needs, and the intersection between micro and macro processes in hospital health care. While local conditions must guide a physician's day-to-day ethical practices, a global bioethics is needed to address universal problems experienced in economically developing nations.