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The phenomenon of violence has been part of human history. It raises some ethical issues which are very important in bioethics. These ethical issues are autonomy of persons, beneﬁcence, non-maleﬁcence, and justice. In this entry on violence, these are discussed from both local and global perspectives. The bioethical point of view adopted here is the pluralist view.
The phenomenon of violence has been a part of human history or existence, and it is therefore an issue that is central to all forms of human organization. It is in view of this that Aristotle notes that “the history of man has been history of war” (Aristotle 1998). In recent times, the phenomenon of violence has assumed a larger dimension. In global media, we are inundated with portrayals of violent occurrences in almost all parts of the world. This has become prominent in the media because of the activities of terrorist groups across the globe and the counter-insurgence measures taken by various governments in the world as well as violent actions by individuals occurring in all parts of the world. In fact, the recent upsurge of the phenomenon of violence has made some commentators to dub this century as a century exhibiting “the culture of violence” (Enns et al. 2004; Kiras 2005).
The pervasiveness of violence in the world in recent times has also been made possible because it has become a form of entertainment in the media, especially in television. Many researches indicate that the unrestrained presentation of violent programs in the media has contributed significantly to the actual deployment of violence in real life (Brandes 1998). It is noted further that violence has become part and parcel of our social fabric – our families, in schools, in public transport, etc. This entry will focus on violence as it relates to bioethics.
Conceptual Clarification Of Violence
The nature of clariﬁcation that will be undertaken in this work would be modeled along the pattern made by Cavell (1979). Cavell posits two forms of interpretative understanding – phenomenological interpretation and conceptual interpretation. The phenomenological interpretation is grounded on facts, while conceptual understanding is anchored on the meaning of concepts that are used in any discursive strategy which leads to the understanding of various concepts in the discourse. The entry will deploy the two approaches since facts will be used to illustrate violence occurrences.
The concept of violence is an essentially contested one (Honderich 1976). Violence is a physical assault or the threat of physical assault against a person or property. It could also be viewed as an act of aggression that causes or intends to cause injury to person(s) (Dentan 2000). In this concept of violence, the central idea is the intention to cause physical injury, damage, and harm. Another view of violence is when it is used to characterize the use of (legal) political force, such as executed by the police or military force of the state. This does not mean that all police or military force is legal; what this just shows is that this has the backing of the state and is in the public domain (Irele 1993).
The concept of violence has underpinning it the idea of force against people or things, “a use of force that offends against a norm” (Honderich 1976). It also has in it the notion of coercion. There is what could be described as coercion of force. In this case, there is no room for any form of action on the part of the victims (Honderich 1976). There is also coercion of persuasion which does not allow for action on the part of the victims due to certain unpleasant consequences that may follow if one does that. The two forms of coercion are not totally distinct because there is no criterion “such that all instances of coercion fall clearly into one category or the other” (Honderich 1976). Violence therefore involves the use of coercion which has embedded in it the use of “force against people or things” (Honderich 2003). Violence is therefore a form of force or coercion against people. It is a denial and abuse of life. Violence in this regard denies people of their dignity and also denies people of their personhood since harm is perpetrated against the victims of violence. It could be physical, structural, and psychological. Victims of violence in this entry were mostly the innocent and powerless whose lives were affected by the violent actions of those who inﬂicted the violent acts on them.
The conceptual analyses of violence in this entry have a sort of family resemblance with each other. The concept of violence in this regard consists of family resemblances. It is therefore an open or open-textured concept, non-sharply distinct from each other in terms of analysis of any form of violence. The deﬁnition of violence by World Health Organization in the World report on violence and health is as follows: “the intentional use of physical force or power, threatened or actual, against oneself, another person or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation” (Krug et al. 2002). This deﬁnition also highlights certain key characteristics found in the other analyses of violence.
Violence And Bioethics
Bioethics as a branch of applied ethics deploys the principles and methods of moral philosophy to practical problems in biomedical researches and allied bio-disciplines. The issue of violence that this entry is concerned with would have to be discussed from moral angles which are pluralist (Bennet et al. 2003). The pluralist view appropriates the “best insights from deontology, consequentialism and virtue ethics in some form of coherent framework” (Bennet et al. 2003). It should be noted that the pluralist view is trailed by certain problems because the “deeper theoretical foundations of the pluralist project are often very difﬁcult to defend” (Bennet et al. 2003). However, this entry shall not be concerned with those problems.
Violent acts as earlier pointed out infringe on the dignity of the victims, and as such those whose lives were affected by the violent acts had their personhood trampled upon. The ethical guidelines and codes underlying these ethical principles are based on some ethical theories as earlier pointed out. These theories have been incorporated into bioethics. As earlier mentioned, pluralist perspective would be used to illuminate certain violent acts that were perpetrated against people who were victims of these acts. These principles and codes grew out of the discovery of Nazi abuses committed in the name of medical research prior to and during World War II. As a result of this, the Nuremberg code was proposed to guide medical research (Alderson and Morrow 2011). There have been subsequent ethical guidelines and codes like the Declaration of Helsinki of 1964, with successive amends most recently in 2013 which was basically proposed for medical research and has been adopted as ethical codes for other biological based researches as well as social research.
There is also the Belmont Report National Commission for the Protection of Human subjects, 1979. The Belmont Report was a response to the Tuskegee study of syphilis in which 600 African-American men, 400 of whom had the disease, were monitored from 1932 to 1972, without treatment, in order to observe the natural cause of this lifelong deadly disease, even though there was an effective drug that could treat the disease. The experiment ended in 1974 as a result of the press coverage which exposed the immoral research. Now most of these codes and guidelines, as earlier pointed out, list some ethical theories that should be upheld in any situation, but four basic ethical principles are always listed: respect for persons, beneﬁcence, non-maleﬁcence, and justice (Beauchamp and Childress 2013; Bennet et al. 1993).
The idea of respect for persons is deontological in nature which was emphasized by Kant, beneficence by the utilitarians, and justice by Aristotle and many others. In the case of respect for persons, there are two ethical principles in it – that individuals should be treated as autonomous agents and, second, that persons with diminished autonomy should be protected. This last one is paternalism. The principle of autonomy refers to the individual’s capacity to make decisions about issues that affect them (Richter et al. 2007). Autonomy has four elements:
- Information about any biological research must be disclosed to those who might be affected by it.
- Arising from the ﬁrst element, those affected by the research must understand the relevant information.
- Those involved must have the competence to consent.
- The consent is a freely given, valid consent, without coercion, and those who are affected by the research have the option to back out from the research (Bennet et al. 1993; Richter et al. 2007).
Now, in the speciﬁc case of violence inﬂicted on the Nazi victims, we can see that the principles of autonomy was violated because the victims did not freely consent to the research, and in the case of Tuskegee, the victims were not informed. The violence in the Nazi’s case was also horrendous because some victims were eliminated through the gas chamber they were thrown into. The respect for person’s dignity or human rights was completely trampled upon. Terrorist violence has been such that they don’t respect the people their violence is targeted at. In the case of Boko Haram in Nigeria, innocent people have been killed by their violent acts.
Beneficence And Non-Maleficence
The discursive strategy of beneﬁcence and non-maleﬁcence has dominated bioethics for so long. The principles in their bare outlines state that good should be promoted in any action we undertake. This is encapsulated in these ways; we should maximize possible beneﬁts and maximize possible harms (Belmont Report, Part B, 1979). There is conﬂict or tension in the principle of beneﬁcence, and this tension trails utilitarian ethical theory (Baron 2006). This will not be dwelled upon here. The non-maleﬁcence principle states that we should “do no harm.” This principle is a fallout from the Hippocratic Oath and is interpreted as enjoining people not to injure or harm anybody in our actions. This principle has a consequentialist bent: the rightness or wrongness of our action depends on the nature of the consequences. In this context, actions that are considered right are those that promote the greatest overall good for the greatest number of people (Gallager 2009).
In the speciﬁc case of violence, it would have been noted that most violent actions do not have any beneﬁcial result. In fact, the outcome of violence is simply that harm is done to the individuals and the society at large. The Boko Haram violence in Northeast part of Nigeria has inﬂicted unbearable harm to the victims of the violent acts. People have been injured and killed. Besides that, many people have been displaced from their homes. The atrocities are such that most people are now disoriented or traumatized, and they may never recover from the violence perpetrated against them. In the case of Nazi’s atrocities, violence was deployed as an institutional weapon to eliminate the Jews, and this violated the principle of non-maleﬁcence because it involves harm as well as negates the principle of respect for human life.
The principle of justice means fairness and equity. In this regard, burdens and beneﬁts should be distributed fairly in any society. This principle also entails that no harm or unfair treatment or burden should be meted on any segment of the populations whether or not they belong to our ethnic group or religious group. The Nazi’s research program on prisoners of war was against the idea of justice. The prisoners bear the risk of the research program. Most of them died. Some of them were maimed and they could not live a meaningful life anymore. The research did not seek their consent before it was carried out. Harm was inﬂicted on them. The prisoners had no choice since their imprisonment had already limited the options available to them. The Boko Haram jihadist group in Nigeria treats people unfairly because they don’t belong to their religious group. They have killed and maimed innocent people through their violent actions. Justice at both the individual and collective (distributive) levels in the cases pointed out to illustrate the concept of justice was not implemented fairly.
Other Issues That Involve Violence
There are many issues now in the world that involve violence. One of such is the violence against children and women. In most parts of the globe where war is raging, children and women have become targets. In the case of children, they have been coerced into war. Their consent was not sought since they cannot even do this at their age. The United Nations Convention on the Rights of the Child deﬁnes the child as follows: “every human being below the age of 18 years unless, under the law applicable to the child, majority is attained earlier.” From this deﬁnition, their autonomy has been violated since they cannot make decisions for themselves at their age. In the scenario where the child has been coerced into war, violence has been inﬂicted on the child and as such harm has been done to the child. In the case of women, some of them have been raped; hence, their autonomy has been trampled upon. Moreover, harm has been inﬂicted upon them through this violent act.
There is also now human trafﬁcking and this is mostly rampant in the third world where people have been kidnapped or lured into leaving their country by promise of better future in other countries, especially in Europe, only to realize later that this is not the case. In this case, the people concerned were subtly coerced, and their autonomy was trampled upon. Some of them were used for research projects. Some of the women have been coerced into sex workers in some of the countries they were taken to, and the young children became servants as well as sex objects. In these cases, a sort of violence has been inﬂicted on the victims and as such their autonomy has been infringed upon.
Another aspect of violence inﬂicted on people, especially in the third world countries, is the sale of human organs. Some of the people concerned were lured or induced to sell their organs. In fact, money is involved and most people in the third world are poor and because of this rich people in the developed world had taken advantage of this fact. This trade in human organs offends against human dignity because it violates respect for persons and hence their autonomy. There is a subtle coercion by persuasion or inﬂuence on those who sell their organs. The people who are affected by selling their organs are not properly informed about the risks involved in organ transplant if any complications arise. This scenario occurs in other areas of medical research or new technologies which are tested on people in the third world countries. For example, there were some experiments done in Africa to test some new drugs for AIDS. One of the drugs, zidovudine (AZT), reduced the rate of transmission of HIV from mother to new born by some percentage in some developed countries. Shortly after the results became known, the experiments were introduced in some African countries because most pregnant women in Africa with AIDS cannot bear the cost of the new drug which prevents the transmission of AIDS from mother to the new born. The test was to compare the new drug with shorter doses of AZT drug within a control group. The experiment initiated was that a control group was set up, and within this group some pregnant women were given the new drug, while the other women in the control group were given only a placebo. A no-treatment control was the only way to ﬁnd out whether the treatment was effective or not. There was uproar about these experiments because some people felt it was unethical to perform such trials on people. It was felt that they infringe on the autonomy of the people involved in the experiment. The experiment also inﬂicted harm and risk on the individuals involved in the placebo trials because it was done for the beneﬁts of other individuals especially in the developed countries.
Drug research is another subject that has been a controversial one. Most pharmaceutical companies have carried out experiments of their new drugs in the third world countries, especially in Africa. The drug companies exploit the people in the third world countries because of the poverty prevalent in these countries by paying little amount to them compared with what they could have paid in the developed countries. Moreover, they would have to follow certain stringent measures in developed countries which they do not observe in most poor countries. The exploitative nature of the action could be termed as a form of coercion. Moreover, there is a sense in which one could argue that it is unfair for drug companies to take advantage of the people in poor countries by paying them less than what they could have paid in the developed countries. This controversy will not be pursued here because some moral points of view especially the utilitarian might still justify this payment of the drug companies in poor countries.
Another form of unfairness is that the poor people in these poor countries might not beneﬁt from the drug research compared with some people in the developed countries. In other words, they are paid to bear the risk for some people, especially in the developed countries. In some cases, the drugs that are tested on the poor people in the poor countries might not be affordable to them once they are developed. The risks involved in the drug testing became a controversial issue in some poor countries. A case in point is the meningitis drug that was tested on some children in Kano state of Nigeria in the 1990s which led to certain unpleasant consequences. This led to series of court cases which were later settled out of court after some payments were made to those affected by the testing of the drugs. Some drug companies carry out research in most poor countries without adequate precautions which they cannot do in developed countries. They are not sensitive to the local religious and cultural values of the third world countries. In all those cases, one form of violence or the other has been inﬂicted on individuals involved. The whole four principles or codes have been infringed upon.
Violence And Global Bioethical Issues
There are other bioethical issues which are related to violence. In most parts of the world today, there is human slavery going on now. About 38.5 million people have been enslaved, and they are treated in an inhuman way. All forms of atrocities have been perpetrated against them. Some have been used for all kinds of experiments without their consent. The issue of the jihadists is also a raging one now. The ISIS jihadists in Syria and Iraq have deployed violence as a weapon against people in these parts of the world. They have caused harm to people and have trampled upon their autonomy. The migrant issue in Europe has also become a very pathetic and tragic one. It troubles the human conscience because of the suffering inﬂicted on the migrants which has been caused by the jihadists and the state in Iraq, Libya, Syria, and other parts of the world especially in some Middle East and Asian countries. Some of these migrants have paid huge sum of money to smugglers who use boats to transport them to some parts of Europe. In some cases, these boats have sunk and many migrants have died. In some cases, they have trekked long distances to Europe. Violence has been inﬂicted on these migrants and as such their personhood has not been respected.
Many violent issues have been discussed above, but there is the need to distinguish the different forms of violence from each other. This is necessary in order to place them within certain ethical realms. There are certain acts of violence which are morally reprehensible because they maim or hurt or even kill other people. They are acts of violence which do not respect the sanctity of human life; hence, they are against Kantian injunction that human life should be respected. The jihadist acts of violence fall into this category of violence. The jihadists undertake violence acts from a religious perspective which does not believe that nonbeliever of their religion has any right to life. Their violence has no rational basis; it is what Karl Popper has characterized as an irrational violence in another context (Popper 1963).
There are other forms of violence that are undertaken without any reason. These acts of violence do not respect human life like the jihadist violence.
There are some forms of violence that are directed toward some worthy goals – enhancement of freedom and removal of autocratic regimes. This entry will not be enmeshed in any controversy about these forms of violence – that is, whether this is true or not; however, as Honderich has argued, some forms of violence can be allowed if the goal is to achieve human freedom and also justice (Honderich 1976). These goals can be encapsulated in the Kantian theory of autonomy for the individuals which forms parts of his larger formulation of categorical imperative.
Violence could be employed to defend innocent people or as a self-defense if the violence will protect the freedom of the people affected by it. In a war situation, it is not certain what form of violence could be permitted, but if violence is employed to free some people from an autocratic regime, the violence could be justiﬁed on a certain moral ground like the Kantian autonomy of the individuals (Cushman 2005). The case for violence could also be made if the violence deployed is for self-defense, and this is for freedom of the people of a country or the violence is meant to forestall a tyrant for deploying a weapon that could annihilate other people in other countries (Cushman 2005; Rawls 1999). These forms of violence could be justiﬁed on Kantian moral ground.
Violence needs to be distinguished from the one that is involved in experimentation from that of healthcare context. For instance, the Nazi experimentation was a sort of violence that was targeted against people because of their political views and ethnic origin. It violated every norm of civilized behavior. The Nazi violated every moral or ethical theory – Kantian utilitarian and justice (Baron 2006).
The healthcare context violence arises when people are subtly coerced to certain forms of drug testing in some countries especially in the developing world. The concepts of autonomy, justice, beneﬁcence, and maleﬁcence have implications for healthcare context. What has to be noted is that violence in the Nazi case was an overact whereas that of healthcare context is a subtle one.
However, the issues of autonomy, justice, beneﬁcence, and maleﬁcence feature in this realm since the allocation of healthcare resources arise, if some segments of the population especially the poor are neglected.
The entry has discussed the ethical issues that trail violence. The ethical theories deployed in this entry are heuristic device which are used to look at certain violent acts. There is need to reconceptualized these theories to take cognizance of new forms of violence that have been brought about by the new technologies.
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