Journal of Clinical Research & Bioethics

Conference Report: Third National Bioethics Stakeholders Conference for the Development of National Bioethics Documents in Nigeria, 20^th to 22^nd August, 2019

Chitu Womehoma Princewill^1*, Francis Chukwuemeka Ezeonu², Adefolarin Obanishola Malomo³, Omokhoa Adedayo Adeleye⁴, Abdulwahab Ademola Lawal⁵, Ayodele Samuel Jegede⁶ and Christie Oby Onyia^{7 1}National Biotechnology Development Agency, Umaru Musa Yar’Adua Expressway, Federal Capital, Abuja, Nigeria
²Department of Applied Biochemistry, Nnamdi Azikiwe University, Anambra State, Nigeria
³Department of Surgery, University College Hospital, University of Ibadan, Oyo State, Nigeria
⁴Department of Community Health, University of Benin, Benin City, Nigeria
⁵National Coordinator, Civil Society for Ethics and Value Development Initiatives, Abuja, Nigeria
⁶Department of Sociology, University of Ibadan, Oyo State, Nigeria
⁷Department of Biotechnology, Godfrey Okoye University, Enugu State, Nigeria
^*Correspondence: Chitu Womehoma Princewill, National Biotechnology Development Agency, Umaru Musa Yar’Adua Expressway, Federal Capital, Abuja, Nigeria, Tel: +234(0)8037236069, Email:

Received: 23-Sep-2022, Manuscript No. JCRB-22-18136; Editor assigned: 27-Sep-2022, Pre QC No. JCRB-22-18136 (PQ); Reviewed: 14-Oct-2022, QC No. JCRB-22-18136; Revised: 24-Oct-2022, Manuscript No. JCRB-22-18136 (R); Published: 03-Nov-2022, DOI: 10.35248/2155-9627.22.13.436

Introduction

For the first time since Nigeria became a member state of UNESCO on the 14^th of November, 1960, the Federal Government of Nigeria through the National Biotechnology Development Agency organized and sponsored a National Bioethics stakeholders meeting. Prior to this conference, at the expression of interest by the Federal Government of Nigeria, UNESCO organized and sponsored two National Bioethics Stakeholders meeting in 2009 and 2017 respectively. The third National Bioethics Stakeholders meeting which is the first to be hosted by the Federal Government of Nigeria was organized by the National Biotechnology Development Agency (NABDA) in collaboration with the Nigeria National Commission for UNESCO (NATCOM-UNESCO). This meeting brought together well over a hundred participants from all over Nigeria in the public and private sectors, as well as CSOs, NGOs, and the programme Specialist, Social and Human Sciences Sector, UNESCO Regional Office in Abuja in attendance. The two affiliate Ministries of Science, Technology and Innovation and that of Education were represented at the Conference. This report is a highlight of the thematic issues discussed and the conference resolutions.

Key Highlights and Thematic Areas

The main objectives of the meeting were to discuss bioethical issues surrounding health, medicine, research, biotechnology, agriculture, environment, defense and security, law, public policy, religion, and education amongst others, and to develop the National Bioethics Framework and Policy Documents which in turn will guide the establishment of a National Bioethics Committee for Nigeria [1].

The workshop which lasted for two-days began with an opening ceremony which featured a keynote presentation from the representatives of the Permanent Secretary of the Federal Ministry of Science, Technology and Innovation, which is the supervising Ministry for NABDA, Abayomi Oguntunde. In his keynote address, he commended NABDA for the successful organization of the conference. He observed that Nigeria is a member state of UNESCO and is a signatory to the 2005 UNESCO Declaration on Bioethics and Human Rights which affirms “that ethical issues raised by rapid advances in the sciences and its technological advancement should be examined with due respect to the human dignity and universal respect for, and observance of human rights and fundamental freedoms” (UNESCO 2005). He noted that one obligation of this membership is the establishment of a National Bioethics Committee and expressed the Federal government’s desire to accomplish this. He submitted that a National Bioethics Framework and National Policy guidelines are key prerequisites for establishing such a committee and therefore challenged the conference to take up the mandate. Six thematic areas of the conference, to wit; agricultural ethics, educational ethics, environmental ethics, defense and security ethics, health ethics and societal ethics, were identified as challenging areas that demand urgent attention in the country. He challenged the conference to interrogate these themes thoroughly and help develop appropriate frameworks and policy guidelines. To adequately dissect these areas, Technical Working Groups were created and headed by chairpersons. The different working groups went into syndicate sessions and later presented their formulations and recommendations to the plenary session.

Agricultural Ethical Framework

This Technical Working Group, Chaired by Francis Chukwuemeka Ezeonu of the Nnamdi Azikiwe University, Awka, Anambra State, observed that ethical concerns related to food and agriculture are essentially twofold; these were, the group said, the production, and distribution of sufficient foods to ensure access to safe and adequate food to all; and to promote policies and measures that ensure ecological sustainability of food production (including animals and fisheries) and biodiversity sustainability. The Group identified several issues in the practice of agriculture in Nigeria that require ethical considerations. Among these are the issues of land use and ownership. The Group observed that traditional systems of common resource use, including land, forestry, fisheries and biodiversity resources are under increasing pressure from both population growth and increasing market penetration. In the search for more farmland and settlement, huge areas are being deforested, leading to soil erosion and massive flooding. The increased migration of cattle herdsmen is one consequence of desert encroachment in the Northern part of the country. The Group noted that the pressure on land is made worse by the commodification of land which is a common good and that the decline in land holding of the poor raises an ethical question. Complicating this issue is the fact that there is no clearly delineated policy on the pattern of animal husbandry in the country leading to uncontrolled open grazing and wandering of animals. This raises ethical issues as wandering animals destroy economic crops leading to clashes between herders and farmers.

Other areas identified by the group that require ethical considerations include poor animal welfare and handling, food safety, food security, impact of agricultural practices on the environment, agribusiness, proper labeling of food and consumers consent and choice. The group proposed that the framework for approaching ethical issues in agriculture and food production in Nigeria should focus on the following considerations:

• To ensure that food available to the people is sufficient, by promoting the use of advance technique and adaptive technology in agricultural practices, which are safe, contributing to the health and welfare of people and affordable. Subsidizing farm input and incentives to farmers.

• To protect the interest of agriculturalist through education of farm extension workers on best practices and provision of grants and subsidy on farm inputs.

• Protection of consumers through appropriate food pricing, proper food labeling, consumer consent and choice. Authorities need to act more deliberately in enforcing local regulations and participating in National and International Policy formulations to ensure Beneficence and Autonomy of citizens in choice making.

• To engage relevant agencies and stakeholders in policy formulation and implementation. Generally, farmers need to be involved as autonomous agents to participate in policies that affect them and generally need to be supported in making risk assessment in Agricultural business decisions.

• To ensure oversight of agricultural practice methods, including animal methods and husbandry, to ensure environmental friendliness and sustainable methods of operation than is currently the case and enforcement by relevant agencies.

Some of the above prescriptions apply to international scenarios too and in that respect, unequal economic and other powerimbalances/ relations that may jeopardize poor farmers; this as well as activities that threaten biodiversity need to be definitely addressed, in some cases, as issues affecting survival and social security and stability. Ethical issues in Biotechnology such as uncertainties of environmental impacts, species balance and ecology, unintended transfer of genes, impoverishing of poor farmers among others were interrogated.

Defence and Security Ethical Framework

The Defence and Security Ethics Technical Working Group was Chaired by Abdulwahab Ademola Lawal of the Civil Society for Ethics and Value Compliance, Constitution Avenue CBD, Abuja. It reported that the Defence and Security sector in Nigeria is affected by the general educational and social lags and lapses in the country, as reflected in our standards of interaction, governance and the rates of development. A major need in this sector, it noted, is the restoration of professionalism which issues from a non-negotiable civil control of the nation’s apparatus of defence and security. This will help restore the priority of Human Rights and Freedoms and rectify instructions and practices that are less than ethical (usually due to the extreme pressures that the sector faces during operations). The sector’s personnel face conflicts of interest like all humans, only under greater heat. The need to emphasize indices of professionalism in the sector as well as to strengthen moral conviction and robustness in the personnel and systems, like in many of our other sectors, is urgent. The military reflects its society; unfortunately, professionals are usually judged by the highest global standards. Proper social values such as: civil liberty, honor, sanctity of human life, discipline, the rule of law and equity must be adhered to by the military otherwise it loses legitimacy. Loss of legitimacy is known to have disgraced the military apparatus of even very powerful nations. The needs to: reform individuals and peerage to conform to and reinforce sectorial professionalism, for the Command and Control structure to entrench, exemplify and continually develop high ethics in the entire structure and functioning of the sector, establishment of mechanisms for internal monitoring and evaluation, protected reportage and similar facilities to promptly detect and address ethical lapses when they occur, are very important. Committees and possible strategies for fostering these are recommended.

Information technology crimes form a significant threat to society. Such include cyber bullying, stalking, invasion of privacy as well as phishing and identity theft scams. This set of unethical practices deserves a section in the defence and security sector in order to: raise awareness of, and education on, unethical practices in the cyber space, network from local to global levels, support global approach to curtail this borderless evil, and continuously upgrade awareness and modes of addressing these wrong practices that tend to grow as rapidly as information technology itself.

Education Ethical Framework

Education, the process and attainment of the capability to discern, desire, develop and defend the True, the Good and the Beautiful at all times and places, is inherently good as such. It has a complex ethics because it is itself at once both a cause and consequence of Ethics, yet it can be wrongly and dangerously undertaken, and needs an ethical framework too. The theoretical web of educational theories in the light of equally complex ethical theories and frameworks imply that the joint enterprise of education and educational ethics should be systematic and should derive insights from the physical sciences, sociology, psychology, philosophy and spirituality in a manner that practically demonstrates social accountability and transparency. Several regulatory frameworks exist to foster ethical models of educational endeavors in Nigeria. To make impact, the frameworks require significant public and professional participation as well as monitoring, evaluation and continuous development. Nigeria is very rich in cultural views and values; thus, in the context of educational ethics, the curriculum of a subject or course or programme should derive its essence from our dominant philosophy and metaphysics of societal education as well as social accountability. In terms of organization, a nation like Nigeria with admitted battle with evil, needs in various sectors and levels, teams dedicated to continuing ethics monitoring and education. Ethics governance at all levels and sectors that affect education should have scientific and systematized mode of governance. This was the report from the Educational Ethics Technical Working Group which was chaired by Omokhoa Adeleye of the of Community Health University of Benin.

Environmental Ethical Framework

This Technical Working Group was chaired by Christie O. Onyia of Godffery Okoye University, Enugu, Enugu state. The group offered an insight into challenges facing the country in the area of the environment. It is reported that it is important from an African holistic viewpoint to conceive of the environment as the organic complex web of relationships and interactions between us and all other entities around us, all bound by the laws, orders and dynamics of nature. This is sometimes somewhat summed up as Humans and Nature. African holistic view aligns with the anthropocentric worldview of life that is arguably hitherto supported by several other theories of ethics including the Kantianism deontology as Africans have sense of duty to use the environment in a sustainable way. Environmental ethics in Africa indicates that individuals should have a sense of duty to care for the environment. It also aligns with the theory of utilitarianism in that the focus of environmental ethics in Africa is on community-wide interest. The decision about the use of environment is based on the overall interest of the society and not the narrow individual interest. On virtue ethics, environmental ethics in Africa depends on individual virtue which is acquired through socialization and sustained by family and societal normative value. The practical purpose of environmental ethics is to provide moral grounds for social policies for the protection of the environment. Environmental ethics is concerned with ethical issues related to our physical and human environments. The physical environment can be sub-divided into Air, Water, and Land. Six topical issues listed under the framework include solid waste, desertification, climate change, biodiversity loss, erosion, soil pollution, air pollution, water pollution and the human environment. In an organic universe, violation of environmental ethics is selfviolation in the sense of ultimate non sustainability of our species and nature as it presently is. In this context, the ethical issues in the glaring challenge of solid waste disposal in Nigeria is addressed under: Promotion of societal value, Cost-benefit assessment after maximizing benefit and minimizing cost to society and individual stakeholders, Risk assessment and management, Protecting future generations, Justice, Sharing of benefits/Inclusion, Socially accountable procedures and Public enlightenment. Specific issues such as desertification, gully erosion, air, water and soil contamination, bio-resource loss and threat to biodiversity among others are discussed and suggested; ethical assessment and addressing of them are documented.

Health Ethics Framework

Adefolarin Malomo of the University College Hospital, Ibadan chaired the Health Ethics Technical Working Group. The group reported that the health sector is, globally, very rich in ethical frameworks because of its nature and history as well as its role in the emergence and development of Bioethics [2]. In Nigeria, as in many similar settings, the sector constituents have been less socially accountable than required. This Group therefore addresses only newer challenges in our national context and utilized numerous sources. ‘Principlism’, Care ethics, works from the Presidential Committee on Bioethics, Nuffield Bioethics Committee and the Framework from the USA National Academies Reports (2019), among others form the spine of our approaches.

Traditional Medicine framework was discussed with recommendation about standards, regulation and mutual respective engagement with Scientific Medicine. Access to Medicine was reviewed at global, national and local levels and issues of justice, non-maleficence among others, discussed and recommendations made. Human Immunodeficiency Virus/ Acquired Immunodeficiency Disease Syndrome (HIV/AIDS) response in Nigeria was discussed with ethical comments and areas with varying residual dilemmas highlighted, such as rights violation and public health aspects, testing, disclosure, nondiscrimination among others; ethical measures were recommended for various levels of governance and towards various aspects of the condition.

Issues of (embryonic) stem cell research and therapy were discussed especially the moral status of the embryo, nonmaleficence, patenting, enhancement, uncertainties and consent taking, therapy involving vulnerable individuals among others. Human cloning is reviewed in its individual and social costs, uncertainties about the biology of cloned individuals’ genes and experiences, and the poor benefit to cloned individuals as against the costs. Genetic Medicine was discussed in its areas of privacy of relatives, screening, counseling, capacity for consenting in the face of uncertainties, individual mental distress in cases where nothing can be done about a chronic debilitating condition among others [3]. Ethical issues in Biotechnology such as uncertainties of environmental impacts, species balance and ecology, unintended transfer of genes, impoverishing of poor farmers among others were discussed. Ethical issues in Malaria treatment and research, and those of Non-communicable diseases at global, national, professional, and individual levels were also discussed with hints at policy issues.

Ethics of Research involving human participants and Biobanking which are well documented by the National Health Research Ethics Committee (NHREC) were stated with certain local issues highlighted. Neuro-ethics in its various aspects and its potential impacts on our human self-conception and values, Public Health ethics as it differs from individual engagement in areas of individual rights and societal threats were highlighted. Nano-ethics with its possible dangers at individual and societal levels, Transplant Medicine with its issues of donor sourcing, allocation and post-transplant issues were discussed. Health institutional ethics were reviewed in terms of Governmental roles and regulations, structural ethical capacitation, Leadership, institutional culture and accreditation.

Also, Artificial Intelligence (AI) was discussed in this group. It is important because it affects human beings directly and indirectly in the area of health and other aspects of human endeavor like Agriculture, Education, Security, Social life including Culture. The science and technology behind implemented AI are no longer neutral once deployed in practical ways because they consume universal resources and impact on our organic universe, humanity, society and individual realities. Hence, it becomes necessary to maximize their benefits and minimize the potential risk associated with it.

This section of the framework discusses the following issues: the low rate of adoption of artificial intelligence in Low and Middle Income Countries (LMIC), openness and accountability issue in data use, explanation, Interpretation and Degree of ‘Truth’ and Auditability, Autonomy and Consent Issues, and Privacy issues.

All these issues suggest the need for global, national and local AI Governance systems in the world, the way Human Research Ethics have been fairly improved.

Societal Ethics

This Technical Working Group was chaired by Ayodele Samuel Jegede from the Department of Sociology, University of Ibadan. According to the group, Societal Ethics is important for developing social standards for ensuring justice and fairness in interpersonal relationship and interaction in all spheres of life. The need for ethical standard and guidelines that will respond appropriately to the advancement of technologies including its accessibility by people is necessitated by the rate of new invention and innovation. This is more compelling in Nigeria because of the influx of the new technologies and the threat to human interaction and normative values.

Nigeria is experiencing many social problems which have eaten deep into the fabrics of the society. There is a need to put in place ethical standards to guide policy decision-making geared towards the attainment of the Sustainable Development Goals (SDGs) and other developmental milestones in order to ensure dignity of life, freedom and justice. Hence, the objective of the section is to promote the ethical values of discipline, integrity, dignity of labour, social justice, religious tolerance, self-reliance and patriotism geared towards sustainable national development [4-6].

This section on societal ethics provides social standard of ethical and moral behavior in society, business and government and how to ensure peaceful co-existence [7-9]. People oriented policies are formulated taking into consideration the traditional values, as well as the traditions and norms. This will bring about justice and fairness in execution and regulation of societies. Following from the above the following issues were addressed in this section: Leadership ethics, Family ethics, Work ethics, Religious tolerance, Communication ethics, Sexual Relationship, Mode of Dressing, Gratification, Political Patronage, Domestic violence and National Patriotism. This section states the dominant ethical Principles of guiding the issues raised, highlights other principles or virtues desired and provides strategies for attaining the stated objectives.

Discussion and Conclusion

Bioethics, an “application of moral principles to the knowledge of human values in relationship to life” has continued to receive attention across the world because it addresses the wellbeing of people directly or indirectly. It uses a holistic lens to assess and guide decision making. In Nigeria, a National Bioethics Policy is long overdue for the establishment of ethical standard to guide against the effect of modern technology on society, social change and perpetuation of harmful traditional practices. Six thematic areas identified namely; agriculture, defence and security including cyber security and cybercrime, education, environment, health, and society are considered adequate to respond to these threats. Details of this was published in an article [9].

These themes are interrelated and overlap in many instances. For instance, education overlaps with other sectors in many ways. Since the Nigerian society is not a monolithic system it consist of different parts working together to ensure security and wellbeing of the people as contain in Chapter II Section 14 (2b) of the constitution of the Federal Republic of Nigeria. The National Bioethics Framework is desired to guide the Nigerian society towards ethical standards of conducting business in various sectors of the economy at all levels using appropriate ethical principles.

The purpose is to promote a society where the highest ethical standards and conduct pervade every part in reflection of her local values and in line with global best practices. It is designed to facilitate good working relationship with all governments, sectors and communities to internalize, demonstrate and promote the Nigeria national ethics of discipline, Integrity, dignity of Labour, social, justice, religious tolerance, self-reliance and patriotism as stipulated in Chapter II section 23 of the Nigeria constitution. The ethics framework is to serve as a guideline for the National Bioethics Committee, as well as serve as appropriate contexts and scenarios which can help decision makers at all levels to engage in ethical reflections. The goal is to stimulate ethical reasoning and not to enforce such reflections.

The policy, written by a group of experts and stakeholders with representation across the country will guide decision makers at all levels of activities to reflect on ethical standard that guides their actions. While the framework is mindful of the social and cultural diversity of the Nigerian society it takes into cognizance the existing laws and legal codes. For instance, in writing this framework the existing regulatory guidelines like the National Ethical Code for Health Research and the Health Act aside from other relevant policy guidelines like the National Agency for Food and Drugs (NAFDA) guidelines were acknowledged and taken into consideration. The code does not to replace existing regulations, policies or guidelines but its position will be strengthened by making reference to them where and when necessary. Engaging with varying degrees of ethical reflections the framework recognizes the role of culture in national development. As a result, where applicable useful cultural practices shall be promoted to achieve desired ethical standards in every aspect of human endeavor especially in the areas addressed in this document and those that will be added in the near future updates.

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