Bioethics as a western culture-bound syndrome

In this article I argue that the four guiding principles of medical ethicsautonomy, beneficence, non-maleficence, and justicereflect the values of western culture, but do not necessarily apply outside of it. Western medical practitioners faced with the care of nonwestern patients need to examine their own prejudices in order to accept, not merely tolerate, other values. Acceptance of the other requires that the doctor welcome the patient as one welcomes a guest, openly and equally, with a willingness to listen and to be changed by the encounter. It is through the nurture of trusting relationships that ethical dilemmas in clinical medicine may be resolved, without recourse to the colonial moral hegemony of the principlist approach.