How Should We Respond to the Global Pandemic: The Need for Cultural Change

Round 1

Reviewer 1 Report

The essay is an embarrassment. The author is well-intentioned, and has read around, but clearly is unfamiliar with the vast literature on ethics and cultural relativism, whether in cultural anthropology or in philosophy. The problems begin with the abstract, which contradicts itself, saying both that ethics is culture-bound and that we need to find a common, universal ethics to survive. If the latter is the case how can he hold onto the former?

Author Response

The essay is an embarrassment.

The author is well-intentioned, and has read around, but clearly is unfamiliar with the vast literature on ethics and cultural relativism, whether in cultural anthropology or in philosophy.

The reviewer has made an assumption on how much of the literature I may or may not have read. they have not engaged with the argument that I am running. The whole idea of cultural relativity is based on the premise that there is a agreed "norm" that different cultural values may be seen as relative to. Rather than trying to unpick this large literature I used the quote from Veatch which summarises well the central quandry of how do we decide who is right. This paper is written from my own background in clinical primary care looking after people from many backgrounds, and engagement in academic bioethics as a teacher and researcher. I have not engaged significantly with the cultural anthropology literature, which I am sure I would find interesting. I have an understanding of culture developed from the coal face. The argument that I run should be judged on its merits, not on whether it has come from a particular background.

I have significantly rewritten the paper so that it is much more focussed on why despite detailed International ethical agreements the international community failed so badly at managing the pandemic.

The problems begin with the abstract, which contradicts itself, saying both that ethics is culture-bound and that we need to find a common, universal ethics to survive. If the latter is the case how can he hold onto the former?

The reviewer has failed to appreciate the idea that a person is a member of many cultures. They have misquoted me...I have not argued that we need to find a common, universal ethics. I have argued that we need to develop a global ethics, as to address global problems we all need to think of "us" as including all those who live on the planet. Given the diversity of people on the planet I argue the task is that we need to both have the ethics of "our" culture, and a global ethics. Holding onto both is not easy but is the complex task that we need to engage in or we will not be able to address global problems. As noted above I rewritten the paper and the abstract to reflect the change in orientation of the argument

Reviewer 2 Report

There are a few minor points I want to raise to the author, none of which should prohibit publication. The paper is a commentary and does not generate new data, but does an effective job at bringing together many themes within the ethical literature before stating his conclusions.

This is a well written commentary that is well supported by published research--both anthropological and philosophical. The review of different viewpoints in the published literature provided support for the author's final analysis. For a paper that discusses the potential universality of ethics, I was surprised there was no mention of Immanuel Kant who built his ethical system on the idea of universality--"all persons are ends in themselves, not a means to an end." Also, the categorical impetrative, he viewed as a universal principle of pure reason.

I believe the author's argument for a universal ethics is sound and persuasive given the dangers of pandemics, climate change, and species extinction.  Also, the anthropological evidence  of ethics as integral and adaptive to the survival of populations is strong.

The author states: "My hypothesis is that ethics is culture bound."  If it is a hypothesis then it must be testable (empirically).  It sounds more like a presupposition or a general conclusion.

The author states that to have a global ethics there must be a global culture. Yet, he cites global agreement on certain ethical issues, but there is not global culture. This could be clarified. Because we have a global agreement against torture, does that mean we have a global culture?

Also, the fact that nation states sign on to a convention, does not mean that the ethical principle is universally accepted by all residents of those nation states. Some residents for insurgent groups that violate UN treaties.

The strongest statement in the essay is: "All of us belong to many different cultures and the stories of those different cultures not infrequently conflict."

Over all I enjoyed the essay and would use it in my classes.

Author Response

For a paper that discusses the potential universality of ethics, I was surprised there was no mention of Immanuel Kant who built his ethical system on the idea of universality--"all persons are ends in themselves, not a means to an end." Also, the categorical impetrative, he viewed as a universal principle of pure reason.

Thankyou for this comment. It focussed my mind on what I was trying to say. My argument is that the legitimacy of a universal ethics can only come from a dialogue including people at least from all countries. No matter how good Kant's arguments are they are inevitably grounded in his cultural background.

The author states: "My hypothesis is that ethics is culture bound." If it is a hypothesis then it must be testable (empirically). It sounds more like a presupposition or a general conclusion.

Thankyou for this comment, I agree. and have removed reference to a hypothesis

The author states that to have a global ethics there must be a global culture. Yet, he cites global agreement on certain ethical issues, but there is not global culture. 

Thankyou for this comment. I did significantly more reading to clarify my understanding and thoughts on this. I have significantly re-written the paper to respond to this point.

Reviewer 3 Report

Review of the Viewpoint manuscript1064642 - Towards a Global (Bio) Ethics

General Comments

The author has crafted an elegant, thought-provoking manuscript that is worthy of publication and widespread dissemination. The manuscript draws on well-known sources, such as best-selling author Harari, to build a novel case for  developing a global culture. While attempts have been made to discuss ethics within the planetary health context (e.g. Foster, et al. Planetary Health Ethics: Beyond First Principles. Challenges. 2019; 10(1):14), they have largely elided culture in general, and the notion that ethics are indeed culture-bound. The viewpoint is well- written, and with minor revisions and some tightening, this could be a notable paper, one that has the potential to encourage vital interdisciplinary discourse.

Suggested Revisions

1. Before jumping straight into Harari, the manuscript might be enhanced by a short introductory paragraph outlining the interconnected global challenges faced by humanity. The Abstract discusses unspecified global problems and a certain fate if they are not addressed, but it would help the reader is those were stated clearly (that is, the grand challenges embodied by planetary health). There are numerous papers published in Challenges that summarize those grand challenges.
2. Lines 81-83 states that " Many modern bioethicists would argue...". In order to support the statement, one or two references should be provided.
3. There are several points of discussion concerning COVID, including 190-199 and 305-313. I would suggest combining these into a Box (or, separate "figure" in Journal parlance) or under a unique heading. This discussion is not only timely, it cuts to the heart of the matter. In the opinion of this reviewer, it should be expanded upon.
4. Consider the work of others who have addressed culture in global bioethics:

Heather Widdows: Widdows H. Is global ethics moral neo-colonialism? An investigation of the issue in the context of bioethics. Bioethics 2007;21:305-15.

Weingarten M. Bioethics as a Western Culture-Bound Syndrome. The European Legacy 2011;16:327-337 

Tosam, M.J. Global bioethics and respect for cultural diversity: how do we avoid moral relativism and moral imperialism?. Med Health Care and Philos 2020;23:611–620.

5. Give the role of modern technology as a positive means to (as described by the author) negotiate a healthy global culture -- or by the same token, the means by which, through mis/disinformation spread, the role by which the negotiation of a global culture might never be negotiated -- a brief discussion of technology seems warranted. See Thomas Froehlich "A not-so-brief account of current information ethics: The ethics of ignorance, missing information, misinformation, disinformation" in BiD...or an older (2008) chapter by Charles Ess " Culture and Global Networks Hope for a Global Ethics?" In Van den Hoven, etal al. Eds. Information Technology and Moral Philosophy. Cambridge. 2008.
6. I would think there is a place to examine the need for a global culture in the context of Timothy Snyder's recent New York Times piece (The American Abyss, Jan 9 - available open-access)...how did technology meshing with misinformation relate to American (sub)culture on January 6th? Snyder's article is largely descriptive, and not prescriptive. It is brought up in this context because there is an opportunity for the manuscript author to discuss, even briefly, what the pathways to global culture negotiation might look like.

Review of the Viewpoint manuscript1064642 - Towards a Global (Bio) Ethics

General Comments

The author has crafted an elegant, thought-provoking manuscript that is worthy of publication and widespread dissemination. The manuscript draws on well-known sources, such as best-selling author Harari, to build a novel case for  developing a global culture. While attempts have been made to discuss ethics within the planetary health context (e.g. Foster, et al. Planetary Health Ethics: Beyond First Principles. Challenges. 2019; 10(1):14), they have largely elided culture in general, and the notion that ethics are indeed culture-bound. The viewpoint is well- written, and with minor revisions and some tightening, this could be a notable paper, one that has the potential to encourage vital interdisciplinary discourse.

Suggested Revisions

1. Before jumping straight into Harari, the manuscript might be enhanced by a short introductory paragraph outlining the interconnected global challenges faced by humanity. The Abstract discusses unspecified global problems and a certain fate if they are not addressed, but it would help the reader is those were stated clearly (that is, the grand challenges embodied by planetary health). There are numerous papers published in Challenges that summarize those grand challenges.
2. Lines 81-83 states that " Many modern bioethicists would argue...". In order to support the statement, one or two references should be provided.
3. There are several points of discussion concerning COVID, including 190-199 and 305-313. I would suggest combining these into a Box (or, separate "figure" in Journal parlance) or under a unique heading. This discussion is not only timely, it cuts to the heart of the matter. In the opinion of this reviewer, it should be expanded upon.
4. Consider the work of others who have addressed culture in global bioethics:

Heather Widdows: Widdows H. Is global ethics moral neo-colonialism? An investigation of the issue in the context of bioethics. Bioethics 2007;21:305-15.

Weingarten M. Bioethics as a Western Culture-Bound Syndrome. The European Legacy 2011;16:327-337 

Tosam, M.J. Global bioethics and respect for cultural diversity: how do we avoid moral relativism and moral imperialism?. Med Health Care and Philos 2020;23:611–620.

5. Give the role of modern technology as a positive means to (as described by the author) negotiate a healthy global culture -- or by the same token, the means by which, through mis/disinformation spread, the role by which the negotiation of a global culture might never be negotiated -- a brief discussion of technology seems warranted. See Thomas Froehlich "A not-so-brief account of current information ethics: The ethics of ignorance, missing information, misinformation, disinformation" in BiD...or an older (2008) chapter by Charles Ess " Culture and Global Networks Hope for a Global Ethics?" In Van den Hoven, etal al. Eds. Information Technology and Moral Philosophy. Cambridge. 2008.
6. I would think there is a place to examine the need for a global culture in the context of Timothy Snyder's recent New York Times piece (The American Abyss, Jan 9 - available open-access)...how did technology meshing with misinformation relate to American (sub)culture on January 6th? Snyder's article is largely descriptive, and not prescriptive. It is brought up in this context because there is an opportunity for the manuscript author to discuss, even briefly, what the pathways to global culture negotiation might look like.

Review of the Viewpoint manuscript1064642 - Towards a Global (Bio) Ethics

General Comments

The author has crafted an elegant, thought-provoking manuscript that is worthy of publication and widespread dissemination. The manuscript draws on well-known sources, such as best-selling author Harari, to build a novel case for  developing a global culture. While attempts have been made to discuss ethics within the planetary health context (e.g. Foster, et al. Planetary Health Ethics: Beyond First Principles. Challenges. 2019; 10(1):14), they have largely elided culture in general, and the notion that ethics are indeed culture-bound. The viewpoint is well- written, and with minor revisions and some tightening, this could be a notable paper, one that has the potential to encourage vital interdisciplinary discourse.

Suggested Revisions

1. Before jumping straight into Harari, the manuscript might be enhanced by a short introductory paragraph outlining the interconnected global challenges faced by humanity. The Abstract discusses unspecified global problems and a certain fate if they are not addressed, but it would help the reader is those were stated clearly (that is, the grand challenges embodied by planetary health). There are numerous papers published in Challenges that summarize those grand challenges.
2. Lines 81-83 states that " Many modern bioethicists would argue...". In order to support the statement, one or two references should be provided.
3. There are several points of discussion concerning COVID, including 190-199 and 305-313. I would suggest combining these into a Box (or, separate "figure" in Journal parlance) or under a unique heading. This discussion is not only timely, it cuts to the heart of the matter. In the opinion of this reviewer, it should be expanded upon.
4. Consider the work of others who have addressed culture in global bioethics:

Heather Widdows: Widdows H. Is global ethics moral neo-colonialism? An investigation of the issue in the context of bioethics. Bioethics 2007;21:305-15.

Weingarten M. Bioethics as a Western Culture-Bound Syndrome. The European Legacy 2011;16:327-337 

Tosam, M.J. Global bioethics and respect for cultural diversity: how do we avoid moral relativism and moral imperialism?. Med Health Care and Philos 2020;23:611–620.

5. Give the role of modern technology as a positive means to (as described by the author) negotiate a healthy global culture -- or by the same token, the means by which, through mis/disinformation spread, the role by which the negotiation of a global culture might never be negotiated -- a brief discussion of technology seems warranted. See Thomas Froehlich "A not-so-brief account of current information ethics: The ethics of ignorance, missing information, misinformation, disinformation" in BiD...or an older (2008) chapter by Charles Ess " Culture and Global Networks Hope for a Global Ethics?" In Van den Hoven, etal al. Eds. Information Technology and Moral Philosophy. Cambridge. 2008.
6. I would think there is a place to examine the need for a global culture in the context of Timothy Snyder's recent New York Times piece (The American Abyss, Jan 9 - available open-access)...how did technology meshing with misinformation relate to American (sub)culture on January 6th? Snyder's article is largely descriptive, and not prescriptive. It is brought up in this context because there is an opportunity for the manuscript author to discuss, even briefly, what the pathways to global culture negotiation might look like.

Review of the Viewpoint manuscript1064642 - Towards a Global (Bio) Ethics

General Comments

The author has crafted an elegant, thought-provoking manuscript that is worthy of publication and widespread dissemination. The manuscript draws on well-known sources, such as best-selling author Harari, to build a novel case for  developing a global culture. While attempts have been made to discuss ethics within the planetary health context (e.g. Foster, et al. Planetary Health Ethics: Beyond First Principles. Challenges. 2019; 10(1):14), they have largely elided culture in general, and the notion that ethics are indeed culture-bound. The viewpoint is well- written, and with minor revisions and some tightening, this could be a notable paper, one that has the potential to encourage vital interdisciplinary discourse.

Suggested Revisions

1. Before jumping straight into Harari, the manuscript might be enhanced by a short introductory paragraph outlining the interconnected global challenges faced by humanity. The Abstract discusses unspecified global problems and a certain fate if they are not addressed, but it would help the reader is those were stated clearly (that is, the grand challenges embodied by planetary health). There are numerous papers published in Challenges that summarize those grand challenges.
2. Lines 81-83 states that " Many modern bioethicists would argue...". In order to support the statement, one or two references should be provided.
3. There are several points of discussion concerning COVID, including 190-199 and 305-313. I would suggest combining these into a Box (or, separate "figure" in Journal parlance) or under a unique heading. This discussion is not only timely, it cuts to the heart of the matter. In the opinion of this reviewer, it should be expanded upon.
4. Consider the work of others who have addressed culture in global bioethics:

Heather Widdows: Widdows H. Is global ethics moral neo-colonialism? An investigation of the issue in the context of bioethics. Bioethics 2007;21:305-15.

Weingarten M. Bioethics as a Western Culture-Bound Syndrome. The European Legacy 2011;16:327-337 

Tosam, M.J. Global bioethics and respect for cultural diversity: how do we avoid moral relativism and moral imperialism?. Med Health Care and Philos 2020;23:611–620.

5. Give the role of modern technology as a positive means to (as described by the author) negotiate a healthy global culture -- or by the same token, the means by which, through mis/disinformation spread, the role by which the negotiation of a global culture might never be negotiated -- a brief discussion of technology seems warranted. See Thomas Froehlich "A not-so-brief account of current information ethics: The ethics of ignorance, missing information, misinformation, disinformation" in BiD...or an older (2008) chapter by Charles Ess " Culture and Global Networks Hope for a Global Ethics?" In Van den Hoven, etal al. Eds. Information Technology and Moral Philosophy. Cambridge. 2008.
6. I would think there is a place to examine the need for a global culture in the context of Timothy Snyder's recent New York Times piece (The American Abyss, Jan 9 - available open-access)...how did technology meshing with misinformation relate to American (sub)culture on January 6th? Snyder's article is largely descriptive, and not prescriptive. It is brought up in this context because there is an opportunity for the manuscript author to discuss, even briefly, what the pathways to global culture negotiation might look like.

Author Response

1. Before jumping straight into Harari, the manuscript might be enhanced by a short introductory paragraph outlining the interconnected global challenges faced by humanity. The Abstract discusses unspecified global problems and a certain fate if they are not addressed, but it would help the reader is those were stated clearly (that is, the grand challenges embodied by planetary health). There are numerous papers published in Challenges that summarize those grand challenges.

Thankyou for this helpful comment. I have rearranged the paper as suggested and significantly rewritten to emphasise the points suggested

1. Lines 81-83 states that " Many modern bioethicists would argue...". In order to support the statement, one or two references should be provided.

I have deleted this section

1. There are several points of discussion concerning COVID, including 190-199 and 305-313. I would suggest combining these into a Box (or, separate "figure" in Journal parlance) or under a unique heading. This discussion is not only timely, it cuts to the heart of the matter. In the opinion of this reviewer, it should be expanded upon.

I have changed the focus of the paper to be directly about the pandemic and used many quotes from the report of the Independent Panel for Pandemic Preparedness and REsponse

1. Consider the work of others who have addressed culture in global bioethics:

Thankyou for these references. They stimulated me to read more widely. Rather than using those references per se I have relied much more on the work of ten Have who has written extensively on Global Ethics.

5. Give the role of modern technology as a positive means to (as described by the author) negotiate a healthy global culture -- or by the same token, the means by which, through mis/disinformation spread, the role by which the negotiation of a global culture might never be negotiated -- a brief discussion of technology seems warranted. See Thomas Froehlich "A not-so-brief account of current information ethics: The ethics of ignorance, missing information, misinformation, disinformation" in BiD...or an older (2008) chapter by Charles Ess " Culture and Global Networks Hope for a Global Ethics?" In Van den Hoven, etal al. Eds. Information Technology and Moral Philosophy. Cambridge. 2008.

Thankyou for this suggestion. I have re-written the whole paper with a different focus. I agree that technology and mis-information is very important but I decided that there were many other areas of importance that could equally be covered in more detail and that keeping the discussion at a higher level made the paper of a readable length

5. I would think there is a place to examine the need for a global culture in the context of Timothy Snyder's recent New York Times piece (The American Abyss, Jan 9 - available open-access)...how did technology meshing with misinformation relate to American (sub)culture on January 6th? Snyder's article is largely descriptive, and not prescriptive. It is brought up in this context because there is an opportunity for the manuscript author to discuss, even briefly, what the pathways to global culture negotiation might look like.

Thankyo for this reference I enjoyed reading it. Having read more widely about the processes of international negotiation at the UN UNESCO and UNDP I felt that the global ethics that has been established sits on a sufficiently firm foundation that the focus needs to be on how we achieve cultural change to put into effect the well thought through principles that have already been negotiated.

Reviewer 4 Report

It was my pleasure reading the manuscript entitled “Toward a Global (bio)Ethics.” While the paper is rich with interesting and intriguing ideas, and conclusions, it is not ready for publication in its current format. Once the following points are addressed, the manuscript will be much stronger, and is more apt for publication. 

1. The concept of culture is one of the most widely discussed constructs across the social sciences and humanities. It would be a great idea if the author supplies an overview section of how others have understood the construct. This may include Geertz's famous delineation, Ingelhart's conception, and other canonical texts in culture. The concepts of thin versus thick culture needs to be better explained. 

2. The ways in which others have understood cultural difference needs to be emphasized. An illustration, not necessarily accurate is Huntington's different civilizations in his Clash of Civilizations thesis. Another example could be the heuristic map of cultures provided by Ingelhart and colleagues at the World Values Survey. 

3. One important section that is missing is cultural change and evolution. Many like Knutsen and Carmines argued that culture is apt for change. This is because of mass transformations like modernization or other forces along the lines of globalization. This makes the different cultures converge to a similar one. This makes it more possible for an emergence of a universal culture of some sort. 

4. The importance of a universal ethics or the problems caused by its existence, whatever the argument the author is trying to make, needs to be better justified. Why do we need this universal ethics? Show us the bad outcomes we have if this does not exist. Otherwise, show us the disastrous outcomes resulting from its absence or emergence. 

5. I would like to see a clearer implications section. How does your finding or conclusion benefit people, professional communities, communities of practice or any actors? By the same token, what theoretical contributions do they offer. Do they solve some theoretical conundrums? How? 

While I understand that those comments are somewhat broad and challenging, I firmly believe that the paper got more potential than what appears on its surface. 

Some of the additional references that can addressed in the revised manuscript:

• Geertz, C. (1973). The interpretation of cultures (Vol. 5019). Basic books.
• Inglehart, R. (2006). Mapping global values. Comparative sociology, 5(2-3), 115-136.
• Inglehart, R., & Welzel, C. (2010). The WVS cultural map of the world. World Values Survey.
• Inglehart, R. (1988). The renaissance of political culture. The American Political Science Review, 1203-1230.
• Knutsen, O. (1995). Value orientations, political conflicts and left‐right identification: A comparative study. European journal of political research, 28(1), 63-93.
• Carmines, E. G., Ensley, M. J., & Wagner, M. W. (2012, October). Political ideology in American politics: one, two, or none?. In The Forum (Vol. 10, No. 3). De Gruyter.
• Huntington, S. P. (2000). The clash of civilizations?. In Culture and politics (pp. 99-118). Palgrave Macmillan, New York.

Author Response

1. The concept of culture is one of the most widely discussed constructs across the social sciences and humanities. It would be a great idea if the author supplies an overview section of how others have understood the construct. This may include Geertz's famous delineation, Ingelhart's conception, and other canonical texts in culture. The concepts of thin versus thick culture needs to be better explained. 

Thankyou for this suggestion and the references. I have included a quote from Geertz. Ingelhart's work was very much included in the work of Hofsted that i have quoted. In the time given for paper revision I felt I would not be able to come to grips with this literature in full. Given the broad scope of the paper giving a definitive overview of each of the elements would be difficult

2. The ways in which others have understood cultural difference needs to be emphasized. An illustration, not necessarily accurate is Huntington's different civilizations in his Clash of Civilizations thesis. Another example could be the heuristic map of cultures provided by Ingelhart and colleagues at the World Values Survey. 

I fouund Huntington's (1996) analysis some what dated. It covers some of the same material as Harari, Diamond and Morris. As noted above the work in the World Values Survey is incorporated into Hofstede's work

3. One important section that is missing is cultural change and evolution. Many like Knutsen and Carmines argued that culture is apt for change. This is because of mass transformations like modernization or other forces along the lines of globalization. This makes the different cultures converge to a similar one. This makes it more possible for an emergence of a universal culture of some sort. 

I agree that this is an important topic but again beyond my capacity in the time and space available to come to grips with.

4. The importance of a universal ethics or the problems caused by its existence, whatever the argument the author is trying to make, needs to be better justified. Why do we need this universal ethics? Show us the bad outcomes we have if this does not exist. Otherwise, show us the disastrous outcomes resulting from its absence or emergence. 

This was a very helpful comment. I have significantly rewritten the paper to address these particular points, and quoted significantly from the Independent Panal on Pandemic Preparedness and Prevention

5. I would like to see a clearer implications section. How does your finding or conclusion benefit people, professional communities, communities of practice or any actors? By the same token, what theoretical contributions do they offer. Do they solve some theoretical conundrums? How? 

I have done a final section on what I see to be the implications of these thoughts

While I understand that those comments are somewhat broad and challenging, I firmly believe that the paper got more potential than what appears on its surface. 

Some of the additional references that can addressed in the revised manuscript:

• Geertz, C. (1973). The interpretation of cultures (Vol. 5019). Basic books.
• Inglehart, R. (2006). Mapping global values. Comparative sociology, 5(2-3), 115-136.
• Inglehart, R., & Welzel, C. (2010). The WVS cultural map of the world. World Values Survey.
• Inglehart, R. (1988). The renaissance of political culture. The American Political Science Review, 1203-1230.
• Knutsen, O. (1995). Value orientations, political conflicts and left‐right identification: A comparative study. European journal of political research, 28(1), 63-93.
• Carmines, E. G., Ensley, M. J., & Wagner, M. W. (2012, October). Political ideology in American politics: one, two, or none?. In The Forum (Vol. 10, No. 3). De Gruyter.
• Huntington, S. P. (2000). The clash of civilizations?. In Culture and politics (pp. 99-118). Palgrave Macmillan, New York.