Healthcare professionals encounter many moral challenges in their daily clinical practice. However, there have been few studies on the subject matter in Tanzania. This study aims to provide an account of moral challenges faced by healthcare professionals in Tanzanian hospitals, their understanding of clinical ethics, and the ethics education they have received. Many participants reported receiving some kind of ethics training through formal education and on-the-job training. Some participants understood ethics in healthcare settings as adherence to established laws, regulations, guidelines, (...) procedures, norms, and rules essential in clinical practice. Analysis of the data identified four themes of moral challenges. These challenges are related to 1) decision-making and communication in clinical practice, 2) scarcity of medical resources and prioritization in clinical practice, 3) withdrawal of curative treatment, and 4) conflicts between professional judgment, religious convictions and adherence to alternative treatments. Based on the findings, we suggest a context-sensitive form of clinical ethics training to prepare healthcare professionals to recognize and address these moral challenges. (shrink)

Human development, grounded on the capability approach, focuses on the enhancement of people’s real freedom to choose the kinds of lives they have reason to value. Amartya Sen’s capability approach conceptualizes human wellbeing in terms of an individual’s ability to achieve physical or mental states that allow individuals to participate in life. That approach, however, has been criticized for its individualism and its lack of attention to the inherent worth of relationships and communities. This chapter agrees with Nimi Hoffmann and (...) Thaddeus Metz’ critique of the capability approach, which draws on Ubuntu ethics. Hoffmann and Metz argue that human development consists of having the propensity to pursue communal relations with other individuals or relations of fellowship. Such that relationships, or people’s capacity for having them, they claim have fundamental value. They also hold that development is meant to enhance people’s relations as ends in themselves, not merely as means. Based on their argument, this chapter argues that self-help groups would be both useful and good for their own sake, as forms of enhancing human development in Africa, since individuals undertake collective actions in order to improve their own lives. For any collective actions to be effective, it is necessary that members should have a sense of shared identity and solidarity which are core values of Ubuntu. (shrink)

Healthcare professionals (HCPs) encounter various moral challenges in clinical practice. In various countries, clinical ethics support (CES) services are developed to support HCPs. One of these CES services is clinical ethics committees (CECs): they address moral challenges faced in healthcare settings and offer support for HCPs. However, in Tanzania, CECs have not yet been implemented. For implementation purposes, greater knowledge about how healthcare professionals navigate and respond to moral challenges, their understanding of CECs, and what they perceive as key needs (...) for implementing CECs in hospitals, are valuable. This study explores HCPs’ ways of dealing with their moral challenges at the moment and identifies key needs for establishing CECs in Tanzanian healthcare settings in the near future. The findings show that various implicit ways have been acknowledged as being useful in addressing moral challenges (e.g., regular meetings, family conferences, social welfare units, hospital procedures and guidelines, as well as consulting legal and management units). In addition, HCPs reported that a necessity exists for implementing more formal and systematic modalities to address moral challenges in clinical settings. The research in this paper has served as a preparation for establishing the first CEC in Tanzanian healthcare settings. (shrink)