Provincializing bioethics: Dilemmas of end-of-life care in an Indian ICU

Abstract

Since the 1980s, anthropologists have criticized a US-centric view of bioethics that presents individual autonomy as a universal principle without acknowledging its embeddedness in time and place. A recent turn in this critique points out how this view has gained dominance across the world, traveling alongside clinical trials and global health interventions. Here, centering a competing bioethical vision disrupts this division between the Global North as a site of ethical conceptualization and the South as the recipient of its diffusion. Indian legal bioethics—concerned with protecting the critically ill body in intensive care—rejects the primacy of autonomy, instead empowering courts to override the choices of patients, families, and doctors. This competing bioethics commits its own harms, misrepresenting vulnerability as a problem of sociomoral underdevelopment rather than as the outcome of increasing inflows of global capital, new patterns of land acquisition, and a growing public-private health care divide. [bioethics, end of life, norms, ethics, medicine, law, intensive care, Delhi, India].