title: The anthropological approach challenges the conventional approach to bioethical dilemmas: a Kenyan Maasai perspective.
abstract: BACKGROUND
  The cultural background, religion and societal norms have a huge influence on the decision making process for physicians, patients and their families, when faced with medical ethical dilemmas. While the medical professionals, through their training, can rely on the principles of autonomy, justice, beneficence and non-maleficence to guide them, the patients can only draw from their personal and cultural experiences.
  
  
  OBJECTIVE
  To explore some of the challenges that face physicians when presented with ethical dilemmas.
  
  
  METHODS
  A review of the literature on the principles of medical ethics and the cultural practices of the Maasai tribe, as well as, interview, interaction and observation of the patients and family during patient. management.
  
  
  RESULTS
  In the Maasai community in Kenya, where family is the center of all attention and decision-making, the listed ethical principles and rules have a very different understanding of the self-determination, and autonomy becomes collective rather than individualistic. Medical practitioners when faced with ethical medical dilemmas are neither comfortable in adopting the conventional bioethical guidelines, nor in offering a health care purely based on cultural and historical practice.
  
  
  CONCLUSIONS
  In our set up, developing culturally relevant principles of bioethics appears to be the most effective solution in addressing medical ethical dilemmas.
authors.affiliation: Aga Khan University Hospital, Pain Management/Aaesthesiology.
authors.forename: Thikra
authors.initials: T
authors.lastname: Sharif
authors.affiliation: Aga Khan University Hospital, Pain Management/Aaesthesiology.
authors.forename: John
authors.initials: J
authors.lastname: Bugo
mesh_terms: D000884:Anthropology, Cultural; D060432:Anthropology, Medical; D003657:Decision Making / Q000941:ethics*; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D007630:Kenya; D008297:Male; D028701:Patient Rights / Q000941:ethics; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D012945:Social Values / Q000208:ethnology*; D013727:Terminal Care / Q000523:psychology*; D014342:Truth Disclosure / Q000941:ethics*
keywords: Bioethical dilemmas; Kenyan Maasai perspective