Listening, as method, and the poor/oppressed, as agents

: towards plural global bioethics

Abstract

Considering global health challenges, this essay seeks to understand the impact of the global on the local from
a global bioethics proposal that is not universal, but rather plural. Actions in global health are dominated by a Western perspective of health care in local realities that starts from a top-down approach. This article analyzes this perspective through essential aspects of global health initiatives – methods, main actors, finding, and mentality – that lead us to realize their limitation in sustaining global health delivery and, at the same time, their contradictory contribution to the same problems global health claims to address when responding to the immediate health needs of impoverished populations. Following the identification of this limitation, the article argues for a perspective that begins from the local, from people’s experiences in their concrete reality, to then move towards the global, which will be a plural and inclusive global in order to build collaboration. Thus, there is no global epistemology and normativity guiding practices as it is in the dominant Western perspective, but a plural global that is universal in proceeding – from local to global – but plural in the way of understanding and facing global health challenges, without a dominant epistemology. Thus, an ethos of collaboration is developed based on listening and mutual learning that occur where the challenge is experienced. Finally, the author presents listening as the first movement in global health grounded on a plural and inclusive global bioethics, in a constant epistemological development with ethical impact.