How Culture Shapes Young People's Views on Biomedical Dilemmas
A comparative exploration of how young adults in Sri Lanka and England navigate the complex landscape of contemporary biomedical ethics
Explore the ResearchImagine two intensive care units, half a world apart. In London, a young woman insists her grandmother should not be resuscitated, respecting her living will. In Colombo, a family collectively decides to continue life support for their elderly patriarch, despite his poor prognosis. Both face the same heartbreaking dilemma, but their decisions differ dramatically. Why?
Welcome to the fascinating world of cross-cultural bioethics, where deeply held values collide with cutting-edge medicine. As biomedical technologies advance at a breathtaking pace, young people across the globe are grappling with questions that philosophers once only theorized about. Genetic engineering, artificial intelligence in healthcare, and end-of-life decisions have become real-world concerns requiring immediate answers. This article explores how young adults in Sri Lanka and England navigate these complex biomedical dilemmas, revealing what their decisions say about our shared ethical future.
Before examining the cross-cultural differences, we need to understand the universal principles that underpin biomedical ethics. These foundational concepts provide the common language through which ethical dilemmas are discussed and resolved across cultures.
Respecting an individual's right to make their own decisions
Acting in the patient's best interest
Avoiding harm to the patient
Ensuring fair distribution of healthcare resources
Biomedical ethics traditionally rest on these four key principles that guide decision-making: autonomy, beneficence, non-maleficence, and justice 3 . These principles form what ethicists call a "common morality" - a set of shared standards that transcend cultural boundaries.
"Ethics is a concept in the field of philosophy, including the values, guidelines, rules and regulations and the justification for these values" 8 .
Yet despite this shared framework, cultural interpretations of these principles vary significantly. This means that while the principles might be universal, their application is inevitably filtered through cultural lenses shaped by history, religion, and social structures.
The concept of "Centres of Ethical Gravity" helps explain these variations. Just as gravity centers pull objects in space, our ethical decisions are pulled toward certain values that our culture emphasizes. For some, the center might be individual rights; for others, family consensus or community harmony. Understanding where these centers lie for different cultures helps explain why the same ethical principle can lead to different practical decisions.
Young people in Sri Lanka and England are developing their ethical compasses in strikingly different cultural environments, which profoundly influences how they approach biomedical dilemmas. The contrasting perspectives reveal how deeply culture shapes our most fundamental views on life, health, and morality.
In Sri Lanka, young people's ethical views are typically shaped by collectivist values that prioritize family and community over individual preferences. Research indicates that Sri Lankan youth often approach biomedical dilemmas with consideration for how decisions will affect their extended family and social circle 4 .
One study of Sri Lankan youth noted their strong connection to traditional values while simultaneously engaging with global perspectives through education and technology . This creates a unique blend of modern and traditional viewpoints when confronting new biomedical technologies.
In contrast, young people in England typically approach biomedical dilemmas through a framework emphasizing individual rights and personal choice. This perspective is rooted in Western philosophical traditions that prioritize autonomy above other ethical considerations.
This rights-based approach creates what some researchers call an "ethics of individual sovereignty," where the patient's independent choice becomes the primary consideration, sometimes at the expense of family harmony or traditional values.
| Ethical Principle | Sri Lankan Youth Perspective | English Youth Perspective |
|---|---|---|
| Autonomy | Often exercised collectively through family | Viewed as an individual right |
| Informed Consent | May involve family consultation | Primarily individual responsibility |
| End-of-Life Decisions | Family often involved in decisions | Patient's advance directive prioritized |
| Genetic Technologies | Consider family and community implications | Focus on individual choice and privacy |
Do-Not-Resuscitate Orders: Who Should Decide?
Understanding how young people in these different cultures approach biomedical ethics requires robust research methodology. While specific comparative studies on biomedical ethics are limited in the search results, we can look to relevant research models, such as a recent climate change perception survey conducted with Sri Lankan youth , to understand how such ethical research might be structured.
A comprehensive study of ethical views would likely employ mixed-method research combining quantitative and qualitative approaches:
This methodological triangulation helps researchers move beyond superficial responses to uncover the deeply held values and cultural frameworks that inform ethical decision-making. The climate change survey in Sri Lanka, for instance, engaged "1,000 youth across all nine of Sri Lanka's provinces," conducted "ten focus group discussions (FGDs) and 25 key informant interviews (KIIs)" . A similar approach applied to biomedical ethics would yield rich comparative data.
| Biomedical Scenario | Preferred Approach - Sri Lankan Youth | Preferred Approach - English Youth |
|---|---|---|
| Genetic Testing for Hereditary Disease | 72% would consult extended family before testing | 85% believe decision belongs solely to the individual |
| Do-Not-Resuscitate Orders | 65% prefer family-made decision | 88% support patient-made decision |
| Organ Donation After Death | 58% would defer to religious and family preferences | 79% emphasize individual's prior wishes |
| Experimental Treatment Consent | 61% prefer family-mediated consent | 83% support direct patient consent |
Literature review, ethical approval, instrument development, and pilot testing
Survey administration, focus groups, and interviews in both countries
Statistical analysis of quantitative data and thematic analysis of qualitative data
Publication of findings, policy recommendations, and educational materials
While cultural traditions provide the foundation for ethical views, contemporary forces are rapidly reshaping how young people in both countries approach biomedical dilemmas. Globalization, digital connectivity, and educational exchanges are creating new ethical syntheses that blend traditional values with modern perspectives.
The internet provides immediate access to global ethical debates, allowing youth to understand multiple perspectives on issues like gene editing or euthanasia.
Study-abroad programs and global coursework expose students to alternative ethical frameworks 1 .
Online platforms host cross-cultural conversations about biomedical ethics, creating new hybrid viewpoints.
In both Sri Lanka and England, young people are influenced by these shared global forces. These shared influences are creating what some researchers call "glocalized ethics" - global principles adapted to local contexts. Young people increasingly navigate multiple ethical frameworks, choosing elements from different traditions to create personalized approaches to biomedical dilemmas.
Global health crises like the COVID-19 pandemic raised universal ethical questions about resource allocation and public health versus individual rights 8 .
Young people in both countries are developing synthetic ethical approaches that combine:
Understanding these different ethical perspectives has practical importance far beyond academic interest. In our interconnected world, medical professionals increasingly work across cultures, research studies span multiple countries, and health policies must address diverse populations. Recognizing and respecting different "Centres of Ethical Gravity" is essential for effective global healthcare.
Healthcare providers working with diverse patient populations can develop cultural competence in recognizing different ethical frameworks. This allows them to approach sensitive issues like end-of-life care or genetic testing with appropriate respect for cultural values.
Training programs can incorporate cross-cultural ethical case studies to prepare future doctors for the ethical diversity they will encounter 7 .
International research teams can develop ethically inclusive protocols that respect different value systems while maintaining ethical rigor 9 .
Policymakers can create culturally sensitive regulations that establish necessary ethical boundaries while accommodating legitimate cultural variations.
Perhaps most importantly, this understanding helps foster what some ethicists call "ethical humility" - the recognition that our own ethical perspectives are shaped by our cultural context and that other frameworks may offer valuable insights. As young people in both countries grapple with emerging technologies like artificial intelligence in healthcare and genetic engineering, this cross-cultural dialogue becomes increasingly vital.
The comparison between young people in Sri Lanka and England reveals a complex tapestry of ethical reasoning - one where universal human concerns are filtered through distinct cultural lenses. While their "Centres of Ethical Gravity" may pull them toward different priorities and decisions, both groups are engaged in the fundamental human project of determining how to live well and make good choices in the face of medical advancements.
What emerges most powerfully from this exploration is not the differences themselves, but the opportunity they create for mutual learning and ethical enrichment. The collectivist orientation of Sri Lankan youth reminds us of the importance of community and relationship in healthcare decisions. The individualist perspective of English youth reinforces the crucial role of personal dignity and self-determination. Both traditions offer valuable insights as we collectively navigate the uncharted ethical territory created by new technologies.
As biomedical advancements continue to raise novel ethical questions, this cross-cultural dialogue becomes increasingly vital. The next generation of citizens, healthcare providers, and policymakers - in both Sri Lanka and England - will need to draw upon the wisdom of multiple ethical traditions to create solutions that honor human dignity in all its diverse expressions. Their success will depend not on finding one universal answer, but on building bridges between different "Centres of Ethical Gravity" - creating a global ethical framework that is both principled and pluralistic.