Although Kirk Lougheed recognises the need to integrate diverse frameworks into its predominantly Anglo-American tradition,1 his argument contains a limited understanding of vital force as well as a restricted view of communal relationships. We therefore suggest a broader framework for understanding vitality, community and what is permissible by emphasising how African beliefs by the Akan, advance care directives and Afro-Caribbean religious practice such as Santería expand perspectives within global bioethics and thus encourage more inclusive approaches to addressing bioethical dilemmas. For (...) the Akan (in Ghana), the fundamental concept of ‘being’ is construed on the belief that Okra (considered as soul, or the life-giving spirit in man) and Nkrabea (considered as destiny) determine the life of every individual. Individual autonomy in the matter of ‘death’ is linked to the collective responsibility for the preservation of life. For a terminally ill person, his family and community members, this responsibility is upheld by allowing Nkrabea (destiny) to take its natural course without any human intervention especially in matters of ‘death’. Thus, the Akan belief and conviction concerning Nkrabea or destiny run contrary to the approval of euthanasia.2 The impermissibility of euthanasia, from this perspective …. (shrink)