- A-Z Publications
- South African Journal of Bioethics and Law
- Previous Issues
- Volume 1, Issue 1, 2008
South African Journal of Bioethics and Law - Volume 1, Issue 1, 2008
Volume 1, Issue 1, 2008
Source: South African Journal of Bioethics and Law 1, pp 2 –3 (2008)More Less
Central to health care practice and the moral contract between the public and the profession lies professionalism and professional integrity. The purpose of health care practice is to always care for the ailing and the sick, promote health interests and well-being and strive towards healing environments. Professionalism, which sets the standard of what a patient should expect from his or her health care practitioner, is an ideal that should be sustained. Health care practitioners are important agents through which scientific knowledge is applied to human health, thereby bridging the gap between science and society.
Author Elizabeth Christina MeyerSource: South African Journal of Bioethics and Law 1, pp 4 –5 (2008)More Less
Sections of the new National Health Act are generally understood to be aimed at protecting the public and ensuring the acceptability, standards and safety of private health establishments. Its objective is to provide adequate public liability protection to patients, in respect of all such private facilities.
Author T.J. MaribaSource: South African Journal of Bioethics and Law 1 (2008)More Less
The Board has considered a number of matters relating to education and training in its bid to ensure quality health standards. The standard generation function in terms of the South African Qualifications Authority requirements has resulted in the production of documents for undergraduate training in medicine and dentistry. These will be finalised through the Board's structure and general consultations and submitted to SAQA before the 2009 deadline.
Author David McQuoid-MasonSource: South African Journal of Bioethics and Law 1, pp 7 –10 (2008)More Less
Bioethical principles, human rights and the law are interlinked. Aspects of the principles of autonomy, beneficence, non-maleficence and justice are included in the South African Constitution and the country's statutory and common law. A breach of these ethical principles and the Constitution may lead to an action for medical malpractice or professional negligence.
In this paper, I explore the link between bioethical principles, human rights and the law.
Confinement in the management of drug-resistant TB : the unsavoury prospect of balancing individual human rights and the public goodAuthor Leslie LondonSource: South African Journal of Bioethics and Law 1, pp 11 –19 (2008)More Less
In the context of expanding TB and HIV epidemics in South Africa, the decision to enforce non-voluntary admission for XDR TB raises many ethical and human rights dilemmas, principally because it trades off the human rights of individuals against the public good. However, the dichotomy may also involve competing rights claims and rights obligations of the state to control infectious diseases. A more careful rights analysis is provided, using established analytical frameworks, to elicit the possible criteria that could justify limitation of individual rights. Generally, only in very restricted situations where there is a clearly defined risk to one or more third parties, based on evidence, and conditional on thorough consideration of available alternatives, could non-voluntary admission be considered. Community-based strategies will need to be developed to cope with infection control without forced admission for most cases. Even when compulsory admission is needed, strict adherence to administrative justice procedures would be required. Confinement has no place as a strategy for the broader control of an epidemic which should be contingent on improved health system functioning and addressing the abysmal investment in research and development for drugs for neglected diseases worldwide.
Author Willem A. LandmanSource: South African Journal of Bioethics and Law 1, pp 20 –23 (2008)More Less
Bioethics and organisational ethics are applied ethics disciplines with different objects of investigation. Bioethics focuses on the moral aspects of caring for the health of individuals and populations, and organisational ethics on the moral aspects of organisations' strategies and operations. So these two disciplines converge insofar as they bring moral arguments to bear on applied normative or value issues.
Additionally, when organisational ethics impinges on ethical issues in, specifically, health care organisations - such as government health departments, pharmaceutical companies and private hospital groups - there is a more concerted convergence of bioethics and organisational ethics in that both are concerned with the ethics of health care and, consequently, of health.
Withholding and withdrawing treatment : practical applications of ethical principles in end-of-life careAuthor Liz GwytherSource: South African Journal of Bioethics and Law 1, pp 24 –26 (2008)More Less
Consideration of withholding or withdrawing treatment as a sound clinical decision developed as a consequence of the availability of advanced medical technology and the resultant ability to prolong life that in some cases is in fact unwanted prolongation of the dying process. This prolongation of life may occur without allowing for patient perspectives such as quality of life, being close to family members at a critical stage of life, and the implications of provision of end-of-life care in the alien environment of the hospital or intensive care unit.
Many people fear the process of dying rather than the fact of dying. This fear is often associated with interventions that may be undertaken at the end of life as well as with the knowledge that suffering may be a part of dying and that both may be associated with loss of dignity of the individual.
The paper discusses the statement that withholding or withdrawing treatment can be considered a sound clinical decision when reached in discussion with the patient (if competent), the family and the clinical care team. This decision is not taken lightly and it may not be easy to reach consensus on the decision. It is therefore important that the discussion and decision making are based on established bioethical principles.
Author A. DhaiSource: South African Journal of Bioethics and Law 1, pp 27 –30 (2008)More Less
The traditional Hippocratic belief that one could do almost anything on a patient as long as the principles of beneficence (best interests) and non-maleficence (no harm) were upheld has been considerably revolutionised over the last century. Paternalism, the belief that the health care practitioner should protect or advance the interests of the patient even if contrary to the patient's own immediate desires or freedom of choice, no longer has a place in the health care context. Pursuant to the Nuremburg Trials, the Universal Declaration of Human Rights and several other codes and guidelines emanating from international bodies such as the World Medical Association underscore, among other ethical tenets, the value of autonomy and self-determination. Autonomous actions are the outcome of deliberations and choices by rational agents as persons in the moral sense. Rational persons meet the criteria necessary to decide what is in their own best interests. Health care practitioners have a duty to recognise and respect this value in their patients. Not to do so would not only violate their patients' autonomy, but would be synonymous with treating them as less than persons. An autonomous person is someone who has the ability to deliberate about personal goals and to act under the direction of such deliberation. Respecting autonomy denotes valuing the autonomous person's considered opinions and choices and refraining from obstructing their actions unless they are clearly detrimental to others.