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- Volume 2, Issue 2, 2009
South African Journal of Bioethics and Law - Volume 2, Issue 2, 2009
Volume 2, Issue 2, 2009
Author Ames DhaiSource: South African Journal of Bioethics and Law 2 (2009)More Less
The Johannesburg offices of Deneys Reitz Inc. hosted a Medical Law Seminar in June this year. Several interesting papers were presented, some of which are published in the Forum section of this issue of SAJBL. That the law should be perceived as a tool towards the pursuance of justice for patients echoed throughout the seminar, both during presentations and the ensuing discussions. The notion of doctors as soft targets at the mercy of litigation-eager patients and legal practitioners did not feature in any way during the day's proceedings.
Author Donrich JordaanSource: South African Journal of Bioethics and Law 2, pp 39 –40 (2009)More Less
Do you, dear reader, care about human pre-embryos - embryos during the first 14 days of development? Do you know that most pre-embryos never implant and are routinely excreted from women's bodies - without the women ever knowing of the pre-embryos' existence? Does anybody care about all these millions and millions of 'exterminated' pre-embryos? Well, apparently some bioethicists do care about pre-embryos - but specifically research pre-embryos in lab dishes. (None of the former, however, have suggested any serious plans to rescue the millions of in vivo pre-embryos that perish after having been excreted.)
Liability of medical practitioners to children born with congenital defects - a discussion of Stewart v. Botha : forumAuthor Sandra SitholeSource: South African Journal of Bioethics and Law 2, pp 41 –42 (2009)More Less
South African law recognises claims against medical practitioners by mothers whose children have been born with congenital defects, the so-called 'wrongful birth actions'. The basis of such claims is that if the medical practitioner had detected and informed the mother of the fetus's congenital defects, she would have terminated the pregnancy and the child would not have been born and suffered from the defects and caused her additional expense. The Supreme Court of Appeal in Stewart v. Botha (340/2007)  ZASCA 84 had to consider whether a child born with congenital defects can himself or herself sue the medical practitioner for allowing the child to be born, the so-called 'wrongful life actions'. The court held that wrongful life actions should not be recognised in our law because the core of such cases is to require the court to decide whether it is preferable, from the child's perspective, not to have been born at all.
Exposure to the consumer court under the Consumer Protection Act - more litigation for the medical industry? : forumAuthor Donald DinnieSource: South African Journal of Bioethics and Law 2, pp 43 –45 (2009)More Less
The Consumer Protection Act introduces consumer courts as a means of achieving protection and speedy enforcement of consumers' rights. In the medical industry, this raises the concern that medical practitioners and hospitals may soon face increased litigation by consumers exercising their statutorily enshrined rights. However, the Consumer Protection Act provides only a limited basis for complaints to the consumer court, which is likely to result in continued reliance on the common law remedies by consumers seeking to recover damages. In this article, the limitations of the consumer court as well as general considerations under the Consumer Protection Act applicable to the medical industry are discussed.
Author Sandile KhozaSource: South African Journal of Bioethics and Law 2, pp 46 –47 (2009)More Less
University of KwaZulu-Natal Vice-Chancellor Professor William Makgoba was quoted in a newspaper article as saying: 'Trading in human organs is one of the most serious allegations that can be made in the medical profession.'
In KwaZulu-Natal, criminal charges were instituted against three medical practitioners on allegations of human organ trafficking. Investigations are still being conducted in Brazil, Israel and several other jurisdictions.
Source: South African Journal of Bioethics and Law 2, pp 48 –50 (2009)More Less
Medical professionalism is under threat today and its future is quite uncertain. In order to influence the future rather than let it be determined by external forces, physicians and their associations need to understand its past and its present status, including the challenges posed by commercialism, consumerism, bureaucratisation and unprofessional behaviour. Two future scenarios are presented, one unfavourable and the other favourable to professionalism. Unless the profession acts quickly and decisively, it is likely that the unfavourable scenario will prevail. Suggestions are offered for how a favourable future can be achieved.
Source: South African Journal of Bioethics and Law 2, pp 51 –53 (2009)More Less
Becoming a medical professional is a gradual process that begins at entry into medical school and continues throughout the entire training period. Four events mark key stages in this process: entry into medical school, beginning of clinical rotations, graduation and beginning of independent practice. Essential characteristics of student professionalism are commitment, honesty, discretion, co-operation, participation, diligence and temperance. Students need to know how to deal with unprofessional behaviour, whether their own or other students' or teachers'. Medical schools must have comprehensive programmes for teaching and supporting student professionalism.
Moral principlism alone is insufficient, and traditional moral theories remain important for practical ethicsAuthor D.L. ClarkeSource: South African Journal of Bioethics and Law 2, pp 54 –58 (2009)More Less
Bioethics is a new discipline that arose out of a general revulsion for the events of the Holocaust and concerns about the unique dilemmas created by the rapid progress of modern knowledge. The four principles approach to medical ethics has been widely adopted as a basis for ethical decision-making in clinical practice. Although the four principles have succeeded in raising general awareness of biomedical ethics, there are several problems with principlism. This review discusses the criticisms of the four principles and attempts to provide an integrated approach to ethics based on the character of the moral agent.
Author Jamil Ddamulira MujuziSource: South African Journal of Bioethics and Law 2, pp 59 –61 (2009)More Less
The release on medical parole of a prominent and influential South African businessman, Mr Schabir Shaik, who served less than 3 years of his 15-year prison term, put the issue of medical parole under the spotlight with several newspaper articles, radio stations and television channels expressing different views regarding his release. There were also allegations that the medical officers who had recommended his release had acted unprofessionally - until they were vindicated by the Health Professions Council of South Africa. This article discusses the law relating to medical parole in South Africa and cases where courts have released offenders on medical parole, and gives statistics of offenders who have been released on medical parole since 1996. It also highlights some of the contentious issues relating to medical parole.
Prescription pattern of unlicensed and off-label medicines for children aged 0 - 5 years in a tertiary hospital and a primary health care centre in NigeriaSource: South African Journal of Bioethics and Law 2, pp 62 –66 (2009)More Less
Background. Many medicines prescribed for children are unlicensed for their age category or used outside the specifications in the medicine licences (off-label use), and few medicines have been properly tested for use in children in clinical trials prior to licensing. These problems raise ethical and safety concerns about use of medicines in children. The pattern and extent of unlicensed and off-label use of medicines in the Nigerian health care system has been poorly documented.
Objectives. This research was carried out to study the pattern and extent of unlicensed and off-label use of medicines in children aged 0 - 5 years in a tertiary hospital and a primary health care centre in Nigeria.
Method. A retrospective study of prescriptions received by children during admission or as outpatients during the 12-month period April 2003 - March 2004 was done.
Results. The 531 children included in the study received 2 190 prescriptions during the study period. Of these 446 (20.4%) were for unlicensed use and 470 (21.5%) for off-label use. The most common form of unlicensed medicine use was modification of licensed dosage forms (e.g. crushing of tablets to make suspensions), while the most frequent pattern of off-label use was using doses other than those recommended for the paediatric age categories.
Conclusion. Unlicensed and off-label medicines are widely used for children in the centres studied. Further research on this subject is recommended in other parts of Nigeria and Africa.
Author S.M. LukhoziSource: South African Journal of Bioethics and Law 2, pp 67 –69 (2009)More Less
The Bill of Rights is the cornerstone of democracy in South Africa, and enshrines rights of all people in South Africa. This imposes a duty on the state to respect, protect, fulfil and promote these rights. Organs of state and certain persons, including medical practitioners, have duties arising from the Bill of Rights.