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- Volume 3, Issue 2, 2010
South African Journal of Bioethics and Law - Volume 3, Issue 2, 2010
Volume 3, Issue 2, 2010
Author Ames DhaiSource: South African Journal of Bioethics and Law 3 (2010)More Less
In March this year, the Independent Online published an article entitled 'SA's dodgy doctors'. This was sparked off as a result of a spate of high-profile cases involving practitioners and patients, several of which were claims against practitioners of sexual impropriety or misconduct. At around that time there was also extensive media coverage on the conduct of a former Cape Town orthopaedic surgeon who had been found guilty in the Bellville Magistrate's Court of raping and indecently assaulting a female patient. He had also been found guilty on 14 counts of indecent assault of 9 female patients. This case is just one of several that have received widespread media coverage with far-reaching consequences for practitioners at large.
Source: South African Journal of Bioethics and Law 3, pp 55 –58 (2010)More Less
Regulators feel that telemedicine presents challenges. In part this is because of the assumption that telemedicine is new and unproven, and must therefore be regulated in order to protect the patient. Regulation requires clear and careful definition of what is to be regulated. The Health Professions Council of South Africa's proposed definition of telemedicine has deficiencies. Telemedicine is not new, nor is it a special discipline or a new branch of medicine. It involves the use of information and communication technologies in the provision of health care over distance. This includes the telephone. Instead of proposing a one-size-fits-all approach to regulations and guidelines, a more pragmatic approach to issues such as signed, written consent, prior doctor-patient relationship and licensure is required. It is proposed that regulators should seek to find deficiencies in existing guidelines and regulations and address these if required, and that clinical, operational and ethical guidelines should be developed by the governing bodies or associations of the various clinical disciplines using information and communication technologies in the provision of health care. An enabling regulatory environment is required if we are to realise the goals of improved access, service delivery and quality of care for the rural communities of South Africa through telemedicine.
Author David BenatarSource: South African Journal of Bioethics and Law 3, pp 59 –62 (2010)More Less
Confidentiality is a central principle of medical ethics. The most common breaches of this principle are not the rare cases in which the principle is overridden by other considerations. Instead, confidentiality is most often breached when it clearly should be respected. In this paper I outline these threats to confidentiality, the most frequent and disturbing of which is indiscretion in its many forms.
Evaluating the right to autonomy argument in the debate on coercive antenatal HIV testing in South AfricaAuthor Mpho SelemogoSource: South African Journal of Bioethics and Law 3, pp 63 –66 (2010)More Less
Several authors have recently argued for coercive HIV testing policies of pregnant women in areas of high HIV prevalence such as South Africa which also have poor uptake in their prevention of mother-to-child transmission (PMTCT) programmes. The autonomy argument, which holds that it is within women's right to exercise their autonomy in opting out of such programmes, is the most cited argument for rejecting such proposals. This paper examines the autonomy argument and arrives at the conclusion that it is problematic, particularly in the context of a public health intervention, in view of the demands of other competing moral interests, and because it is silent on the ethics of the actual implications of the autonomous decision to opt out of HIV testing.
Reproductive health issues emanating from the Children's Act No. 38 of 2005 as amended in 2008 : a pilot study of the rights of parents versus rights of childrenSource: South African Journal of Bioethics and Law 3, pp 67 –74 (2010)More Less
The study took as its point of departure the Children's Act No, 38 of 2005 implemented in 2010, which aims to promote the preservation and strengthening of families and to give effect to the rights of children as enshrined in the Constitution of the Republic of South Africa. When the Act was introduced certain segments of society applauded the government for its efforts to promote the rights of children, while others condemned the government's approach towards parents' rights in relation to reproductive health issues affecting their children. The primary aim of the research project was to explore the views of a group of parents in Johannesburg Metro Region 11 regarding reproductive health care as embedded in the Children's Act. A small-scale, descriptive, cross-sectional pilot research design was employed which involved individual interviews with 35 participants. The main findings that emerged from the study were that participants did not participate in the process leading up to the promulgation of the Act and consequently had little knowledge about the Act or its objectives. The fact that participants did not support certain clauses on reproductive health care and were of the opinion that their rights as parents were being violated has implications for amendment of the Act.
Author David McQuoid-MasonSource: South African Journal of Bioethics and Law 3, pp 75 –78 (2010)More Less
There is a conflict in the South African Bill of Rights between the rights of women to reproductive health care and to make decisions about their reproductive capacity, and freedom of conscience on the part of the medical profession. State-employed doctors, unlike private practitioners, cannot pick and choose their patients. In emergency cases where there is a risk to the patient's life or danger of grave illness, all doctors have a legal duty to render assistance to eliminate such risk or illness, and the same applies where the risk or danger arises from pregnancy. In non-emergency cases, doctors wishing to exercise freedom of conscience must refer patients to another doctor who is prepared to terminate the pregnancy - failure to do so may be construed as preventing or obstructing access to termination of pregnancy under the Choice on Termination of Pregnancy Act 92 of 1996.
Smoking in the workplace in South Africa : law and practice relating to the rights and obligations of employers and employeesAuthor Jamil Ddamulira MujuziSource: South African Journal of Bioethics and Law 3, pp 79 –83 (2010)More Less
South Africans have a high prevalence of smoking. The preamble to the Tobacco Products Control Act, which regulates the production, marketing, advertising, selling and smoking of tobacco products in public places, acknowledges that tobacco use 'is extremely injurious to the health of smokers, non-smokers and other users of tobacco products'; 'has caused widespread addiction in society'; and 'warrants, in the public interest, a restrictive legislation'. One of the objectives of the Tobacco Products Control Act is to regulate the circumstances in which tobacco products can be used in public places, including workplaces. The Act makes smoking in a public place an offence and obliges employers who still allow smoking in the workplace to provide designated smoking areas. However, the Act also empowers employers to ban smoking totally at workplaces.
This paper highlights the provisions and regulations relating to smoking in workplaces and discusses the reported cases in which the various bargaining council arbitrators have dealt with the issue of employers' and employees' rights in cases relating to smoking at workplaces.