Pub Date : 2023-12-20DOI: 10.7196/sajbl.2023.v16i3.1819
A. Dhai
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{"title":"The situation in Gaza – will cruelty and hatred triumph?","authors":"A. Dhai","doi":"10.7196/sajbl.2023.v16i3.1819","DOIUrl":"https://doi.org/10.7196/sajbl.2023.v16i3.1819","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":43498,"journal":{"name":"South African Journal of Bioethics and Law","volume":"116 26","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138953774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.7196/sajbl.2023.v16i3.1250
A. E. Obasa, M. Botes, A. Palk
The transmission of cholera, a highly infectious disease, is closely linked to inadequate access to clean water and sanitation facilities, with resource-poor communities, including refugees, rural communities and temporary displacement camps particularly vulnerable to outbreaks. Any disruption in water and sanitation systems or a sudden surge in community size owing to displacement can spark a humanitarian and health crisis, elevating the risk of cholera transmission and possibly triggering a regional epidemic. Recently, Hammanskraal in Gauteng, South Africa, experienced such an epidemic. A multifaceted approach is essential to minimise fatalities and effectively manage healthcare services in such health emergencies. This approach includes early detection, rapid response to contain outbreaks, and the effective deployment of technical support, advocacy, resource mobilisation and partnerships at local, national, and international levels. This paper explores the responsibilities of individuals, healthcare workers, communities and governments in addressing epidemics. It also delves into the concept of collective responsibility with regard to climate change and cholera, as part of the multifaceted approach for cholera prevention and control. While economic development, equal access to safe drinking water, and adequate sanitation are necessary for cholera control, major challenges persist in achieving the fundamental right to a healthy environment in the long term. We also discuss these obstacles and conclude with practical suggestions and recommendations for future cholera prevention.
{"title":"Collective responsibility during a cholera outbreak: The case of Hammanskraal","authors":"A. E. Obasa, M. Botes, A. Palk","doi":"10.7196/sajbl.2023.v16i3.1250","DOIUrl":"https://doi.org/10.7196/sajbl.2023.v16i3.1250","url":null,"abstract":"The transmission of cholera, a highly infectious disease, is closely linked to inadequate access to clean water and sanitation facilities, with resource-poor communities, including refugees, rural communities and temporary displacement camps particularly vulnerable to outbreaks. Any disruption in water and sanitation systems or a sudden surge in community size owing to displacement can spark a humanitarian and health crisis, elevating the risk of cholera transmission and possibly triggering a regional epidemic. Recently, Hammanskraal in Gauteng, South Africa, experienced such an epidemic. A multifaceted approach is essential to minimise fatalities and effectively manage healthcare services in such health emergencies. This approach includes early detection, rapid response to contain outbreaks, and the effective deployment of technical support, advocacy, resource mobilisation and partnerships at local, national, and international levels. This paper explores the responsibilities of individuals, healthcare workers, communities and governments in addressing epidemics. It also delves into the concept of collective responsibility with regard to climate change and cholera, as part of the multifaceted approach for cholera prevention and control. While economic development, equal access to safe drinking water, and adequate sanitation are necessary for cholera control, major challenges persist in achieving the fundamental right to a healthy environment in the long term. We also discuss these obstacles and conclude with practical suggestions and recommendations for future cholera prevention.","PeriodicalId":43498,"journal":{"name":"South African Journal of Bioethics and Law","volume":"2 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139168960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.7196/sajbl.2023.v16i3.1272
B. L. L. S Mahomed
Mitochondrial donation or mitochondrial transfer enables a woman with mitochondrial disease to have a genetically related child without transmitting the disease to the child. The techniques used for mitochondrial donation or transfer which are maternal spindle transfer or pro-nuclei transfer, require three gametes to ultimately produce a healthy embryo. Both these techniques result in the child inheriting nuclear DNA from the intending parents and mitochondrial DNA from the female donor. Following the legalisation of mitochondrial donation in the UK, after a rigorous process of scientific and ethical review, and the birth of another baby using the technique, coupled with the fact that there is no cure for mitochondrial disease, suggests that it is prudent for us to consider this reproductive intervention and its application in the South African setting. In addition, the 2019 UNESCO Report of the International Bioethics Committee (IBC) on assisted reproductive technologies (ART) and parenthood, encourages debate on changes in models of parenthood influenced by ART including the emergence of new models of families and forms of parenthood that extend beyond the classical rule of mater semper certa est (the mother is always known). ART, in particular mitochondrial donation, challenges this rule. The aim of this paper is to provide an outline of the legal and ethical positions of mitochondrial donation and resume the discussion with specific focus on the South African context.
线粒体捐献或线粒体移植可使患有线粒体疾病的妇女在不将疾病传染给孩子的情况下，生下一个具有遗传相关性的孩子。线粒体捐赠或移植的技术是母体纺锤体移植或原核移植，需要三个配子才能最终产生一个健康的胚胎。这两种技术都会使孩子继承父母的核 DNA 和女性捐赠者的线粒体 DNA。在英国，经过严格的科学和伦理审查程序，线粒体捐赠合法化，而且又有一名婴儿使用该技术出生，再加上线粒体疾病目前尚无治愈方法，这表明我们应该审慎考虑这种生殖干预措施及其在南非环境中的应用。此外，教科文组织国际生物伦理委员会（IBC）关于辅助生殖技术（ART）和父母身份的 2019 年报告鼓励就受辅助生殖技术影响的父母身份模式的变化展开辩论，包括新家庭模式和父母身份形式的出现，这些模式和形式超越了传统的 "母亲永远是已知的"（mater semper certa est）规则。抗逆转录病毒疗法，尤其是线粒体捐赠，对这一规则提出了挑战。本文旨在概述线粒体捐献的法律和伦理立场，并以南非的具体情况为重点继续进行讨论。
{"title":"Three to one – an ethicolegal outline of mitochondrial donation in the South African context","authors":"B. L. L. S Mahomed","doi":"10.7196/sajbl.2023.v16i3.1272","DOIUrl":"https://doi.org/10.7196/sajbl.2023.v16i3.1272","url":null,"abstract":"Mitochondrial donation or mitochondrial transfer enables a woman with mitochondrial disease to have a genetically related child without transmitting the disease to the child. The techniques used for mitochondrial donation or transfer which are maternal spindle transfer or pro-nuclei transfer, require three gametes to ultimately produce a healthy embryo. Both these techniques result in the child inheriting nuclear DNA from the intending parents and mitochondrial DNA from the female donor. Following the legalisation of mitochondrial donation in the UK, after a rigorous process of scientific and ethical review, and the birth of another baby using the technique, coupled with the fact that there is no cure for mitochondrial disease, suggests that it is prudent for us to consider this reproductive intervention and its application in the South African setting. In addition, the 2019 UNESCO Report of the International Bioethics Committee (IBC) on assisted reproductive technologies (ART) and parenthood, encourages debate on changes in models of parenthood influenced by ART including the emergence of new models of families and forms of parenthood that extend beyond the classical rule of mater semper certa est (the mother is always known). ART, in particular mitochondrial donation, challenges this rule. The aim of this paper is to provide an outline of the legal and ethical positions of mitochondrial donation and resume the discussion with specific focus on the South African context.","PeriodicalId":43498,"journal":{"name":"South African Journal of Bioethics and Law","volume":"3 3","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139168629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.7196/sajbl.2023.v16i3.1568
PhD D W Thaldar
Background. South Africa (SA) currently has a golden opportunity to legislate on human heritable genome editing (HHGE), as the country is revising its assisted reproductive technology regulations. A set of sub-regulations that deals with HHGE, which could seamlessly slot into the current regulations, has already been developed. The principles underlying the proposed set of sub-regulations are as follows: HHGE should be regulated to improve the lives of the people and should not be banned; the well-established standard of safety and efficacy should be used in the regulation of HHGE; quality of life is what matters, and not preserving a ‘normal’ genome; parents’ reproductive autonomy must be respected; and equality of access to approved HHGE technology should be promoted. Objectives. To ascertain whether the proposed set of sub-regulations that deals with HHGE is aligned with public opinion in SA, and SA’s Bill of Rights. Methods. Public opinion in SA is determined with reference to a deliberative public engagement study on HHGE conducted among South Africans, and the relevant rights in the Bill of Rights are interpreted with reference to recent case law. Results. This proposed set of sub-regulations that deals with HHGE is aligned with public opinion in SA, and SA’s Bill of Rights. Conclusion. Despite the legal and ethical complexities of HHGE, the proposed set of sub-regulations provides a targeted and effective legislative approach. They fit seamlessly into the country’s existing health law framework, creating specific legal standards for HHGE that align with both public opinion and the country’s Bill of Rights.
{"title":"A golden opportunity for South Africa to legislate on human heritable genome editing","authors":"PhD D W Thaldar","doi":"10.7196/sajbl.2023.v16i3.1568","DOIUrl":"https://doi.org/10.7196/sajbl.2023.v16i3.1568","url":null,"abstract":"Background. South Africa (SA) currently has a golden opportunity to legislate on human heritable genome editing (HHGE), as the country is revising its assisted reproductive technology regulations. A set of sub-regulations that deals with HHGE, which could seamlessly slot into the current regulations, has already been developed. The principles underlying the proposed set of sub-regulations are as follows: HHGE should be regulated to improve the lives of the people and should not be banned; the well-established standard of safety and efficacy should be used in the regulation of HHGE; quality of life is what matters, and not preserving a ‘normal’ genome; parents’ reproductive autonomy must be respected; and equality of access to approved HHGE technology should be promoted. Objectives. To ascertain whether the proposed set of sub-regulations that deals with HHGE is aligned with public opinion in SA, and SA’s Bill of Rights. Methods. Public opinion in SA is determined with reference to a deliberative public engagement study on HHGE conducted among South Africans, and the relevant rights in the Bill of Rights are interpreted with reference to recent case law. Results. This proposed set of sub-regulations that deals with HHGE is aligned with public opinion in SA, and SA’s Bill of Rights. Conclusion. Despite the legal and ethical complexities of HHGE, the proposed set of sub-regulations provides a targeted and effective legislative approach. They fit seamlessly into the country’s existing health law framework, creating specific legal standards for HHGE that align with both public opinion and the country’s Bill of Rights.","PeriodicalId":43498,"journal":{"name":"South African Journal of Bioethics and Law","volume":"74 ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139169704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.7196/sajbl.2023.v16i3.1141
C. Ellis
This paper describes the practical ethical issues and addresses some of the difficulties that arise at the interface between religion and the practice of medicine.Situations that arise between the physician and the patient concerning religious and spiritual beliefs are described. Approaches and caveats to offering religious opinions, instructions and evangelising in the medical encounter are proposed by the author.
{"title":"Pragmatic ethical approaches to evangelising in the medical encounter","authors":"C. Ellis","doi":"10.7196/sajbl.2023.v16i3.1141","DOIUrl":"https://doi.org/10.7196/sajbl.2023.v16i3.1141","url":null,"abstract":"\u0000\u0000\u0000\u0000This paper describes the practical ethical issues and addresses some of the difficulties that arise at the interface between religion and the practice of medicine.Situations that arise between the physician and the patient concerning religious and spiritual beliefs are described. Approaches and caveats to offering religious opinions, instructions and evangelising in the medical encounter are proposed by the author.\u0000\u0000\u0000\u0000","PeriodicalId":43498,"journal":{"name":"South African Journal of Bioethics and Law","volume":"126 31","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138953661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.7196/sajbl.2023.v16i3.1734
M. A. Sathar
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{"title":"The war on Gaza. A test of our humanity","authors":"M. A. Sathar","doi":"10.7196/sajbl.2023.v16i3.1734","DOIUrl":"https://doi.org/10.7196/sajbl.2023.v16i3.1734","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":43498,"journal":{"name":"South African Journal of Bioethics and Law","volume":"358 ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139170565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.7196/sajbl.2023.v16i3.1764
S. Soni
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{"title":"Gaza and international law: The global obligation to protect life and health","authors":"S. Soni","doi":"10.7196/sajbl.2023.v16i3.1764","DOIUrl":"https://doi.org/10.7196/sajbl.2023.v16i3.1764","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":43498,"journal":{"name":"South African Journal of Bioethics and Law","volume":"82 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138956823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.7196/sajbl.2023.v16i3.1470
D. McQuoid-Mason
A hypothetical scenario is presented in which a female patient is admitted to a private hospital to undergo a mastectomy and breast reconstruction. The surgeons and anaesthetists conducting the different procedures charge three times the medical aid rates. When the patient asks what the co-payments are likely to be, she is informed by the doctors’ accounts section that they can only provide this information after each procedure. The patient’s medical scheme also advises her that it cannot determine the likely co-payments unless she completes the assessment form sent to her. The form requires her to include the costs reflected against the relevant ICD10 codes. The patient cannot complete the form because the doctors’ accounts sections have not informed her about the proposed procedures and the likely costs of each. This article builds on a previous article discussing doctors’ overarching responsibility to disclose medical treatment costs in advance. The present article outlines the legal requirements in the South African Constitution, the National Health Act and the Health Professions Act, and refers to the Promotion of Access to Information Act and Consumer Protection Act. Similar to the earlier article, this article addresses the ethical requirements of the Health Professions Council of South Africa and the internationally recognised biomedical ethical principles. Furthermore, it also refers to the National Patients Charter, the government’s policy document on health care services.
{"title":"Is there a legal and ethical duty on doctors to inform patients of the likely co-payment costs should they be treated by practitioners who have contracted out of medical scheme rates?","authors":"D. McQuoid-Mason","doi":"10.7196/sajbl.2023.v16i3.1470","DOIUrl":"https://doi.org/10.7196/sajbl.2023.v16i3.1470","url":null,"abstract":"\u0000\u0000\u0000\u0000A hypothetical scenario is presented in which a female patient is admitted to a private hospital to undergo a mastectomy and breast reconstruction. The surgeons and anaesthetists conducting the different procedures charge three times the medical aid rates. When the patient asks what the co-payments are likely to be, she is informed by the doctors’ accounts section that they can only provide this information after each procedure. The patient’s medical scheme also advises her that it cannot determine the likely co-payments unless she completes the assessment form sent to her. The form requires her to include the costs reflected against the relevant ICD10 codes. The patient cannot complete the form because the doctors’ accounts sections have not informed her about the proposed procedures and the likely costs of each. This article builds on a previous article discussing doctors’ overarching responsibility to disclose medical treatment costs in advance. The present article outlines the legal requirements in the South African Constitution, the National Health Act and the Health Professions Act, and refers to the Promotion of Access to Information Act and Consumer Protection Act. Similar to the earlier article, this article addresses the ethical requirements of the Health Professions Council of South Africa and the internationally recognised biomedical ethical principles. Furthermore, it also refers to the National Patients Charter, the government’s policy document on health care services.\u0000\u0000\u0000\u0000","PeriodicalId":43498,"journal":{"name":"South African Journal of Bioethics and Law","volume":"38 21","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138957339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.7196/sajbl.2023.v16i3.1732
S. Mahomed
The people of Gaza endure physical traumas, and psychological and social wounds directly linked to the combination of military occupations and the closing of its border, essentially forcing and trapping them in despair. The destruction of healthcare infrastructure in particular, has methodically added strain on an already hopeless situation, severely affecting the availability and accessibility of essential healthcare services for the population, which further perpetuates the cycle of peoples suffering. Such suffering has escalated to extreme proportions in 2023. As the violence and attacks continue with flagrant disregard of the Geneva and Hague conventions, the Rome Statute, occupational law, and international and humanitarian law, amid outcries from the international community, we see hospitals, that are traditionally regarded as sanctuaries of humanity transform into corridors of horror.
{"title":"When sanctuaries of humanity turn into corridors of horror: The destruction of healthcare in Gaza","authors":"S. Mahomed","doi":"10.7196/sajbl.2023.v16i3.1732","DOIUrl":"https://doi.org/10.7196/sajbl.2023.v16i3.1732","url":null,"abstract":"The people of Gaza endure physical traumas, and psychological and social wounds directly linked to the combination of military occupations and the closing of its border, essentially forcing and trapping them in despair. The destruction of healthcare infrastructure in particular, has methodically added strain on an already hopeless situation, severely affecting the availability and accessibility of essential healthcare services for the population, which further perpetuates the cycle of peoples suffering. Such suffering has escalated to extreme proportions in 2023. As the violence and attacks continue with flagrant disregard of the Geneva and Hague conventions, the Rome Statute, occupational law, and international and humanitarian law, amid outcries from the international community, we see hospitals, that are traditionally regarded as sanctuaries of humanity transform into corridors of horror.","PeriodicalId":43498,"journal":{"name":"South African Journal of Bioethics and Law","volume":"258 8","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139170767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-09DOI: 10.7196/sajbl.2023.v16i3.1656
A Soni
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{"title":"Israel desecrates the sanctity of healthcare with its attacks","authors":"A Soni","doi":"10.7196/sajbl.2023.v16i3.1656","DOIUrl":"https://doi.org/10.7196/sajbl.2023.v16i3.1656","url":null,"abstract":"-","PeriodicalId":43498,"journal":{"name":"South African Journal of Bioethics and Law","volume":" 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135242805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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