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South African Journal of Bioethics and Law最新文献

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Disciplinary proceedings against healthcare practitioners facing criminal charges: The role of the Health Professions Council of South Africa 对面临刑事指控的保健从业人员的纪律处分程序:南非卫生专业委员会的作用
IF 0.9 Q4 MEDICAL ETHICS Pub Date : 2022-10-12 DOI: 10.7196/sajbl.2022.v15i2.804
M. Kwinda, M. Labuschaigne, M. Slabbert
The purpose of this article is to address the questions as to whether a criminal conviction of a healthcare practitioner should affect his or her professional standing, and whether such conviction constitutes ‘unprofessional conduct’ in terms of the Health Professions Act. The article also explores a related matter, namely whether the Health Professions Council of South Africa (HPCSA) has a legal duty to refer complaints regarding unprofessional conduct that displays criminal elements for criminal prosecution. After considering relevant case law on these issues, the article concludes that a practitioner, after being convicted of an offence, should be afforded an opportunity to explain him- or herself to the board, not only in extenuation of the conduct in question, but also in response to the question of whether the conduct constitutes improper or disgraceful conduct. Moreover, the article explains why the HPCSA and professional boards have a legal duty to refer matters of unprofessional conduct with criminal elements in terms of section 34 of the Prevention and Combating of Corrupt Activities Act to law enforcement agencies.
本文的目的是解决以下问题:对医疗从业人员的刑事定罪是否应影响他或她的专业地位,以及这种定罪是否构成《卫生专业法》规定的“非专业行为”。本文还探讨了一个相关问题,即南非卫生专业委员会(HPCSA)是否有法律义务将有关显示犯罪成分的不专业行为的投诉提交刑事起诉。在考虑了有关这些问题的判例法后,该条的结论是,执业者在被定罪后,应该有机会向委员会解释他或她自己,不仅要减轻有关行为,而且要回答有关行为是否构成不当或可耻行为的问题。此外,这篇文章解释了为什么HPCSA和专业委员会有法律责任根据《预防和打击腐败活动法》第34条将带有犯罪成分的非专业行为事项提交执法机构。
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引用次数: 5
Rights of the fetus: Voice of the Unborn Baby and Constitutional Court decision 胎儿的权利:未出生婴儿的声音和宪法法院的裁决
IF 0.9 Q4 MEDICAL ETHICS Pub Date : 2022-10-12 DOI: 10.7196/sajbl.2022.v15i2.819
P. Soma-Pillay, L. Nkosi-Thomas, Y. Pillay
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引用次数: 0
Informed consent in clinical trials 临床试验中的知情同意
IF 0.9 Q4 MEDICAL ETHICS Pub Date : 2022-10-12 DOI: 10.7196/sajbl.2022.v15i2.802
G. P. Kovane, V. C. Nikoderm, O. Khondowe
Background. Informed consent (IC) is not only a regulatory but also an ethical requirement to participate in any clinical trial. It is essential to determine that research participants understand what they consent to. Studies that evaluate participants’ understanding of IC conclude that recall and understanding of IC is often low, and researchers recommend that interactive multimedia interventions should be implemented to optimise understanding. Objectives. To assess participants’ understanding of IC of the research trial that they agreed to participate in.Methods. A descriptive survey design, within a quantitative research approach, was used to conduct the study at two government hospitals in the Eastern Cape Province. A semi-structured, self-administered questionnaire was used to collect information from 170 participants in research studies. Descriptive statistics were used to analyse the results.Results. Participants were recruited from among women who enrolled in any of the three studies that were ongoing at the two sites during the recruitment period. The study participants had a mean age of 25.9 years. Nearly one-third (30%) could not recall the purpose of the original trial that they consented to. The concept of randomisation was not understood by any of the participants.Conclusion. Regardless of extensive efforts to ensure that participants understood their participation, this study unveiled poor recall of essential information on IC. It is proposed that IC should be short and only address essential components such as purpose, procedure, possible risks or benefits, alternative options if not participating and explaining the concept of voluntary participation.
背景。知情同意(IC)不仅是参与任何临床试验的监管要求,也是伦理要求。确定研究参与者了解他们同意的内容是至关重要的。评估参与者对集成电路理解的研究得出结论,认为集成电路的回忆和理解往往很低,研究人员建议应实施交互式多媒体干预以优化理解。目标。评估参与者对他们同意参加的研究试验的IC的理解。采用定量研究方法的描述性调查设计在东开普省的两家政府医院进行了研究。一份半结构化、自我管理的调查问卷用于收集170名研究参与者的信息。采用描述性统计方法对结果进行分析。参与者是从在招募期间在两个地点正在进行的三项研究中的任何一项中招募的妇女中招募的。研究参与者的平均年龄为25.9岁。近三分之一(30%)的人不能回忆起他们同意的最初试验的目的。任何参与者都不理解随机化的概念。尽管为确保参与者理解他们的参与做出了大量努力,但该研究揭示了对IC的基本信息的回忆不足。建议IC应该简短,只涉及基本组成部分,如目的、程序、可能的风险或利益、不参与的替代方案,并解释自愿参与的概念。
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引用次数: 0
Don’t shy away from the elitist implications of your argument: Response to de Roubaix 不要回避你的论点的精英主义含义:对德鲁拜的回应
IF 0.9 Q4 MEDICAL ETHICS Pub Date : 2022-10-12 DOI: 10.7196/sajbl.2022.v15i2.815
P. Msimang
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引用次数: 0
Parents’ perceptions of ethical issues in adolescents’ HIV care and treatment at Temeke Regional Referral Hospital, Tanzania 坦桑尼亚Temeke地区转诊医院的父母对青少年艾滋病毒护理和治疗中伦理问题的看法
IF 0.9 Q4 MEDICAL ETHICS Pub Date : 2022-10-12 DOI: 10.7196/sajbl.2022.v15i2.784
R. Joseph, G. Mahiti, G. Frumence, C. Ulrich
Background. Decisions to test, enrol and disclose HIV status are among the ethical challenges that may influence adherence to antiretroviral therapy (ART) and HIV care and treatment in adolescents living with HIV. In the Tanzanian setting, how parental perceptions of ethical issues affect adolescents’ adherence to HIV care and treatment is not well known.Objective. To explore parental perceptions of ethical issues in adolescent HIV care and treatment. Methods. The study employed a descriptive qualitative exploratory design and was conducted at Temeke Regional Referral Hospital in Dar es Salaam Care and Treatment Centre (CTC) in the Outpatient Department (OPD). The study population were parents and non-parent caregivers of HIV-infected adolescents 10 - 19 years of age. A total of 16 persons participated in semi-structured interviews after their consent was obtained. All interviews were audiotaped, transcribed verbatim in Swahili and back-translated into English. An inductive content analysis was used, and standards of qualitative rigour applied. Results. Three qualitative themes emerged: balancing adolescents’ autonomy with parents’ desire to protect their children; parental dilemmas regarding disclosure of adolescents’ HIV status; and parental reasons for delayed disclosure.Conclusion. Participants perceived that parental authority should override adolescents’ autonomy in HIV care and treatment. Disclosure of HIV status to adolescents is a challenge to parents. Delays in disclosure often occur because parents feel guilty and because they have fears of rejection by their adolescent children.
背景检测、登记和披露艾滋病毒状况的决定是可能影响感染艾滋病毒的青少年坚持抗逆转录病毒疗法(ART)和艾滋病毒护理和治疗的伦理挑战之一。在坦桑尼亚,父母对道德问题的看法如何影响青少年对艾滋病毒护理和治疗的依从性尚不清楚。客观的探讨父母对青少年艾滋病毒护理和治疗中的伦理问题的看法。方法。该研究采用描述性定性探索性设计,在达累斯萨拉姆护理和治疗中心的Temeke地区转诊医院门诊部进行。研究人群是10-19岁感染艾滋病毒的青少年的父母和非父母照顾者。共有16人在征得同意后参加了半结构化访谈。所有采访都录音,用斯瓦希里语逐字转录,然后再翻译成英语。使用了归纳内容分析,并采用了严格的定性标准。后果出现了三个定性主题:平衡青少年的自主性与父母保护孩子的愿望;父母在披露青少年艾滋病毒状况方面的困境;以及父母延迟披露的原因。结论与会者认为,父母的权威应该凌驾于青少年在艾滋病毒护理和治疗方面的自主权之上。向青少年披露艾滋病毒状况对父母来说是一项挑战。延迟披露往往是因为父母感到内疚,也因为他们害怕被青春期的孩子拒绝。
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引用次数: 0
Guidelines for the ethical review of mental health research protocols from a culturally-sensitive perspective 从文化敏感的角度对精神卫生研究规程进行伦理审查的准则
IF 0.9 Q4 MEDICAL ETHICS Pub Date : 2022-09-19 DOI: 10.58177/ajb2
F. Nabil, Mercury Shitindo
In most of Africa, mental illness is considered a silent epidemic due to structural and systemic barriers such as inadequate health care infrastructure, insufficient number of mental health specialists, stigma and discrimination related to mental illness, and lack of access to all levels of care. The continued suffering and disability due to mental illness calls for newer treatments and continued research into the field of mental health treatment and therapy. Research ethics committees are cognizant of the importance of this aspect yet, the road to this innovative future is fraught with ethical dilemmas as well as ethical, legal, and social implications. There is an urgent need to have guidelines that give guidance to research ethics involving mental health participants. Guidelines were developed for the ethical review of mental health research protocols with the aim of increasing health equity and access in Africa and other low-income countries. We systematically analyzed 13 programme, research, and policy evaluation tools in light of mental health and cultural attributes. A 54-item assessment tool was created to guide the process of mental health research protocol evaluation taking into account ethical, gender, and sociocultural factors in Africa. The emerging themes i.e. research governance, background and justification, methodology and ethical impact of the research forming the basis of the assessment tool are interlinked with the bioethical principles of respect for autonomy, beneficence, non-maleficence and justice. When they are applied to the evaluation of a study they will not only underscore these principles, they enhance their application and increase access to equitable health in Africa and other low-resource settings regardless of the varied contexts.
在非洲大部分地区,由于保健基础设施不足、精神卫生专家人数不足、与精神疾病有关的耻辱和歧视以及无法获得各级保健等结构性和系统性障碍,精神疾病被认为是一种无声的流行病。由于精神疾病造成的持续痛苦和残疾,需要新的治疗方法,并在精神健康治疗和治疗领域继续进行研究。研究伦理委员会认识到这方面的重要性,然而,通往这一创新未来的道路充满了伦理困境,以及伦理、法律和社会影响。迫切需要制定指导方针,为涉及精神卫生参与者的研究伦理提供指导。为精神卫生研究规程的伦理审查制定了准则,目的是增加非洲和其他低收入国家的卫生公平和获得机会。根据心理健康和文化属性,我们系统地分析了13个项目、研究和政策评估工具。创建了一个包含54个项目的评估工具,以指导精神卫生研究议定书评估进程,同时考虑到非洲的伦理、性别和社会文化因素。新兴主题,即研究治理、背景和理由、方法和研究的伦理影响,构成评估工具的基础,与尊重自主、仁慈、无害和正义的生物伦理原则相互关联。当它们被应用于一项研究的评价时,它们不仅强调了这些原则,而且加强了这些原则的应用,并在非洲和其他资源匮乏的环境中增加了获得公平保健的机会,无论其背景如何。
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引用次数: 0
Ethics replaced by politics at the patient’s bedside: Sad and dark times in our post-1994 trajectory 伦理在病人的病床前被政治所取代:1994年之后的悲伤和黑暗时期
IF 0.9 Q4 MEDICAL ETHICS Pub Date : 2022-09-12 DOI: 10.7196/sajbl.2022.v15i2.826
A. Dhai
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引用次数: 0
Note de politique: la gestion de la vulnérabilité dans la revue éthique des protocoles de recherche sur la Covid-19 政策说明:Covid-19研究方案伦理审查中的脆弱性管理
IF 0.9 Q4 MEDICAL ETHICS Pub Date : 2022-09-01 DOI: 10.58177/ajb001
Samba Cor Sarr
L’épidémie a provoqué plusieurs initiatives de recherche en sciences sociales et humaines, épidémiologiques et sur les systèmes de santé amenant le à enregistrer 58 protocoles de recherche sur la Covid-19 avec 2 pics de soumissions notés respectivement en novembre 2020 (15 protocoles) et en janvier 2021 (13 protocoles). La gestion efficace de ce flux a nécessité la mise en place des dispositions particulières de gouvernance éthique de la recherche en période d’urgence. Deux défis étaient à relever par le comité face à la pression de la pandémie: traiter avec diligence des dossiers soumis qui sont souvent des protocoles de recherche pragmatique et veiller au respect des principes éthiques dans l’élaboration et la mise en œuvre des protocoles. Pour ce faire, des innovations étaient nécessaires, tant dans l’organisation des revues, que le de la mise en œuvre de la recherche en période de pandémie Covid-19. La note de politique ainsi rédigée vise à partager les acquis du quant à sa contribution à la protection des participants à la recherche dans le contexte de la pandémie Covid-19. La méthodologie utilisée est centrée sur la revue documentaire avec l’outil FAO et le guide des bonnes pratiques de la . Cela a permis de mettre en exergue les acquis suivants : La prise en compte de la vulnérabilité dans les procédures de recherche sur la covid-19 ; Examen systématique et réduction de la durée de traitement des protocoles Covid-19 ; Matérialisation du consentement par voie digitale ; et Vigilance éthique sur la vulnérabilité en période de Covid-19. En termes de bonnes pratiques on peut citer La digitalisation de la revue éthique et scientifique des protocoles La systématisation des commentaires écrits des reviewers et l’archivage électronique des procès-verbaux et de protocoles de recherche.
疫情引起了若干倡议,在社会科学和人文科学研究、流行病学和对卫生系统,促使该登记规程研究Covid-19 58同书峰2得分分别于2020年11月(15)及其议定书(2021年1月13号议定书)。为了有效地管理这一流动,必须在紧急情况下为研究的伦理治理作出特别规定。面对这一流行病的压力,委员会面临两项挑战:迅速处理提交的文件,这些文件往往是务实的研究方案,并确保在制定和执行方案时尊重伦理原则。为此,在Covid-19大流行期间,期刊的组织和研究的实施都需要创新。起草的政策说明旨在分享其在Covid-19大流行背景下为保护研究参与者作出贡献的成果。所使用的方法侧重于使用粮农组织工具和粮农组织良好做法指南进行的文献审查。这突出了以下成就:在covid-19研究程序中考虑到脆弱性;对Covid-19方案进行系统审查并缩短治疗时间;通过数字方式实现同意;以及对Covid-19时期脆弱性的道德警惕。良好的实践包括伦理和科学协议审查的数字化,审稿人书面评论的系统化,以及会议记录和研究协议的电子归档。
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引用次数: 0
Artificial intelligence in healthcare: Proposals for policy development in South Africa. 医疗保健中的人工智能:南非政策发展建议。
IF 0.9 Q4 MEDICAL ETHICS Pub Date : 2022-08-05 Epub Date: 2022-05-19 DOI: 10.7196/sajbl.2022.v15i1.797
S Naidoo, D Bottomley, M Naidoo, D Donnelly, D W Thaldar

Despite the tremendous promise offered by artificial intelligence (AI) for healthcare in South Africa, existing policy frameworks are inadequate for encouraging innovation in this field. Practical, concrete and solution-driven policy recommendations are needed to encourage the creation and use of AI systems. This article considers five distinct problematic issues which call for policy development: (i) outdated legislation; (ii) data and algorithmic bias; (iii) the impact on the healthcare workforce; (iv) the imposition of liability dilemma; and (v) a lack of innovation and development of AI systems for healthcare in South Africa. The adoption of a national policy framework that addresses these issues directly is imperative to ensure the uptake of AI development and deployment for healthcare in a safe, responsible and regulated manner.

尽管人工智能(AI)为南非的医疗保健提供了巨大的希望,但现有的政策框架不足以鼓励这一领域的创新。需要切实、具体和以解决方案为导向的政策建议,以鼓励创建和使用人工智能系统。本文考虑了需要制定政策的五个不同问题:(i)过时的立法;(ii)数据和算法偏差;(iii)对保健人力的影响;(四)责任强加困境;(五)南非医疗保健领域缺乏人工智能系统的创新和发展。必须通过直接解决这些问题的国家政策框架,以确保以安全、负责任和规范的方式将人工智能开发和部署用于医疗保健。
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引用次数: 2
Are we preparing for the next pandemic? 我们是否在为下一次大流行做准备?
IF 0.9 Q4 MEDICAL ETHICS Pub Date : 2022-07-11 DOI: 10.7196/sajbl.2022.v15i1.809
A. Dhai
-
-
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引用次数: 0
期刊
South African Journal of Bioethics and Law
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