Centre for Medical Ethics and Law

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https://scholar.sun.ac.za/handle/10019.1/97565

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Browsing Centre for Medical Ethics and Law by browse.metadata.advisor "Moodley, Keymanthri"

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    Defining “sufficient maturity”: providing clarity on Section 129 of the Children’s Act
    (Stellenbosch : Stellenbosch University, 2018-03) Pieters, Christian Rudolph Dewet; Moodley, Keymanthri; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Medical Ethics and Law.
    ENGLISH SUMMARY: It becomes increasingly clear that when one deals with a child that one is not only dealing with the child but the entities that are responsible for the child as well. One, however, becomes aware that the intention of these entities, be they bona or mala fide, may not always translate into an outcome that is inherently beneficial to the child who is the subject of medical intervention. This concern was noted by the Legislature and was addressed as best they deemed fit with the inclusion of additional rights for children in section 129 of the Children’s Act. These rights allowed the child a certain level of participation in their health care needs. However, these rights were attached to “sufficient maturity“, a phrase that finds no clarity in the Children’s Act and has been seemingly left to the discretion of the Health Care Provider that finds him/herself in the position of treating a minor. This thesis aims to provide some certainty as what the content of sufficient maturity is and perhaps more importantly how Health Care Providers can give effect to the rights of children. Furthermore, the thesis provides the psychological backdrop for evaluating children and for making certain positive assumptions as to the agency of the child in need of health care. These assumptions are developed and used in tempering the ethical, be they western or ubuntu in nature, and legal landscapes in which Health Care Providers and children find themselves. The product of this thesis is a framework that aims to assist Health Care Providers in their interactions with the child, their parents, caregivers, guardians, or community in circumstances where the nature of the interactions is almost as crucial as the help sought by the child.
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    A System in Crisis: Ethical Concerns about Zimbabwean Healthcare in the 21st Century.
    (Stellenbosch : Stellenbosch University, 2017-12) Moyana, Farayi; Moodley, Keymanthri; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Medical Ethics and Law.
    ENGLISH SUMMARY: Health care services in post-independent Zimbabwe have undergone turbulence with periods of seemingly significant improvements and other periods of definite decline. This thesis looks at health-care systems in general and in particular, the way in which they are reflected through the health-care system of Zimbabwean. Ethical issues and challenges in health care can take many forms ranging from debates and discussions on the fairness or the lack thereof in the health-care reform process, the ethics of inter-professional relationships, the ethical problems with doctorpatient relationships, the state of advocacy in health matters, and patient rights, ethical perspectives influencing discourses on health systems, the ethics of health-care funding, and debates on access to health care. This thesis reflects on the complexities of the challenges, needs and reform requirements of the Zimbabwean situation. A critical analysis of the ethical principles, their impact on the Zimbabwe health care system, using largely the principlist approach as enunciated by Beauchamp and Childress (2013), is conducted. Other moral theories such as the social contract theory is also discussed in some detail because of its important application to issues related to health care. A whole chapter is dedicated to the principle of distributive justice and its relevance and implications for the health care systems in general, but also with particular relevance to the situation in Zimbabwe. Lack of or inadequate insurance is the biggest economic hurdle in accessing health care in many low income countries. There are two main arguments, which appear to support some sort of moral right to a health care funded by the government – “the collective social protection” and the “fair opportunity arguments” (Beauchamp & Childress, 2013). Both of these arguments are discussed in detail. Right to health and right health care are two concepts which confuse a lot of readers because they are close but refer to different dimensions of the concept of health. They are discussed with a particular emphasis on the ethical issues involving allocation of health resources, rationing and setting of priorities. This thesis winds up by looking at the possible solutions to the health crisis in Zimbabwe. The much-flaunted National Health Insurance, amongst other possible remedies, is analyzed. A list of recommendations is outlined, in the last chapter.