Should South African healthcare workers be mandated to receive the covid-19 vaccine

Simple item page
dc.contributor.advisorVan Niekerk, A. A.en_ZA
dc.contributor.authorBotman, Karl Peter Mauriceen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Centre for Medical Ethics and Law.en_ZA
dc.date.accessioned2023-12-01T09:49:05Z
dc.date.accessioned2024-01-08T17:31:42Z
dc.date.available2023-12-01T09:49:05Z
dc.date.available2024-01-08T17:31:42Z
dc.date.issued2023-12
dc.descriptionThesis (MPhil)--Stellenbosch University, 2023.en_ZA
dc.description.abstractENGLISH SUMMARY: The Covid 19 pandemic caused global multifaceted devastation. The world was thrown into unprecedented territory. Not since the Spanish Flu has a viral pandemic had such a remarkably negative impact on society and life in such a short period of time. This virus did not only cause destruction on a global scale, but also far-reaching harm at an individual level. The socioeconomic devastation and governments’ responses to mitigate the unknown, will be felt across the globe for many years. Even in many developed countries, healthcare infrastructure was unable to manage the large number of patients during the several waves of the pandemic. One can only speculate the impact that it has had on developing, under-resourced countries. Whether one lived in a developed or developing country, the impact was felt both directly and indirectly. The devastation caused could only be labelled a public health emergency. The life-saving role that healthcare workers played was unquestionably highlighted during this pandemic. Without these skilled and dedicated individuals, the health system and its resources would definitely not have survived the pandemic. The physical and mental well-being of not only patients were affected, but also that of the healthcare workers (HCW) managing these patients. Healthcare workers have played a crucial role specifically in the prevention, education and management relating to the disease process. These persons, whom many regard as the cornerstone of healthcare, have not been spared the wrath of this disease either. The infectious nature of this virus and its various presentations, especially the asymptomatic cases, made diagnoses difficult, unless persons subjected themselves to microbiological and immunological testing. The virus which caused this devastation was named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) with its associated disease referred to as COVID-19. In many aspects, COVID-19 caused a public health crisis across the globe. COVID-19 brought the world to its knees. Governments, scientists and HCWs across the globe were forced to collaborate with each other regarding different healthcare-related fields, including public health, virology, immunology, epidemiology, and intensive care. The objective was to save lives by means of containment measures, finding a treatment for the infection and, ultimately, a vaccine to prevent the spread of the virus. The legal and ethical considerations in mandating COVID-19 vaccination in resource constrained countries like South Africa needed to be approached judiciously. On the one hand, there was the right to autonomy and thus, by implication, liberty, which the South African Constitution supports. Equally important were the legal and ethical implications in exposing innocent persons, whether it be patients or close contacts of the HCW, to a potential vector (the HCW) for the transmission of the virus. Governments and employers across the world, specifically during times of pandemics, have both ethical and legal obligations to protect their citizens and employees, which may give rise to ethical conflicts. Should South African healthcare workers be mandated to receive the COVID-19 vaccine? This question was approached from several perspectives: I discuss the science behind the effectiveness of a vaccine and the history of vaccination. This is followed by the relevant aspects of the Constitution of South Africa and the various legislated Acts applicable to the implementation of mandatory vaccination. Given this background, I focus on the ethics of mandatory vaccination applicable to HCWs. The familiar principles and general acceptance of bioethics as the protection of individual rights in the medical setting, however, must be considered together with public health ethics in the COVID-19 pandemic context. I argue that these two principles cannot be considered independently regarding HCWs. There is no doubt that a conflict exists between autonomy and the promotion and protection of public health through vaccination. This study highlights the importance of a balance between individual rights and the common good – not only during times of pandemics.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Die COVID-19-pandemie het wereldwyd verrykende verwoesting gesaai. Die wereld het hom bevind op onbekende terrein. Geen viruspandemie het sedert die Spaanse griep oor so kort tydperk so ʼn ingrypende impak op die bevolking en lewe gehad nie. Die virus was nie slegs wereldwyd vernietigend nie, maar het ook wydlopende ontwrigting vir die individu meegebring. Die sosio-ekonomiese vernietiging en regeringsreaksie om die onbekende verloop van die pandemie te temper, sal vir jare wereldwyd gevolge he. Selfs in ontwikkelde lande was gesondheidsinfrastuktuur gedurende verskeie opwellings van die pandemie onvoldoende om die groot aantal pasiente te hanteer. Daar kan slegs spekuleer word oor die invloed wat die pandemie in onderontwikkelde lande met gebrekkige hulpbronne gehad het. Die impak van die pandemie is direk en indirek deur almal beleef in sowel ontwikkelde as ontwikkelende lande. Die vernietiging wat die pandemie tot gevolg gehad het, kan beskryf word as ʼn gemeenskapsgesonheidsnoodtoestand. Gedurende die pandemie was die lewensreddende bydrae van gesondheidswerkers kennelik. Sonder hul kundigheid en toewyding sou gesondheidstelsels en hulpbronne ongetwyfeld nie die pandemie oorleef het nie. Die fisieke en geesteswelsyn van sowel pasiente as gesondheidswerkers wat die pasiente hanteer het, is beinvloed. Gesondheidswerkers het ʼn kardinale en deurslaggewende rol gespeel, in die besonder ten opsigte van voorligting, voorkoming en hantering van die siekteproses. Hierdie werkers, wat deur vele bestempel word as die hoeksteen van gesondheidsorg, het egter nie die woede van die pandemie gespaar gebly nie.Diagnose van infeksie is bemoeilik deur die oordraagbare aard van hierdie virus en verskeie presentasies van die siekte, veral by asimptomatiese gevalle. Daarom moes daar staatgemaak word op mikrobiologiese en immunologiese toetsing. Die virus wat hierdie vernietigende effek gehad het, is die sogenaamde Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) en die siekte wat dit veroorsaak word COVID-19 genoem. In vele opsigte het COVID-19 wereldwyd ʼn gemeenskapsgesondheidskrisis veroorsaak. COVID-19 het die wereld op sy kniee gedwing. Regerings, wetenskaplikes en gesondheidswerkers is wereldwyd genoop om saam te werk in verskeie gesondheidsorg- verwante dissiplines, insluitende gemeenskapsgesondheid, virologie, immunologie, epidemiologie en intensiewe sorg. Die oormerke was om verspreiding te beperk, die ontwikkeling van ʼn kuur vir die infeksie, en uiteindelik, die ontwikkeling van ʼn vaksien om infeksie en verspreiding te voorkom. Die wetlike en etiese oorwegings ten opsigte van verpligte inenting teen COVID-19 in ʼn land met min hulpbronne soos Suid-Afrika verg ʼn oordeelkundige benadering. Enersyds is daar die reg op outonomie (die reg om self te besluit) en word deur die Grondwet van Suid-Afrika ondersteun. Hierteenoor staan die wetlike en etiese implikasies van blootstelling van onskuldige persone (pasiente of nabykontakte van die gesondheidswerker) aan ʼn potensiele vektor (die gesondheidswerker) vir oordrag van die virus. Wereldwyd het regerings en werkgewers, veral tydens pandemies, die etiese sowel as die wetlike verpligting om hul burgers te beskerm. Hierdie benadering kan aanleiding gee tot etiese verskille. Moet inenting teen COVID-19 vir Suid-Afrikaanse gesondheidswerkers verpligtend wees? Hierdie vraag word vanuit verskeie oogpunte benader: Die geskiedenis, wetenskaplike begronding en effektiwiteit van inenting word toegelig. Daarna volg ʼn bespreking van aspekte in die Grondwet van Suid-Afrika en wetgewing ten opsigte van die implementering van verpligte inenting. Gegewe hierdie agtergrond word daar gefokus op die etiek van verpligte inenting van gesondheidswerkers. Individuele regte in die geneeskunde moet beskerm word. Dit moet geskied deur die beginsels en algemene aanvaarding van bio-etiek. Nogtans moet hierdie twee aspekte, naamlik individuele outonomie en kollektiewe voordeel in die scenario van die COVID-19-pandemie eties versoenbaar wees. Ek redeneer dat hierdie twee aspekte ten opsigte van gesondheidswerkers onafskeidbaar. Ten opsigte van inenting bestaan daar ongetwyfeld konflik tussen die outonomie van die individu en die kollektiewe beskerming van die bevolking. Hierdie studie belig die belangrikheid van die balans wat bestaan tussen die regte van die individu enersyds, en die kollektiewe voordeel van die bevolking, andersyds. Hierdie belang geld nie slegs tydens pandemies nie.eaf_ZA
dc.description.versionMasters
dc.format.extent100 pages : includes annexures
dc.identifier.urihttps://scholar.sun.ac.za/handle/10019.1/128966
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch University
dc.rights.holderStellenbosch University
dc.subject.lcshMedical personnel -- Vaccination -- South Africaen_ZA
dc.subject.lcshCOVID-19 Pandemic, 2020 -- Prevention -- South Africaen_ZA
dc.subject.lcshCOVID-19 vaccines -- Vaccination -- South Africaen_ZA
dc.subject.nameUCTD
dc.titleShould South African healthcare workers be mandated to receive the covid-19 vaccineen_ZA
dc.typeThesisen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
botman_should_2023.pdf
Size:
1.27 MB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Masters Degrees (Centre for Medical Ethics and Law)