https://www.ajol.info/index.php/sajbl/issue/feed South African Journal of Bioethics and Law 2019-02-21T10:32:35+00:00 Ames Dhai Amaboo.Dhai@wits.ac.za Open Journal Systems The South African Journal of Bioethics and Law is a bi-annual journal for health professionals dealing with bioethics, law, human rights and related topics. <span style="text-decoration: underline;">A call for papers:</span>The SAJBL is a key new journal that is dedicated to discussions of significant and critical issues surrounding the application of bioethics, health law and human rights in clinical practice, health policy and regulation and research. The journal will be an electronic one that will be issued twice a year. The editors welcome submissions from authors under the following headings: Empirical Ethics, Clinical Ethics, Health Policy and Law, Case Studies, and Review Articles. Cross-disciplinary debate is encouraged in order to increase the understanding of the complex ethical issues challenging consumers and providers of health care.<p>Other websites related to this journal:<a title="http://www.sajbl.org.za/" href="http://www.sajbl.org.za/" target="_blank">http://www.sajbl.org.za/</a></p> https://www.ajol.info/index.php/sajbl/article/view/183779 Advances in biotechnology: Human genome editing, artificial intelligence and the Fourth Industrial Revolution – the law and ethics should not lag behind 2019-02-21T10:32:26+00:00 Ames Dhai ames.dhai@wits.ac.za No Abstract 2019-02-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/sajbl/article/view/183780 Legalising physician-assisted suicide in South Africa: Should it even be considered? 2019-02-21T10:32:27+00:00 R.K. Jacobs ryankjacobs16@gmail.com <p>For many years, euthanasia and physician-assisted suicide (PAS) have been topics that no one dared to mention. However, over the past few decades, the subject has emerged as a very pertinent issue around the world, for a number of reasons – so much so that these life-ending practices have already been legalised or decriminalised in some developed countries, such as Belgium, the Netherlands and Switzerland, and within certain states of the USA. In the states and countries where the practices have been legalised, or at least decriminalised, the effects of the legalisation have been relatively well documented. On the other hand, in countries like South Africa (SA), where they are illegal, whether or not they should be legalised (taking into consideration all the associated benefits and consequences) should be discussed, and a consensus reached, sooner rather than later. A consensus regarding the feasibility of legalising euthanasia and/or PAS in SA is needed because these practices (or mere requests for them) are becoming increasingly common, especially among people with terminal illnesses. Furthermore, the relative ease with which patients who desperately seek to end their life through either of the aforementioned methods, and are able to access them – by applying for them in countries where the pertinent laws and regulations are adjudged to be more liberal – is alarming. This highlights the importance and need for each country to set clear laws or parameters (and regulations, where applicable) that relate to these life-ending practices.</p> 2019-02-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/sajbl/article/view/183781 Mandatory HIV testing as a prerequisite for surgical procedures: Perspectives on rights and ethics 2019-02-21T10:32:28+00:00 B.N. Joseph jbnasara2002@yahoo.com A.M. Jamil jbnasara2002@yahoo.com B.M. Aya jbnasara2002@yahoo.com A.I. Yahya jbnasara2002@yahoo.com D.A. Dangiwa jbnasara2002@yahoo.com D.N. Jangkam jbnasara2002@yahoo.com M.L.P. Dapar jbnasara2002@yahoo.com <p><strong>Background.</strong> Undergoing mandatory HIV testing as a criterion for a surgical or invasive procedure is illegal in Nigeria, and unethical. This includes requesting an HIV test without the consent of the client, and the disclosure of the test results.</p><p><strong>Objectives.</strong> To assess the practice of mandatory HIV testing among health practitioners, and to examine HIV testing without consent, and the disclosure of test results to the patient.</p><p><strong>Methods.</strong> This was a cross-sectional survey of both medical doctors and nurses with surgical skills. We used convenience sampling to select respondents from Jos University Teaching Hospital, Nigeria and Federal Teaching Hospital, Gombe, Nigeria. A total of 99 respondents filled and returned a questionnaire. Statistical Package for the Social Sciences version 20 was used to manage the data, and the results were presented using descriptive statistics.</p><p><strong>Results.</strong> Over one-third (34.3%) of the respondents reported that they would insist on seeing an HIV test result before performing a surgical or invasive procedure; meanwhile, 4 (4%) of the respondents had refused to render surgical or invasive intervention to HIV clients, while (3%) admitted having refused surgical procedures to patients who refused to take an HIV test. The majority of the respondents (79; 79.8%) reported that the basic equipment and consumables needed for universal precautions were either not available or grossly inadequate.</p><p><strong>Conclusion.</strong> Requests for patients to take an HIV test before surgical procedures are frequent; however, only a few respondents had ever refused to provide a surgical intervention on the basis of a patient’s HIV-positive status. Equipment and consumables necessary for universal precautions were either not available or grossly inadequate in the surveyed hospitals.</p> 2019-02-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/sajbl/article/view/183782 Do Tanzanian hospitals need healthcare ethics committees? Report on the 2014 Dartmouth/Penn Research Ethics Training and Program Development for Tanzania (DPRET) workshop 2019-02-21T10:32:29+00:00 M Aboud culrich@nursing.upenn.edu D Bukini culrich@nursing.upenn.edu R Waddell culrich@nursing.upenn.edu L Peterson culrich@nursing.upenn.edu R Joseph culrich@nursing.upenn.edu B.M. Morris culrich@nursing.upenn.edu J Shayo culrich@nursing.upenn.edu K Williams culrich@nursing.upenn.edu J.F. Merz culrich@nursing.upenn.edu C.M. Ulrich culrich@nursing.upenn.edu <p>Ethical issues are common in the global community. The shortage of human and medical resources when working with vulnerable populations requires institutional support to address the challenges that often arise in the patient-provider relationship. The 2014 Dartmouth/Penn Research Ethics Training and Program Development for Tanzania (DPRET) workshop centred on discussions about research and clinical ethics issues unique to Tanzanian healthcare providers. This article discusses some of the ethical challenges that workshop participants reported in their day-to-day work life with patients and families, such as truth-telling, disagreements over treatment plans and patient distrust of local physicians and hospital staff, among others. The Tanzanian participants recognised the need for supportive mechanisms within their local hospital environments. Further dialogue and research on the development of institutional ethics committees within hospital systems is critically needed so that healthcare providers can meet their ethical and professional obligations to patients and families and address ethical conflicts that arise in a timely and productive fashion.</p> 2019-02-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/sajbl/article/view/183783 Involuntary sterilisation of HIV-positive women in South Africa: A current legal perspective 2019-02-21T10:32:30+00:00 M du Toit m.dutoit@atlanticfellows.org <p>This article examines the reality of HIV-positive women being subjected to perpetual stigmatisation as a result of involuntary sterilisation practices. The reproductive autonomy and dignity of HIV-positive persons is protected by various constitutional provisions, and a legal framework providing for the requirement of informed consent, as well as the prohibition of discrimination on the grounds of HIV status. This article considers the issues of both informed consent and discrimination in the context of the practice of involuntary sterilisation of HIV positive women. The article considers the legal framework in light of the physical, emotional, social and cultural implications for HIV-positive women who are subjected to involuntary sterilisation.</p> 2019-02-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/sajbl/article/view/183784 Unpacking the 2-year age-gap provision in relation to the decriminalisation of underage consensual sex in South Africa 2019-02-21T10:32:31+00:00 Z Essack zessack@hsrc.ac.za J Toohey zessack@hsrc.ac.za <p>Over the past 24 years, the South African criminal justice system has undergone major transformations in relation to sexual offences, including sexual violence against children. More recently, there have been a number of developments to certain provisions in the law relating to sexual offences involving children. In response to the Teddy Bear Clinic Court Case and Constitutional Court ruling, sexual offences legislation related to underage consensual sex was amended. In this regard, the legislation now decriminalises underage consensual sexual activity between adolescent peers aged 12 - 15-year-olds. In addition, the law provides broader definitions for consensual sexual activity, including decriminalising consensual sex and sexual activity between older adolescents (above age of consent for sex, i.e. 16 - 17-year-olds) and younger adolescents (below the age of consent for sex, i.e. 12 - 15-year-olds), granted that there is no more than a 2-year age gap between them. One of the reasons for decriminalising consensual sexual activities between adolescent peers was because the expanded legislation cast the net for sexual offences so wide that the effects had far-reaching harmful impacts, particularly for girls, who would then be exposed to the criminal justice system. This paper focuses on unpacking the 2-year age-gap provision in SA legislation relative to selected better-resourced countries, including the rationale and the potential implications for adolescents (outside of the 2-year age gap provisions), for researchers, service providers and policy-makers. It concludes with some recommendations for law reform and further research.</p> 2019-02-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/sajbl/article/view/183785 CRISPR: Challenges to South African biotechnology law 2019-02-21T10:32:32+00:00 S Pillay ThaldarD@ukzn.ac.za D.W. Thaldar ThaldarD@ukzn.ac.za <p>Genome editing using newly discovered tools such as CRISPR-Cas9 offers the potential to modify the genetic make-up of plants, non-human animals and humans in exact ways. Such genetic modification can serve the purpose of correcting gene defects, and can enhance certain characteristics. Apart from reigniting old ethical debates, genome editing also poses a particular challenge to legal practitioners, as this new technology does not always fit into existing definitional moulds, and it lacks clear legal precedent. In this article, we identify the most salient areas of concern in the South African legal context.</p> 2019-02-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/sajbl/article/view/183786 Healthcare, artificial intelligence and the Fourth Industrial Revolution: Ethical, social and legal considerations 2019-02-21T10:32:33+00:00 S Mahomed mahoms1@unisa.ac.za <p>Artificial intelligence (AI) is usually associated with high-tech robotics, automation and science fiction, and can seem daunting to some. However, AI in general has grown considerably over the past 50 years, and is the current driving force behind the Fourth Industrial Revolution. While it proposes improvements to almost every field that it touches, including the medical sciences, ethical, social and legal challenges associated with its implementation arise. One may question whether AI, which can replace the human element by nature of its operation, has a place in South African and African communities, in certain instances. AI systems can potentially become discriminatory and lead to stigmatisation, if the systems are not properly tailored to reflect the specific characteristics of a population group. Over-reliance on the use of technology, without fully understanding the effects and consequences of the systems, could also prove to be problematic.</p> 2019-02-21T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/sajbl/article/view/183787 Partial-birth abortion – is it legally and ethically justifiable? Lessons for South Africa 2019-02-21T10:32:34+00:00 F Jogee faadielajogee@gmail.com <p>Intact dilation and extraction is a surgical abortion procedure dubbed ‘partial-birth abortion’, and is deemed infanticide by conservative pro-life advocates in the USA. Despite its salutary (albeit feticidal) nature, as it is arguably less destructive than alternative surgical abortion procedures, intact dilation and extraction is federally banned in the USA. While ostensibly unrelated, the matter is germane to South Africa (SA) as it may inform legislation and legal policy on the regulation of feticidal abortion procedures, since feticide remains unregulated by law. The objective of this article is to understand why intact dilation and extraction is proscribed, and whether proscription is justifiable in SA. Accordingly, the primary legal, medical and ethical arguments underpinning proscription are presented, followed by an examination of the veracity of each argument before gauging whether intact dilation and extraction is constitutionally and ethically justifiable in SA.</p> 2019-02-21T00:00:00+00:00 Copyright (c)