Pregnant, dead, and on a ventilator : a few thoughts in response to Prof. McQuoid-Mason

Advances made by medical science are able to extend human life, sometimes by highly technical means such as life-support systems. Often these procedures prove life-saving, and the patient recovers fully; at other times, however, life-extending treatment is futile, such as when the patient is declared brain dead. Advances in reproductive technologies, similarly, have been able bring hope by treating and curing infertility. This article responds to an article by Professor McQuoid-Mason entitled ‘Terminating the pregnancy of a brain-dead mother: Does a fetus have a right to life?’ He examines the law in South Africa and the legal implications of the Munoz case, which concerned an application for a court order to have a brain-dead pregnant woman removed from a ventilator. Departing from Prof. McQuoid-Mason’s discussion, this article highlights a few of the ethical and legal implications of new technologies that enable pregnancy to be extended beyond the pregnant woman’s life. This article questions the ethical and legal appropriateness of the use of new technologies, especially in situations where such use is contrary to the pregnant woman’s express wishes. In this context, the article deliberates on whether the dead may be considered to be the bearers of rights that must be respected.http://www.sajbl.org.zaam201

Consent to research by mentally ill children and adolescents : the implications of Chapter 9 of the National Health Act

Chapter 9 of the National Health Act came into effect in March 2012. In this article, the Act’s statutory requirements relating to the informed consent to participation in clinical research by mentally ill children and adolescents in South Africa are examined. The necessity of doing clinical research in mentally ill children and adolescents is canvassed briefly and the requirements that chapter 9 sets out for lawful child and adolescent consent to research participation are presented. Furthermore, the limitations of the newly enacted legislation is deliberated upon and selective improvements are proposed. Because of the likely erosion of the minor’s privacy, the requirement that a parent or legal guardian must consent to children’s and adolescents’ participation in research has the potential to obstruct much-needed mental health research. This requirement is likely to be found unconstitutional. In certain circumstances, ethics committees tasked with the review of research should be allowed to dispense with parental consent, and adolescents recognised as having the necessary capacity to consent independently to research participation. Furthermore, the Act’s classification of research into therapeutic and non-therapeutic categories is considered problematic. It is recommended that research permissible in minors be stated in terms of well-defined risk standards. Finally, the requirement set in subsection 71(3) for ministerial consent in the case of non-therapeutic research in children and adolescents is found to be overly protectionist, as it precludes the capacity of ethics committees to judge the ethics of the proposed research.http://www.sajp.org.za/index.php/sajpam2013ai201

A presumptuous beginner : some thoughts on teaching international law at undergraduate level for the first time

Over the years, scholarly debate regarding the teaching of international law at undergraduate level has centered on various concerns. A variety of teaching methods have been examined: scholars have explored the suitability of less-traditional teaching methods, such as moot courts, simulations and debates, and the use of student learning teams, amongst others. More recently, responding to the demands of the information age, scholars have discussed the use of hybrid and blended teaching methods in international law. In addition, the perspective from which international law should be taught has been debated: some scholars advocate that international law should be taught from the perspective of the municipal legal system (or transnationally); others argue that it should be taught as purely international. Being new to the teaching of international law, I have read with great interest and excitement the contributions on international law teaching methods and the debate around the perspective from which international law should be taught. With this article I should like to add my thoughts on the issue of why law students experience difficulties with the subject of international law - more so than with other law subjects. I think this problem is central to the debate on how the teaching of international law should be approached.http://www.unisa.ac.za/Default.asp?Cmd=ViewContent&ContentID=685am201

The grave's a fine and private place : a preliminary exploration of the law relating to posthumous sperm retrieval for procreation

The application of advances in reproductive technologies continues to raise significant legal and ethical questions. The retrieval of sperm from a dead man for procreation is no exception, not least because individual choice regarding procreation represents the very essence of human self-determination. A request for posthumous sperm retrieval typically comes in a situation where no prior consent for the procedure exists: a person requests the removal of the sperm of a deceased spouse or partner in situations of unexpected loss and tragedy, such as the sudden death of that spouse or partner in a motor vehicle accident

The ‘intentional’ sexual transmission of HIV : a note of caution in light of Phiri v S

Most legal practitioners and laypersons agree, if someone deliberately or intentionally transmits the Human Immunodeficiency Virus (HIV) to a sexual partner, that person deserves legal sanction. South Africa has opted not to establish a separate set of criminal offences to criminalise HIV transmission in this context, unlike several other African countries that have established separate crimes for the intentional or negligent transmission of HIV. In South Africa, policy considerations have prompted the application of existing criminal law principles in court cases dealing with the intentional or negligent transmission of HIV to sexual partners.http://reference.sabinet.co.za/sa_epublication/sapr1http://www.unisa.ac.za/Default.asp?Cmd=ViewContent&ContentID=21413am201

Betekenisvolle kennis? Die reg en etiek in postgenomiese geen-terapie navorsing

Nuwe metodes om menslike gene te “redigeer”, soos CRISPR-Cas9, sal wetenskaplikes in die toekoms in staat stel om presiese veranderinge aan te bring aan die menslike genoom – ʼn feitlik ondenkbare prestasie in die vorige eeu. Die toekoms van genetiese manipulasie is dus vol belofte – en voorspel ʼn einde aan sommige van die mees uitdelgende menslike siektetoestande. Dit is nou hoog tyd om die lesse wat ons geleer het uit die geskiedenis van kliniese navorsing te herroep: lesse van wetenskaplike, filosofiese en etiese belang. Hierdie lesse omvat ook die lesse wat ons geleer het uit die dood van Jesse Gelsinger in 1999 vanweë komplikasies as gevolg van die toediening van ʼn proef-produk in ʼn lewer geen-terapie kliniese proef. Die artikel steun op die geskiedenis van kliniese navorsing ten einde voor te stel dat Suid-Afrikaanse navorsingsetiekkomitees die konsepte tradisioneel gebruik in die evaluering van kliniese navorsing, soos “toestemming”, “risiko” en “geregtigheid”, herevalueer sodat navorsing gedoen word wat betekenisvolle kennis sal oplewer. Die vraag word ge¬vra na wat betekenisvolle kennis daarstel in postgenomiese geen-terapie navorsing, asook die omstandighede waarin sulke kennis betekenisvol sal wees vir wetenskaplikes, die deelnemers aan navorsing of hulle gemeenskappe.The article is based on the author's inaugural address as Head of the Department of Public Law, University of Pretoria, delivered on 22 May 2018.http://www.lexisnexis.co.zaPublic La

Liability for the wrongful transmission of communicable diseases in South African prisons : what about HIV?

Much has been written about prison conditions in South Africa. Overcrowding, violence, poor sanitation and inadequate access to health care are the order of the day in most prisons. These conditions provide the ideal setting for the spread of disease. In the words of Anton van Niekerk: 'Viral diseases, as we know, do not all become epidemics. To become an epidemic, a niche or social context is required'. Although the exact prevalence in South African prisons of communicable diseases, such as the Human Immunodeficiency Virus (HIV) and Tuberculosis (TB), is unknown, we may draw inferences from regional epidemiological studies. According to one study, HIV prevalence in sub-Saharan African prisons is two to 50 times greater than that of the general population. The high prevalence rates of HIV exacerbate the TB infection rates among inmates, as TB is the most common opportunistic infection among people living with HIV in Africa. TB incidence in prisons worldwide has been estimated at more than 20 times higher than in the general population. Consequently, it is not surprising that, according to the Department of Correctional Services' Annual Report for the years 2011 to 2012, the most common causes of natural deaths among inmates were TB, pneumonia and AIDS.am2013ai201

‘The grave’s a fine and private place' : a preliminary exploration of the law relating to posthumous sperm retrieval for procreation

The application of advances in reproductive technologies continues to raise significant legal and ethical questions. The retrieval of sperm from a dead man for procreation is no exception, not least because individual choice regarding procreation represents the very essence of human self-determination.http://reference.sabinet.co.za/sa_epublication/sapr1http://www.unisa.ac.za/Default.asp?Cmd=ViewContent&ContentID=21413am2016Jurisprudenc

Twintig jaar 'n aangeklaagde : 'n ontleding van twee dekades se verrigtinge teen dokter Wouter Basson

Hierdie artikel is 'n analise van die strafregtelike- en dissiplinere verrigtinge teen dokter Wouter Basson wat sedert 1999 aan die gang is, en wat steeds nie afgehandel is nie. Dokter Basson se militere loopbaan sowel as sy betrokkenheid by die voormalige Suid- Afrikaanse Weermag se biologiese en chemiese wapenprogram genaamd Projek Coast, word kortliks bespreek. Die strafsake wat teen dokter Basson ingestel is word bespreek in chronologiese volgorde, so-ook die onderskeie appelle en dokter Basson se uiteindelike ontslag. Dokter Basson se dissiplinere verhoor by die Suid-Afrikaanse Gesondheidsberoepsraad, voortspruitend uit sy betrokkenheid by Projek Coast, word ontleed. Die fokus word geplaas op die voortvloeiende hersieningsaansoeke, die daaropvolgende appelle en relevante regs- en etiese beginsels. Laastens word die praktiese gevolge van die jongste uitsprake in hierdie aangeleentheid aangeraak.The article is based on sections of the first author's LLM thesis titled "Medical professionals in armed conflict: The case of Dr Wouter Basson" (UP 2020). The thesis was prepared under the supervision of the second author.http://www.lexisnexis.co.zaam2021Public La

The right to physical integrity and informed refusal : just how far does a patient’s right to refuse medical treatment go?

The article presents a legal analysis of the right to physical integrity as guaranteed by the South African Constitution, 1996, and the subsequent right of a competent adult person to refuse medical treatment under South African law. We consider whether the right to refuse treatment is an absolute right and very briefly reflect on the application of the constitutional limitations clause to this right. Instances in which patients’ right to physical integrity is limited by factors, which detract from (patient) autonomy, are considered: these represent a limitation of their right to refuse medical treatment. We conclude that forced medical interventions, for the most part, are not desirable but, indeed, necessary in some narrowly defined circumstances. When a person makes a decision to refuse a medical intervention, which may seem unusual or may be perceived as irrational, it does not mean that person does not warrant the protection of the constitution and the courts. Provided that the patient makes an informed refusal while of sound mind, generally there is no reason to discredit his/her decision, difficult as it may be for others to accept. At all times the right to bodily integrity is pivotal in any health-related context and should not be lightly disregarded.http://www.sajbl.org.zaam2017Public La