Informed consent to participation in preventive HIV vaccine efficacy trials in the light of section 12(2)(c) of the South African Constitution

Clinical trials to develop an effective vaccine against HIV are currently underway in South Africa. The scientific, epidemiologic and socio-economic backgrounds against which these trials are likely to take place are described, as well as the risks and benefits attaching to participation. It is argued that, against this background, informed consent will be difficult to achieve. In the light of this reality, the extent of the constitutional guarantee in section 12(2)(c) is investigated. The content of section 12(2)(c) is analysed, and recent case law that deals with section 12 is examined critically. It is concluded that the constitutional guarantee contained in section 12(2)(c) is an important buttress against communities’ exploitation during HIV vaccine trials

Two cheers for equality: A critical appraisal of Act 4 of 2000 from a plain language viewpoint

Legislative writing is often criticised by the lay person for its use of obscure words and complicated sentence structure. This contribution appraises the comprehensibility of the language of South Africa’s new equality legislation, Act 4 of 2000. In its preamble, Act 4 of 2000 promises to undertake the facilitation of “the transition to a democratic society, marked by human relations that are caring and compassionate”. I consider the question as to whether the promise contained in the preamble to the Act does not effectively nullify itself given that the Act is written in language that is accessible  almost exclusively to legislators and members of the legal profession

Enhancing trust or reducing perceived risk, what matters more when launching a new product?

Using a collection of data among 490 participants from different companies in the field of medical engineering market, we contribute to the role of contact intensity by a business partner when launching new products by introducing trust as a mediator to the concept of perceived risk reduction to enhance the relationship commitment. The findings show that the common concept of risk reduction to enhance the relationship commitment is overrated. In detail, the results show first, that the influence of trust on the relationship commitment is decisive instead of reducing perceived risk by the customer. The contact intensity is only important to enhance trust which influences the relationship commitment in a positive way. Hence, managers should concentrate on the development of trust and not on the reduction of perceived risk of the customer. Second, our findings demonstrate that the attitude whether the customer is averse of affine towards innovations has no influence on the relationship between contact intensity and relationship commitment. This is obviously the opposite of the findings of most researchers in literature who usually state customers need different contacts of the seller to purchase a new product depending on their attitude towards innovations. </jats:p

What constitutes adequate legal protection for the collection, use and sharing of mobility and location data in health care in South Africa?

Mobile phone technology has been a catalyst that has added an innovative dimension in health care and created new opportunities for digital health services. These digital devices can be viewed as an extension of the person using them due to the deluge of personal information that can be collected and stored on them. Data collected on mobile phones are used extensively in health services and research. Personal, mobility and location data are constantly collected. The unique mobile phone architecture provides for an easy flow of data between various role players such as application developers and phone manufacturers. The collection, storage and sharing of personal information on mobile phones elicit various legal questions relating to the protection of privacy, consent, liability and the accountability of stakeholders such as health insurance providers, hospital groups and national departments of health

Comorbidity in context: Part 1. Medical considerations around HIV and tuberculosis during the COVID-19 pandemic in South Africa

Infectious diseases pandemics have devastating health, social and economic consequences, especially in developing countries such as South Africa. Scarce medical resources must often be rationed effectively to contain the disease outbreak. In the case of COVID-19, even the best-resourced countries will have inadequate intensive care facilities for the large number of patients needing admission and ventilation. The scarcity of medical resources creates the need for national governments to establish admission criteria that are evidence-based and fair. Questions have been raised whether infection with HIV or tuberculosis (TB) may amplify the risk of adverse COVID-19 outcomes and therefore whether these conditions should be factored in when deciding on the rationing of intensive care facilities. In light of these questions, clinical evidence regarding inclusion of these infections as comorbidities relevant to intensive care unit admission triage criteria is investigated in the first of a two-part series of articles. There is currently no evidence to indicate that HIV or TB infection on their own predispose to an increased risk of infection with SARS-CoV-2 or worse outcomes for COVID-19. It is recommended that, as for other medical conditions, validated scoring systems for poor prognostic factors should be applied. A subsequent article examines the ethicolegal implications of limiting intensive care access of persons living with HIV or TB

Comorbidity in context: Part 2. Ethicolegal considerations around HIV and tuberculosis during the COVID-19 pandemic in South Africa

The COVID-19 pandemic has brought discussions around the appropriate and fair rationing of scare resources to the forefront. This is of special importance in a country such as South Africa (SA), where scarce resources interface with high levels of need. A large proportion of the SA population has risk factors associated with worse COVID-19 outcomes. Many people are also potentially medically and socially vulnerable secondary to the high levels of infection with HIV and tuberculosis (TB) in the country. This is the second of two articles. The first examined the clinical evidence regarding the inclusion of HIV and TB as comorbidities relevant to intensive care unit (ICU) admission triage criteria. Given the fact that patients with HIV or TB may potentially be excluded from admission to an ICU on the basis of an assumption of lack of clinical suitability for critical care, in this article we explore the ethicolegal implications of limiting ICU access of persons living with HIV or TB. We argue that all allocation and rationing decisions must be in terms of SA law, which prohibits unfair discrimination. In addition, ethical decision-making demands accurate and evidence-based strategies for the fair distribution of limited resources. Rationing decisions and processes should be fair and based on visible and consistent criteria that can be subjected to objective scrutiny, with the ultimate aim of ensuring accountability, equity and fairness