Compulsory testing of alleged sexual offenders – implications for human rights and access to treatment

Rape is a major criminal and public health problem in South Africa. Not only does it inflict major trauma on the victim, but it also affects the integrity and dignity of the victim and puts him or her at risk of contracting various sexually transmitted diseases such as HIV and other sexually transmitted infections (STIs). This paper proceeds with the current definition of rape, the provisions of the Criminal Law (Sexual Offences and Related Matters) Amendment Act 32 of 2007 and the arguments relating to compulsory HIV testing of perpetrators, and post-exposure prophylaxis for rape victims/survivors. It reviews the legal and ethical issues relating to compulsory HIV testing of perpetrators, as well as the access to antiretroviral treatment of rape victims and perpetrators if they are diagnosed with HIV infection. It concludes that compulsory testing may provide a feeling of reassurance to victims/survivors but does not protect them from infection, since they have to take all the necessary precautions that they would otherwise have taken had they not demanded the HIV test of the perpetrator

Neonatal circumcision – violation of children’s rights or public health necessity?

There is a growing body of scientific evidence that medical male circumcision substantially reduces the risk of contracting HIV and other sexually transmitted infections. The procedure has been hailed as offering partial protection against HIV infection for men during sexual intercourse, raising the hope that widespread male circumcision could significantly reduce the incidence of HIV transmission in South Africa. The literature also suggests that this procedure may prevent transmission of the human papillomavirus to women. Neonatal circumcision, which is considered to carry the lowest risk, is viewed as a vital component of the goal of realising generalised circumcision in the population. This paper investigates the ethical, legal and public health considerations underlying an HIV prevention strategy that includes neonatal circumcision. It reviews the impact of the practice on the rights of children to bodily integrity, and explores whether proxy consent by a parent or guardian on behalf of a child is appropriate and justifiable on grounds of parental preference, religion, culture or public health policy. This is a complex debate and transcends routine classifications when exploring ethical dilemmas. The article concludes that the rights of neonates to bodily integrity should not be tampered with lightly, and that only a severe public health hazard such as the HIV/AIDS pandemic may justify incursion into this constitutionally protected right

A 'snip' in time: what is the best age to circumcise?

<p>Abstract</p> <p>Background</p> <p>Circumcision is a common procedure, but regional and societal attitudes differ on whether there is a need for a male to be circumcised and, if so, at what age. This is an important issue for many parents, but also pediatricians, other doctors, policy makers, public health authorities, medical bodies, and males themselves.</p> <p>Discussion</p> <p>We show here that infancy is an optimal time for clinical circumcision because an infant's low mobility facilitates the use of local anesthesia, sutures are not required, healing is quick, cosmetic outcome is usually excellent, costs are minimal, and complications are uncommon. The benefits of infant circumcision include prevention of urinary tract infections (a cause of renal scarring), reduction in risk of inflammatory foreskin conditions such as balanoposthitis, foreskin injuries, phimosis and paraphimosis. When the boy later becomes sexually active he has substantial protection against risk of HIV and other viral sexually transmitted infections such as genital herpes and oncogenic human papillomavirus, as well as penile cancer. The risk of cervical cancer in his female partner(s) is also reduced. Circumcision in adolescence or adulthood may evoke a fear of pain, penile damage or reduced sexual pleasure, even though unfounded. Time off work or school will be needed, cost is much greater, as are risks of complications, healing is slower, and stitches or tissue glue must be used.</p> <p>Summary</p> <p>Infant circumcision is safe, simple, convenient and cost-effective. The available evidence strongly supports infancy as the optimal time for circumcision.</p

Learning from experience: the art and science of clinical law

Clinical law is a teaching discipline in terms of which students learn the skills, ethics and values necessary for the practice of law. Its mission is accomplished through the practical involvement of students in legal work, whether it is through simulated exercises or representing actual clients in their legal problems. Throughout this process, they are guided by teachers or supervisors who are practising lawyers within the law school. What is unique to this discipline is the employment of teaching methodologies which are experientially-based and geared towards problem solving, rather than 'academic' in nature. This contribution looks at some recent developments with regard to the regulation of the legal profession and suggests that clinical law is set to assume an even greater significance with the prospect that the period of vocational training is likely to be reduced, in terms of the draft Legal Practice Bill. Furthermore, the contribution argues that such an approach is a more effective form of teaching and learning, and that its methodologies should be integrated into other teaching disciplines. It also explores a model for implementing the notions expressed in this piece. Finally, based on the experiences of South African law clinics, it argues that clinical law can be delivered effectively even in resource-strapped situations. Leer deur ondervinding: die kuns en die wetenskap van kliniese regsopleiding Kliniese regsopleiding is 'n onderrigdissipline in terme waarvan studente die nodige vaardighede, etiek en waardes aanleer om in die reg te kan praktiseer. Hierdie doelstelling (missie) word bereik deur studente prakties in regswerk te betrek, of deur simulasies (gesimuleerde oefeninge) of deur werklike kli&#3619;&#3595;nte behulpsaam te wees (te verteenwoordig) met regsprobleme. Dwardeur die proses word hulle bygestaan deur dosente of toesighouers wat praktiserende regslui is in die regskool (regsfakulteit).Wat uniek is aan hierdie dissipline, is die aanwending van onderrigmetodes wat gegrond is op ervaring en toegespits is op probleemoplossing, eerder as om akademies van aard te wees. Hierdie bydrae is gerig op sekere onlangse ontwikkeling met betrekking tot die regulering van die regsprofessie en redeneer dat dit aanvaar kan word dat kliniese regsopleiding van groter belang sal wees as gevolg van die moontlikheid dat praktiese regsopleidig waarskynlik verminder (verkort) sal word in terme van die voorgestelde wetsontwerp op regspraktyk ("Draft Legal Practice Bill").Verder toon die Jnl for Juridical Sci Vol.29(1) 2004: 116-13

Challenges confronting health care workers in government's ARV rollout: rights and responsibilities

South Africa is renowned for having a progressive Constitution with strong protection of human rights, including protection for persons using the public health system. While significant recent discourse and jurisprudence have focused on the rights of patients, the situation and rights of providers of health care services have not been adequately ventilated. This paper attempts to foreground the position of the human resources personnel located at the centre of the roll-out of the government's ambitious programme of anti-retroviral (ARV) therapy. The HIV/AIDS epidemic represents a major public health crisis in our country and, inasmuch as various critical policies and programmes have been devised in response, the key to a successful outcome lies in the hands of the health care professionals tasked with implementing such strategies. Often pilloried by the public, our health care workers (HCWs) face an almost Herculean task of turning the tide on the epidemic. Unless the rights of HCWs are recognised and their needs adequately addressed, the best laid plans of government will be at risk. This contribution attempts to identify and analyse the critical challenges confronting HCWs at the coalface of the HIV/AIDS treatment programme, in particular the extent to which their own rights are under threat, and offers recommendations to remedy the situation in order to ensure the successful realisation of the ARV rollout.KEYWORDS: Health care, anti-retroviral therapy, HIV/AID

Does One Size Fit All? Patents, the Right to Health and Access to Medicines

The question posed in this article is whether the right to health and patents conflict or coexist. This question is examined from the perspective of the issue of access to affordable medicines in developing countries focusing on the right to health as set out in the ICESCR and patent standards (and flexibilities) as required by the TRIPS Agreement. In the strict sense, there is no conflict between the right to health and patents. ICESCR and TRIPS do not contain mutually exclusive obligations. Yet, it is shown that tension between the two does exist. There are a number of ways in which such tension can be resolved. The UN Sub-Commission for the Promotion and Protection of Human Rights has contended that human rights should enjoy primacy over patents, yet there is no evidence to suggest that the right to health and/ or access to essential medicines are considered prioritised norms under international law. The WTO disagrees and views IPRs and human rights as complementary. In international law there is a strong presumption against conflict. In line with the principle of systemic integration a good faith interpretation of the relevant WTO and human rights provisions should lead to a reading of TRIPS' obligations which is coherent with human rights law. However, this balancing act must also take place at the domestic level and the success of such a coexistence approach, namely whether (developing) states are able to strike a balance between access to medicines and patent protection, will depend much on the actual implementation and interpretation by states. Consequently, some examples of state practice regarding the interpretation and implementation of TRIPS in light of the right to health are highlighted