Department of Philosophy

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Browsing Department of Philosophy by Author "Abdool, Zeelha"

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    Evidence, truth, reality and power: A Foucauldian analysis of the ethics of testing and using novel medical devices
    (Stellenbosch : Stellenbosch University, 2018-12) Abdool, Zeelha; De Roubaix, Malcolm; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy.
    ENGLISH ABSTRACT: From the onset of time, human beings have used substances in all forms and shapes to promote health. Prior to the nineteenth century, traditional folk medicine, religious ceremonies, magical practices, herbs and the balancing of the ‘humors’ were popular methods of healing amongst others practiced by the Greeks. The various earlier Egyptian papyri detail the ancient Egyptian concepts of disease and cures, various ailments and anatomical observations. Informed consent was simplistically manifested by patient trust and cooperation. The nineteenth and twentieth centuries witnessed significant medical advancement is all spheres of medicine i.e. opening of hospitals, training of doctors, era of antibiotics, development of universities and research centres. Since the quest for science and health was a priority, doctors earned a high social standing and began to enjoy the privileged status in society. This resulted in the birth of a heavily professionalized discipline. Developing Michel Foucault’s ideas, we may regard that discipline is a specific technique of power, which aims to objectify human beings using three main practices i.e. dividing practices (e.g. birth of hospitals and asylums), scientific classification (medicine regarded as a discipline) and subjectification of human beings (humans considered as subjects). Using Foucauldian ethics, this thesis aims to deconstruct the power versus knowledge relationship between physicians and the healthcare industry in context of adopting novel medical devices. The last century has been challenged by the invention of medical devices by the healthcare industry. Some of these medical devices have raised both scientific and ethical issues because patients suffered harm. The use of transvaginal mesh for pelvic organ prolapse is currently a global topic questioning how harm came to women. The rationale for mesh development, regulatory clearance and dissemination to society, and conflict with the four ethical principles is discussed. Three other gynaecological devices will also be the focus of this thesis. The power of regulatory authorities to clear medical devices using a substandard clearance mechanism, and the power of the healthcare industry to employ vicious marketing strategies to physicians is critically analysed. Physicians as bodies of knowledge adopt these procedures with noble intentions. The implications of using novel medical devices are significant as physicians represent the final point of care for patients during which informed consent is finalized. The interplay between physicians and the healthcare industry illustrates the clash between the urge to ‘develop’ and market new technology (medical devices in this case) and the ethics of responsibility espoused by physicians to protect against harm, notwithstanding the role of regulatory authorities. Medical device innovation will continue to expand. Physicians aided by sound science and ethical principles have the responsibility to implement safe and efficacious treatment. As this may be not sufficient to prevent harm, the addition of virtue ethics and shifting of the power balance toward physicians is proposed.