Browsing by Author "De Vaal, Celeste"
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- ItemRaising ethical issues in the dead: an exploration of ethical challenges in Forensic Medicine(Stellenbosch : Stellenbosch University, 2018-03) De Vaal, Celeste; Horn, Lyn; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy.ENGLISH SUMMARY: This dissertation explores ethical challenges in the forensic medicine field. Pivotal to forensic pathology are the deceased and the medico-legal investigation. The unique relationship between forensic doctor and deceased is distinctly different to the doctor-patient relationship of most other medical disciplines. This highlights the importance of focused ethical deliberation in this field, which is long overdue. I argue that the deceased is an entity with moral status worthy of moral deliberation. I demonstrate that five concepts, namely, human properties, relationship considerations, moral agency, symmetry, and cultural and religious considerations, contribute to the deceased’s moral standing. The matter is not whether the deceased has moral status, but the scope of obligation to which such a moral status gives rise. Two questions have guided this thesis: First, do ethical issues exist in the field of forensic medicine in the South African context; and what are some of these issues? Secondly, if there are ethical issues, how can they best be identified and explored? South Africa’s recent history demonstrates the existence of ethical issues in forensic medicine, historically. The first major ethical arena revolves around the conflict of interest conundrum, which is especially prevalent in forensic medicine. Current dual loyalty concerns involve the deceased and the intricately linked judicial system, under which the forensic doctor works. The second area of ethical concerns relates to retained post mortem interests of the deceased. Prior to exploring these ethical issues, a framework had to be identified. No forensic medicine-specific framework was forthcoming in my literature search. In chapter four I argue that the principlism approach is a worthy framework to consider in addressing ethical issues in forensic medicine, in comparison with other prominent bioethics theories. Subsequent chapters illustrate ethical issues in forensic medicine by using principlism. The principle of justice was subdivided to incorporate three important aspects of justice, namely legal justice, rights-based justice and distributive justice. Beneficence as a positive act of doing good was discussed and aligned to the different role players involved in the medico-legal investigation. Non-maleficence was then discussed as related to avoidance of harm. Lastly, the principle of autonomy was deliberated to be applicable to the deceased as certain ante mortem interests remained post mortem. In summary, the two opening questions were answered in the dissertation. Ethical issues do exist in forensic medicine. Some of these issues were identified and subsequently explored in the thesis by means of principlism. Raising ethical issues in the dead is not merely a clever play on words, but indeed a necessary ethical discussion. Since ethical deliberation in forensic medicine is a largely unexplored terrain, recommendations for practice and future exploration are made.