Masters Degrees (Philosophy)
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Browsing Masters Degrees (Philosophy) by Subject "AIDS (Disease) -- Moral and ethical aspects -- South Africa"
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- ItemConfidentiality as value in the management of HIV/AIDS in South Africa(Stellenbosch : Stellenbosch University, 2000-12) Mkosi, Barbara Nomsa; Van Niekerk, Anton A.; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy.ENGLISH ABSTRACT: AIDS is the most important threat to world health. Recent years have seen a dramatic spread of HIVand AIDS in South Africa. Health education directed at modifying risk behaviour appears to be the only way in which the disease can be contained. Controlling AIDS is not only by controlling the virus, but also involves tackling social, economic and political issues and putting AIDS into the broader context of sexuality and gender roles. This requires a broader understanding of this aspect of HIV-AIDS ranging from population dynamics, through to research on individual behaviour and its socio-economic impact; so that we can dispel the myths and rumours that surround AIDS and answer searching questions that will be asked by the community. In South Africa, HIV-AIDS remains a stigmatized disease. There have been calls from courageous and influential people for those who are living with HIV-AIDS to be open about their status and to destigmatise the disease. Institutions too have been drawn into the controversy about whether to remain silent or speak out. Southern African Anglican bishops, as well as some politicians declared their intention to undergo testing for HIV status in order to sensitise the public to the seriousness of the epidemic. Were AIDS not regarded as intolerable, the entire issue of confidentiality would fall away. Calls to destigmatise the disease through openness cannot stand alone. Government must put effective treatment programmes in place. In the absence of treatment, AIDS may represent only frustration and hopelessness to those who test positive; and fear, danger and resultant animosity to those who are HIV negative. The text is in four chapters. Chapter 1 focuses on confidentiality as an important principle in the management of disease. In HIV -AIDS, confidentiality is a more sensitive issue as AIDS is particularly viewed as a social stigma, accompanied by discrimination and harassment. The chapter also addresses HIV infection, transmission, counseling and screemng. Chapter 2 deals with the principles of biomedical ethics namely, autonomy, to enable the patient to determine his/her course of treatment; informed consent, designed to protect the interests of patients from exploitation and harm, and encourage health professionals to act responsibly; beneficence and nonmaleficence, to protect the welfare of others; and justice, to ensure access to health care for all. It also highlights the aspects of and limitations to confidentiality. Chapter 3 discusses broadly the ethical dilemmas pertammg to professional-patient relationships, women and HIV-AIDS, religion, prisoners and employer-employee relationships. When the AIDS epidemic started, very few people suffered from the disease, and the disease was treated with great caution and confidentiality. Today, AIDS is a pandemic and emphasis should shift from the ethic of autonomy and confidentiality, to a social ethic, which emphasizes the responsibility of minimizing the risk of spread of infection. The chapter also examines the role of the Department of Health, the participation of health professional bodies and the legal aspects relating to confidentiality in HIV-AIDS. Chapter 4 attempts to construct an argument to destigmatise HIV-AIDS by arguing the responsibility of the government to make sufficient resources available for the treatment and control of the pandemic. Health professionals are challenged to engage their expertise and skills in the service of the sick with dignity and respect. The community is encouraged to support the drive towards controlling the spread of HIV infection and enable people living with AIDS to disclose their status without fear of harassment.
- ItemEthical perspectives on surveillance and preventive strategies for HIV/AIDS in South Africa(Stellenbosch : University of Stellenbosch, 2000-12) Koenane, Mojalefa Johannes; Van Niekerk, Anton A.; University of Stellenbosch. Faculty of Arts and Social Sciences. Dept. of Philosophy.; Jacobs, IvanENGLISH ABSTRACT: It is a well-known fact that the sub-Saharan Africa is a continent most affected by HIV/AIDS. The HIV/AIDS pandemic has in other words become our disease. For many of us, this fact may be difficult to fully accept. There are elements of prejudice in our reactions. Ignorance and intolerance can be found around the world. Therefore, by presenting the facts about HIV/AIDS, this assignment challenges the misconceptions and focuses on the profound dilemmas confronting society. I think the success in combating the HIV/AIDS pandemic could be found in President Thabo Mbeki's terminology "Partnership against HIV/AIDS". In his speech, the President appealed to both the private and public sectors and all South Africans to work together with greater determination than before to fight against HIV infection and AIDS. Arguably, this was the best speech President Thabo Mbeki ever made on HIV/AIDS on October 9, 1998. Back then, the government seems to have had a direction and led from the front in the battle against HIV/AIDS. The title of this thesis reads: "Ethical perspectives on surveillance and preventive strategies for HIV/AIDS in South Africa". Presently, the South African Government through the Ministry of Health is seriously considering making AIDS a notifiable medical condition. This is a serious and a controversial move that has serious ethical and legal implications that will be discussed. Should partners of HIV-infected individuals be informed? If the answer is on the affirmative, who should inform them? I am also looking at the ethical obligation of health care workers to treat HIV/AIDS patients despite the fear of being accidentally infected. Tough questions need to be asked. Should health workers be informed of the HIV status of every patients they treat? On the other hand, some patients have some fears too that HIV-infected health professionals may infect them. Again, the fundamental ethical concerns related to confidentiality, privacy, the right to treatment will also be discussed. The country is divided on this issue. Ethical principles are directly involved in such a decision, for instance, the principle of confidentiality, respect for autonomy and informed consent. How can the government go about implementing this without disregarding these fundamental ethical requirements?Another ethical issue that comes to mind regarding HIV/AIDS concerns AIDS vaccine trials, which are so far dominantly manufactured in 'developed countries' while subjects of these trials are from 'third world' or 'developing countries '. The ethical concerns here are: How will informed consent be protected, especially where subjects of the trials are not educated and do not understand the terms used? What are the cost-effects or benefits of such trials? What are the risks involved? Together with this, other issues include ethical debates concerning market prices of drugs, which are too expensive for poorer countries and affordable for richer countries. Finally, this work does not treat everything that needs to be dealt with insofar as HIV/AIDS is concerned. However, I hope that this thesis will contribute (in a small way) in making people appreciate the ethical dilemmas that are presented by HIV/AIDS.