Dual loyalties, human rights violations, and physician complicity in apartheid South Africa

Moodley, Keymanthri ; Kling, Sharon (2015-11)

CITATION: Moodley, K. & Kling, S. 2015. Dual loyalties, human rights violations, and physician complicity in apartheid South Africa. AMA journal of ethics, 17(10): 966-972, doi: 10.1001/journalofethics.2015.17.10.mhst1-1510.

The original publication is available at http://journalofethics.ama-assn.org

Article

Introduction: From 1948 to 1994, South Africans were subjected to a period of sociopolitical segregation and discrimination based on race, a social experiment known as apartheid. South African history was tainted by a minority Afrikaner Nationalist Party that sought to plunder, exploit, divide, and rule. When that party took power in 1948, human rights abuses permeated all levels of society, including the medical profession, which was to a large extent complicit in various human rights violations. These discriminatory practices had a negative impact on the medical education of black students, the care of black patients in private as well as public institutions, and the careers of black medical doctors. Medical student training programs at most universities ensured that white patients were not examined by black medical students either in life or after death. Postmortems on white patients were conducted in the presence of white students only; students of color were permitted to view the organs only after they were removed from the corpse [1]. Public and private hospitals reflected the mores of apartheid South Africa. Ambulance services were segregated, and even in emergencies a designated “white ambulance” could not treat and transport critically ill or injured patients of color [2]. Public hospitals had separate wings for white and black patients and medical staff. Many private practices had separate entrances and waiting rooms for patients with medical insurance and those paying cash, effectively segregating white and black [1, 2]. Doctors treating political prisoners faced dual loyalties on a regular basis. Some, like Dr. Wendy Orr, resisted the gross human rights violations, while many were complicit [2]. In particular, the abhorrent treatment of medical student and political activist Steve Biko received international attention [2].

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