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Human dignity : a right or a responsibility?De Villiers, Josephine Elizabeth 03 1900 (has links)
Thesis (MPhil)--Stellenbosch University, 2003. / ENGLISH ABSTRACT: While most people acknowledge the dignity of fellow humans, atrocities that deny the
dignity of people are rampant in our world. The ongoing ignorance and aberrations of the
dignity of human beings in the world might mean that there is still not clarity on what
respect for the dignity of others really mean, how it should be practiced and whether human
dignity is an entitlement or a responsibility.
Human dignity was not always bestowed to every individual. In ancient times dignity was
reserved for the strongest individual in and later was extended to certain classes, groups
and nations like the monarchy and clergy, the Egyptians and Romans. The Renaissance
brought a new consciousness of the worth of man. But despite this awareness, and the
advent of a human rights culture as is found in the writings of modem philosophers like
John Locke, Jean-Jacques Rousseau and Immanuel Kant, who all support the notion of
human dignity, liberty and human rights, gross human rights violations still took place
during the twentieth century. Stalin used the Russian people to create a successful
socialistic state; Hitler exterminated all those who obstructed his ideal of creating a pure
Aryan race, while Verwoerd legalized racial discrimination in South Africa and Namibia.
As a result of the atrocities in Europe, especially during World War II, The United Nations
was established with the aim to oversee and address human rights violations in the world.
Human rights and respect for human dignity are included in the Bill of rights of the
Constitutions of America, South Africa and Namibia.
Health care providers acknowledge the rights of patients by respect for the autonomy of
patients. Patients are autonomous persons and health care providers enable patients to take
autonomous action. Autonomous action means that a patient will act with understanding,
intention and without coercion. Paternalism is only justified when it serves to protect the
patient or protect the rights of others. Health care providers practice autonomy by
facilitating informed consent, by providing truthful information, by upholding
confidentiality, to protect privacy of patients and to treat patients with respect. There is little uncertainty that people can claim the right to human dignity because persons
have intrinsic worth as unique beings that are irreplaceable and exist as an end in
themselves. Holy Scripture confirms that humans are created in the image of God.
International human rights instruments and national constitutions provide people with the
statutory right to human dignity and enable people to legally claim this right. But human
dignity is also a responsibility because claiming a right has a reciprocal obligation on
others not to violate the claimed right, but also requires from persons to value their own
lives. Over reliance on science and rational thinking may negate human dignity because
scientists do not always consider the needs of persons. The examples of world leaders like
Gandhi, King and Mandela have also shown that one can earn human dignity through
respectful conduct towards others. Protagoras of Abdera was aware of human worthiness
as right and responsibility as long back as the fifth century Be, and this awareness still
exists today. / AFRIKAANSE OPSOMMING: Ten spyte daarvan dat meeste mense die menswaardigheid van ander erken, misken
gruweldade in die wereld steeds die waardigheid van baie mense. Die miskenning van
menswaardigheid mag beteken dat daar steeds onduidelikheid is oor wat respek vir die
menswaardigheid van ander werklik beteken, hoe dit gepraktiseer moet word en of
menswaardigheid 'n reg of 'n verantwoordelikheid is.
Menswaardigheid was nie altyd aan alle persone verleen nie. In die antieke beskawing was
menswaardigheid grootliks gereserveer vir die sterker persone, en later vir sekere klasse,
groepe en nasies, soos die monargie en geestelikes, die Egiptenare en Romeine. Die
Renaissance het 'n nuwe bewuswording van menswaardigheid gebring. Maar ten spyte van
hierdie bewuswording en die koms van die menseregtekultuur is die werk van moderne
filosowe soos John Locke, Jean-Jacques Rousseau en Immanuel Kant, wat almal die
gedagte van menswaardigheid, vryheid en menseragte ondersteun, het gruwellike
menseregte skendings steeds plaasgevind gedurende die twintigste eeu. Stalin het die
Russiese volk gebruik om 'n suksesvolle sosialistiese staat te skep, Hitler het probeer om
almal wat sy ideaal bedreig het om 'n egte nie-Joodse Kaukasiese nasie te skep, te vermoor,
terwyl Verwoerd rassediskriminasie gewettig het in Suid-Afrika en Namibië. As gevolg
van die gruweldade in Europa, veral gedurende die Tweede Wereldoorlog, het die
Verenigde Nasies tot stand gekom om die menseregteskendings in die wereld te monitor en
aan te spreek. Die Konstitusies van Amerika, Suid-Afrika en Namibië, erken menseregte
en die respek vir menswaardigheid.
Ook in gesondheidsorg word die regte van die pasiënt beskerm deur die beginsel van
respek vir die outonomie van pasiënte. Pasiënte is outonome persone en gesondheidsorg
werkers maak dit moontlik vir pasiënte om outonome handelinge uit te voer. Outonome
handelinge beteken dat die pasiënt sal handel met intensie en sonder dwang en dat die
handeling ten volle verstaan word. Paternalisme is alleen geregverdig wanneer dit die regte
van die pasiënt of ander persone beskerm. Gesondheidsorg werkers fasiliteer outonomie van pasiënte deur ingeligte toestemming te verkry, pasiënte nie te mislei nie, vertroulikheid
te handhaaf, privaatheid van die pasiënt te verseker en deur pasiënte te respekteer.
Daar is min onsekerheid dat persone op die reg tot menswaardigheid kan aanspraak maak
want mense het inherente waarde as mense wat nie vervang kan word nie en wat in hulself
'n bestaansdoel het. Die Skrif bevestig dat die mens na die beeld van God geskape is.
Internasionale menseregte instrumente en nasionale konstitusies maak voorsiening vir die
wettige reg tot menswaardigheid en maak dit vir mense moontlik om wettiglik op hierdie
reg aanspraak te maak. Mense het egter nie net 'n reg tot menswaardigheid nie maar ook
'n verantwoordelikheid. Aanspraak op 'n reg tot menswaardigheid impliseer 'n wedersydse
verantwoordelikheid dat ander die reg nie mag skend nie, maar vereis ook die
verantwoordelikheid dat persone waarde aan hul eie lewens sal heg. Oorwaardering van
die wetenskap en rasionaliteit mag ook menswaardigheid ontken, omdat menslike
behoeftes nie altyd in ag geneem word deur wetenskaplikes nie. Voorbeelde van
wêreldleiers soos Gandhi, King en Mandela bewys dat menswaardigheid ook verwerf kan
word deur ander respekvol te behandel. Protagoras of Abdera was reeds in die vyfde eeu
voor Christus bewus van menswaardigheid as reg en verantwoordelikheid, en hierdie
bewussyn is steeds geldig vandag.
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Armoede in 'n postmodernistiese AfrikaVan Deventer, Francois Abraham 03 1900 (has links)
Thesis (MPhil)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: This thesis looks at poverty in the Third World and tries per implication to understand how the
economy functions. Finally it suggests solutions for the poverty problem.
The first chapter looks at the definition of poverty and why this subject is important to study. It
also mentions that there are two ways to look at the poverty problem. The first is the structural
thesis and the second the modernisation thesis.
The second chapter looks at what the economy is and how it functions. It is emphasised that the
economy should be considered to be a complex ecosystem and not a mechanical machine.
The third chapter points out that there was a change in focus in the passed 50 years. Now
education and information have become much more important. This change is known as
postmodernism or globalisation and resulted in the decline of the power of the state.
The economic success of countries like the USA, Britain, Japan and Germany is considered in
the fourth chapter. The following factors are considered:
• The geographic location of a region includes phenomena like the rainfall, natural
disasters and mineral wealth.
• Historical factors like colonial oppression and the self image of groups.
• Diseases and nutrition which makes individuals less productive.
• Cultural factors like self-discipline, diligence and an over emphasis of the supernatural
• Property rights
• Communalism and social capital
• State intervention
• Technology which makes it possible to produce more with less
This chapter also looks at how these different factors interact together and makes the functioning
of the complex economic system possible.
In the fifth chapter we look at possible solutions for the poverty problem. It is pointed out that the
“annexation of the means of production” is no solution. The ignoring of the problem is also
rejected as no solution. The renewal of people’s mind is put forward as the solution.
The last chapter has a look at the conclusions of the thesis. / AFRIKAANSE OPSOMMING: Hierdie verhandeling poog om na die armoede in Derde Wêreld lande te kyk en dan per
implikasie te verstaan hoe die ekonomie funksioneer en dan oplossings voor te stel.
Die eerste hoofstuk kyk na wat die definisie van armoede is en hoekom dit belangrik is om na
hierdie probleem te kyk. Dit wys ook daarop dat daar twee maniere is om na die armoede
vraagstuk te kyk, naamlik die strukturele tesis en die modernisasie tesis.
Die tweede hoofstuk kyk na wat die ekonomie is en hoe die ekonomie funksioneer. Daar word
daarop gewys dat die ekonomie as ’n komplekse ekostelsel beskou moet word en nie as ’n
meganistiese masjien nie.
Die derde hoofstuk wys daarop dat daar die afgelope 50 jaar ’n klemverskuiwing in die wêreld
plaasgevind het waar onderwys en inligting baie belangriker geword het. Hierdie tendens word
postmodernisme of globalisering genoem en het onder andere daartoe gelei dat die staat se mag
ingeperk is.
In die vierde hoofstuk word na die ekonomiese sukses van lande soos die VSA, Brittanje, Japan
en Duitsland gekyk. Daar word na die volgende faktore gekyk:
• Die geografiese ligging van ’n gebied omsluit verskynsels soos reënval, natuurlike rampe
en minerale rykdomme
• Historiesefaktore soos koloniale onderdrukking en groepe se selfbeeld
• Siektes en voeding wat mense minder produktief maak
• Kultuurfaktore soos selfdissipline, hardwerkendheid en oorbeklemtoning van die
bonatuurlike
• Eiendomsreg
• Kommunialisme en sosiale kapitaal
• Staatsinmenging
• Tegnologie wat dit moontlik maak om met minder meer te produseer
Daar word ook in hierdie hoofstuk gekyk hoe hierdie verskillende faktore op mekaar inwerk om
saam te werk om die komplekse ekonomiese stelsel te laat funksioneer.
Ons kyk in die vyfde hoofstuk na moontlike oplossings vir die armoede vraagstuk. Daar word
uitgewys dat “die anneksasie van die produksiemiddele en die herverdeling van rykdom” nie die
oplossing is nie. Die ignorering van die probleem word ook afgewys. Die oplossing word
voorgehou as die hernuwing van die denke van mense.
In die laaste hoofstuk word die gevolgtrekking van hierdie verhandeling voorgehou.
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The morality and ethics of hunting : towards common groundPatterson, Claire 12 1900 (has links)
Thesis (MPhil (Philosophy))--University of Stellenbosch, 1999. / The hunters and anti-hunting have been arguing for years over whether or not trophy hunting
should be allowed. While attempts have been made to resolve the issue, no widely
acceptable solution has yet been found. Hunters have put forward various arguments
including: religion, instinct, sustainable utilization, money, excessive populations and the
wildlife management support argument. These have usually been criticized for being
management orientate and not addressing the focal question of the anti-hunters: 'What gives
man the right to hunt'. Anti-hunters have countered these arguments and presented new
ones. These include: cruelty, animal rights, animal liberation, special and rare species as well
as religion and wildlife management support arguments. The anti-hunters have used
sympathy and emotion to gain support for their movement while making effective use of the
media. Hunters on the other hand have been slow to make use of this communication tool.
In presenting their arguments, a fundamental difference has been identified between the use
of the various terms. The seemingly simple word 'ethics' has been used by the hunters to
mean a code of conduct while the anti-hunters have used this word in indicate the morality of
man's actions. The inherent value of an animal has also been debated. Does an animal
have value in and of itself or does it only have value in that it is useful to man? Furthermore,
is it the individual animal, the species or the population which has value? The value of wildlife
as a natural resource and the right to use this resource is also discussed. Do developed
countries have the right to determine the use that a developing country may make of its
resources? Leopold's land ethics is discussed an it is shown how hunting preserves the
integrity, stability and beauty of the biotic community. In order to address the issues raised by
the debate, it is necessary for the hunters and the anti-hunters to be willing to work towards
common goals. It is unlikely that either side would ever be willing to give up their position but
if they can agree to work towards some common goals, the long on-going debate would have
achieved something. For this reason, four solution to this debate are looked at and analyzed.
Their weakness and failures are discussed as well as their strong points. Taylor's Priority
Principles are then analyzed to identify the first steps that need to be taken in draWing up
guidelines for hunting. While this assignment does not attempt to identify these guidelines it
does point out the need to have such guidelines and establishes that there can be common
ground. Also, that it is desirable to achieve this aim. The assignment highlights the need for
groups to work towards common goals without having to give up their beliefs and standpoints.
There will be time later to determine whether or not man should hunt. In the meantime, man
should be focussing on hunting ethically - both in the moral sense and within the framework
of a good code of conduct.
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A morally justified policy for assisted euthanasiaBerger, Marcia 12 1900 (has links)
Assignment (MPhil)--University of Stellenbosch, 2000. / ENGLISH ABSTRACT: This study was undertaken to evaluate whether a mentally competent mature
human being, who is suffering an intolerable, irremediable existence resulting
from an incurable agonising or devastating paralysing disease; has a moral,
personal and civic right to end that life or have it ended by requesting assistance
in meeting death in a humane, compassionate and dignified manner.
~ The righteousness of such assistance can only be gauged if it follows the
repeated and voluntary request of someone who is presently not suffering from
any psychiatric disorder, is presently mentally competent or had made such a
written or verbal witnessed advance directive while mentally competent to do so.
~ This study will not deal with assistance in dying either active or passive which is
performed on severely mentally and physically handicapped new-born babies
with scant prospect of survival; nor with euthanasia for the relief of malignant or
paralysing disease in those with life-long [anoxic, congenital, inflammatory or
traumatic] mental incompetencies who have never had decision-making capacity.
~ This study will not address issues of aid-in-dying for mentally incompetent
persons suffering from senile dementia, Alzheimer's disease, or permanent
vegetative states due to brain pathology following anoxic, circulatory, infective,
malignant or traumatic events, who have not made advance directives and who
had never stated preferences concerning assisted euthanasia. The aim of this study is to outline the moral case advanced by those in favour of
legalising Voluntary Assisted Euthanasia [VAE] also called Assisted Euthanasia
[AE] and to develop ethically sound and practical proposals for policy and actions
contributing towards the resolution of the moral dilemma faced daily by doctors
when asked by mentally competent patients suffering from irremediable
malignant or paralysing diseases or the agonising symptoms of end-stage
Acquired Immune Deficiency Syndrome (AIDS) for assistance to end their lives.
}ii> This study will cover and discuss the more important objections of those opposed
to the legalising of assisted suicide for mentally-competent terminal patients who
are irremediably suffering in their bodies or from dehumanising incurable endstage
paralysing diseases and are near to an inevitable death.
}ii> The insights of philosophers, theologians, physicians and sociologists on the
subject of suicide and aid-in-dying, have been researched in the extensive
literature that exists (both in print and in cyberspace) on these subjects and are
presented with the study.
}ii> The study tries to show that a competent adult in certain grim circumstances
should have an inalienable human right, if not a constitutional one, to request
assisted euthanasia or aid-in-dying or assistance in ending their lives.
}ii> Such assistance must be subject to peer review, after careful assessment by a
multidisciplinary team in the healing [both physical and spiritual] professions This paper will try to determine whether the actionalisation of voluntary assisted
suicide or assisted euthanasia is murder or an act of compassion and empathy
performed out of respect for a fellow human being's autonomy and in deference
to their right to self-determination and self-realisation.
~ The relevance of this situation is that aid-in-dying is becoming one of the major,
moral, religious, philosophical and bio-medical dilemmas at this time.
~ The author's position is that it is neither just nor ethical to prevent a mentallycompetent
human being, who is tormented by agonising, incurable terminal
physical or irremediable paralysing disease, from deciding to chose to die when
he/she can no longer bear the torment and asking for professional assistance to
effect this. This relief should be given not only to those who are able to make an
enduring, informed contemporaneous decision, but also to those who [when they
still had decision-making capacity] had previously made a considered informed
advance directive about the use of ordinary and extraordinary medical methods of
sustaining a life that had become merely an existence. / AFRIKAANSE OPSOMMING: Die studie is onderneem om te evalueer of 'n bevoegde, volwasse mens wat 'n
onverduurbare en ongeneesbare bestaan het a.g.v. 'n ongeneesbare, folterende
of vernietigende siekte, 'n morele, persoonlike of burgerlike reg het om daardie
lewe te beeïndig of hulp te vra om dit te laat beeïndig, ten einde die dood op 'n
menswaardige wyse tegemoet te gaan.
~ Die regverdigbaarheid van bogenoemde hulp kan slegs bepaal word as dit volg
op die herhaalde en vrywillige versoeke van iemand wat nie, wanneer hy/sy dit
versoek, ly aan 'n geestessiekte nie, wat bevoeg is of wat so 'n geskrewe of
mondelinge versoek, met getuies, gemaak het terwyl die persoon kompetent was.
~ Die studie handel nie oor bystand-in-sterfte, aktief of passief, waar dit uitgevoer
word op fisies of psigies ernstig gestremde pasgebore babas met 'n skrale kans
op oorlewing nie; ook nie oor genadedood ter verligting van kwaadaardige of
verlammende siekte in diegene met lewenslange [anoksiese, kongenitale,
inflammatoriese of traumatiese] geestelike ongesteldhede, wat nog nooit
besluitnemende kapasiteit gehad het nie.
~ Die studie ondersoek nie gevalle van bystand-met-sterfte waar inkompetente
persone wat ly aan seniliteit, Alzheimer se siekte, of permanente vegetatiewe
toestande a.g.v. brein patologie n.a.v. anoksiese, sirkulatoriese, infektiewe,
kwaadaardige of traumatiese gebeure, nie direk gevra het vir genadedood of
nooit die voorkeur vir geassisteerde genadedood uitgespreek het nie. Die doel van hierdie studie is om die morele saak van diegene ten gunste van die
wettiging van Vrywillige Geassisteerde Genadedood, ook bekend as
Geassisteerde Genadedood, te stel en om praktiese sowel as eties
verantwoordbare voorstelle te maak vir beleid en optrede wat kan bydra tot die
oplos van die morele dilemma wat dokters daagliks in die gesig staar wanneer
hulle deur geestelik bevoegde pasiënte wat ly aan ongeneesbare, kwaadaardige
of verlammende siektes, of die folterende simptome van die finale stadium van
Verworwe Immuniteits Gebrek Sindroom [VIGS], gevra word vir bystand in die
beeïndiging van hulle lewens.
~ Die studie sal die belangriker besware van diegene aanspreek wat teen die
wettiging is van geassisteerde genadedood vir geestelik bevoegde terminale
pasiënte wat ongeneesbaar ly of van dehumaniserende ongeneesbare finale
stadium siektes en wat naby is aan 'n onafwendbare dood.
~ Die insigte van filosowe, teoloë, dokters en sosioloë oor bystand-met-sterfte en
selfmoord, is nagevors in die wye literatuur beskikbaar is (beide in druk en
kuberruimte) oor hierdie onderwerpe en word saam met die studie angebied.
~ Die studie probeer aantoon dat 'n bevoegde volwassene in sekere erge
omstandighede 'n onvervreembare mensereg, indien nie 'n konstitusionele reg
nie, behoort te hê om bystand tydens genadedood te versoek.
~ Sulke bystand moet onderworpe wees aan groepsevaluasie, na versigtige
ondersoek deur 'n multi-dissiplinêre span in die gesondheidsprofessies [beide
fisies en psigies]. Die studie sal probeer bepaal of die uitvoering van vrywillige geassisteerde
selfmoord of geassisteerde genadedood moord is, of 'n aksie van empatie,
uitgevoer uit respek vir 'n medemens se outonomie, sy/haar reg tot selfdeterminasie
en self-realisasie.
)lo- Die relevansie van hierdie situasie lê daarin dat bystand-met-sterfte besig is om
een van die belangrikste morele, religieuse, filosofiese en biomediese dilemmas
van ons tyd te word.
)lo- Die outeur se posisie is dat dit nie regverdig of eties is om te verhoed dat 'n
geestelik bevoegde mens, wat ly aan folterende, ongeneesbare terminale fisiese
of ongeneesbare verlammende siekte, self kies om te sterf wanneer hy/sy nie
meer die lyding kan verdra nie en vir professionele bystand vra om dit uit te voer.
Die verligting behoort gegee te word, nie net aan diegene wat in staat is om 'n
bindende en ingeligte besluit te maak nie, maar ook aan -diegene wat [toe hulle
nog besluitnemende kapasitiet gehad het] vroeër 'n oorweegde, ingeligte
vroegtydige versoek gemaak het aangaande die gebruik van gewone en
buitengewone mediese metodes vir die verlenging van 'n lewe wat bloot 'n
bestaan geword het.
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Power in the physician-patient relationshipBroekmann, Reginald J. (Reginald John) 04 1900 (has links)
Thesis (M.A.)--University of Stellenbosch, 2000. / ENGLISH ABSTRACT: This paper examines aspects of power within the physicianpatient
relationship. The historical development of the
physician-patient relationship is briefly reviewed and some of
the complexities of the relationship highlighted. It is shown
that, historically, there is no imperative for the physician to
consider only the interests of the patient and it has always
been acceptable to consider the interests of a third party,
such as the State or an employer - essentially the interests of
whoever is paying the physician.
The classical sources of power are then considered. These
sources include legitimate power, coercive power, information
power, reward power, expert power, referent power,
economic power, indirect power, associative power, group
power, resource power and gender power. Other approaches
to power are also considered such as principle-centred power
as described by Covey, power relationships as explained by
Foucault, the power experience as described by McClelland
and an analysis of power as expounded by Morriss.
The various sources of power are then considered specifically
within the physician-patient relationship to determine:
if this particular type of power is operative in the physicianpatient
relationship, and if so
if it operates primarily to the advantage of the physician or the
advantage of the patient.
A simple method of quantifying power is proposed. Each form
of power operative in the physician-patient relationship is then
considered and graphically depicted in the form of a bar chart.
Each form of power is shown as a bar and bars are added to
the chart to 'build up' an argument which demonstrates the
extent of the power disparity between physician and patient.
It is clearly demonstrated that all forms of power operate to
the advantage of the physician and in those rare
circumstances where the patient is able to mobilize power to
his/her advantage, the physician quickly calls on other sources of power to re-establish the usual, comfortable, power
distance. Forms of abuse of power are mentioned.
Finally, the ethical consequences of the power disparity are
briefly considered. Concern is expressed that the power
disparity exists at all but this is offset by the apparent need for
society to empower physicians.
Conversely, consideration is given to various societal
developments which are intended to disempower physicians,
particularly at the level of the general practitioner.
Various suggestions are made as to how the power
relationships will develop in future with or without conscious
effort by the profession to change the relationship. / AFRIKAANSE OPSOMMING: Hierdie voordrag ondersoek aspekte van mag in die
verwantskap tussen pasiënt en geneesheer. Die historiese
ontwikkeling van die verwantskap word kortliks hersien en 'n
kort beskrywing van die ingewikkeldheid van die verwantskap
word uitgelig.
Vanuit 'n historiese oogpunt, word 'n geneesheer nie verplig
om alleenlik na die belange van die pasiënt om te sien nie en
was dit nog altyd aanvaarbaar om die belange van 'n derde
party soos die Staat of 'n werkgewer se belange to oorweeg -
hoofsaaklik die belange van wie ookal die geneesheer moet
betaal.
Die tradisionele bronne van mag word oorweeg. Hierdie
bronne sluit in: wetlike mag of 'gesag', die mag om te kan
dwing, inligtingsmag, vergoedingsmag, deskundigheidsmag,
verwysingsmag, ekonomiesemag, indirektemag,
vereeningingsmag, groepsmag, bronnemag en gelslagsmag.
Alternatiewe benaderings word ook voorgelê, naamlik die
beginsel van etiese mag soos deur Covey beskryf, krag in
menslike verhoudings soos deur Foucault, die ondervinding
van krag soos beskryf deur McClelland en 'n ontleding van krag
soos deur Morriss verduidelik.
Hierdie verskillende mag/gesagsbronne word spesifiek met
betrekking tot die geneesheer-pasiënt verhouding uiteengesit
om te besluit:
of hierdie tipe mag aktief is tussen geneesheer en pasiënt, en
indien wel, werk dit tot die voordeel van die geneesheer of die
pasiënt.
'n Eenvoudige sisteem vir die meting van mag/gesag word
voorgestel. Die bronne word individueeloorweeg en gemeet
en die resultaat in 'n grafiese voorstelling voorgelê op so 'n
wyse dat 'n argument daardeur 'opgebou' word om die verskille
van van mag/gesag tussen geneesheer en pasiënt uit te wys.
Dit word duidelik uiteengesit dat alle vorms van mag/gesag ten
gunste van die geneesheer werk. Kommer is getoon dat
hierdie magsverskil werklik bestaan, asook die snaakse teenstelling dat die gemeenskap wil eintlik die geneesheer in
"n magsposiesie plaas.
Die etiese gevolge van hierdie ongebalanseerde verwantskap,
asook die moontlikheid van wangebruik van hierdie mag word
ook genoem.
Verskillende gemeenskaplike ontwikkelinge wat die mag van
die geneesheer wil wegneem word geidentifiseer, meestalop
die vlak van die algmene praktisyn.
Verskeie voorstelle vir toekomstige ontwikkeling van die
verwantskap word voorgelê, met of sonder spesifieke pogings
van die professie om die verwantskap te verbeter.
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Our complex world : understanding it, living in it, sustaining itBenfield, Ian Lindsay 12 1900 (has links)
Thesis (MPhil)--Stellenbosch University, 2003. / ENGLISH ABSTRACT: We live in a complex world. We have questions and face problems that
defy conventional reductionist approaches to finding answers and solutions.
This is because we find ourselves dealing with complex systems that are
dynamic, self-organizing and adaptive, while maintaining a balance between
static order and chaotic change.
The Earth, or Gaia, is such a system. So is the biosphere, and so is an ecosystem,
an economy, a business and any living organism, including homo sapiens. By
concentrating on the connections and interactions between entities, and not
things in themselves, complexity research is enabling us to grasp a better
understanding of the spontaneous, self-organizing dynamics of our world.
Complexity studies can have an enormous impact on the conduct of economics,
business and politics.
This thesis describes the characteristics of complex systems, analyzes the Earth
and its evolutionary story as a complex adaptive system, discusses how we can
harness complexity, and how through cooperating and caring we can survive and
even prosper in the world of today. A pluralistic moral 'world vision' is argued for,
founded on an ethics of universal compassion for all living things, that can lead to
responsible and pragmatic action.
As human beings, if 'He are to uplift the poor and restore and preserve the ecology
of the Earth, what will be required is a major transformation of our environmentally
destructive world economy into one that can sustain progress and human flourishing.
This will entail a change of mind and heart, a sense of global interdependence and
universal responsibility.
The challenges we face are immense. However, there are encouraging signs that
worldwide people are becoming increasingly aware of what is called for. More and
more people are showing their willingness to rise to the occasion. It is a time of
transition. It is complex, daunting, yet exciting. / AFRIKAANSE OPSOMMING: Ons leef in 'n komplekse wêreld waarin ons gekonfronteer word met vrae en probleme
wat nie beantwoord of opgelos kan word deur middel van die gebruiklike reduksionistiese
benaderings nie. Die rede hiervoor is dat ons te make het met komplekse sisteme wat
dinamies, selforganiserend en selfaanpassend is, terwyl dit tegelykertyd 'n balans
handhaaf tussen statiese orde en chaotiese verandering.
Die aarde, of Gaia, is so 'n sisteem. Ook die biosfeer, 'n ekosisteem, 'n ekonomie, 'n
besigheid en enige lewende organisme, insluitend homo sapiens, konstitueer komplekse
sisteme. Daarom kan kompleksiteitsnavorsing, wat klem lê op die verbande en interaksies
tussen entiteite, eerder as op die entiteite self, dit vir ons moontlik maak om die spontane
en selforganiserende dinamiek van ons wêreld beter te begryp. Kompleksiteitstudies kan
dan ook 'n enorme impak hê op die manier waarop ekonomie, besigheid en politiek
beoefen word.
Hierdie tesis beskryf die eienskappe van komplekse sisteme, en analiseer die Aarde en
haar evolusionêre verhaal as 'n komplekse, selfaanpassende sisteem. Verder bespreek
dit ook hoe kompleksiteit ontgin kan word, en hoe ons deur samewerking en sorg kan
oorleef en selfs floreer in die wêreld van vandag. Op grond van 'n etiek van universele
medelye met alle lewende dinge word 'n pleidooi gelewer vir 'n pluralistiese morele
"wêreldvisie" wat kan lei tot verantwoordelike en pragmatiese optrede.
Wat egter vereis word indien ons, as mense, armoede wilophef en die ekologie van die
aarde wil herstel en handhaaf, is 'n daadwerklike transformasie van ons
omgewingsvernietigende wêreldekonomie in die rigting van 'n ekonomie wat vooruitgang
en menslike florering kan onderhou. So 'n transformasie sal 'n verandering van denke en
ingesteldheid vereis, asook 'n sin vir globale interafhanklikheid en universele
verantwoordelikheid.
Dit is duidelik dat die uitdagings wat ons moet trotseer kolossaal is. Daar is egter
bemoedigende tekens wêreldwyd wat aandui dat mense toenemend begin bewus raak
van wat vereis word. Meer en meer mense toon hul bereidwilligheid om die situasie die
hoof te bied. Dit is 'n tyd van verandering. Dit is 'n komplekse en angswekkende tyd, maar
uiteindelik tog ook 'n opwindende tyd.
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Die kompleksiteit van menswees in geneeskunde : 'n krities-filosofiese ondersoekVan Niekerk, Marilu 04 1900 (has links)
Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The dehumanising of human beings which often underpins western medicine lead to this study. Moreover a predominant mechanistic and reductionist view of a human being necessitated a philosophical investigation to revisit the stance. It is argued that western medicine is based upon uncritical assumptions about humans as a result of the dualism and mechanistic views of Descartes. The philosophy of Merleau-Ponty transcended dualism by his emphasis on the bodylines of a human being situated in his life world. Complexity thinking concurs with the above-mentioned view, however, takes the argument further by focusing on the importance of continuous interactions and relations between the whole and the parts. Interdependent aspects of our being in the world constitute our humanness, such as our human relations between family members, friends, that which we experience, ponder, feel, and believe. Our unique experience of disease often goes hand in hand with a deep-seated sub-conscious longing for meaning. According to complexity theory being ill is not a static condition, but rather an imbalance as a result of various dynamic interactions between many spheres of human life. Multiple causality due to various dynamic interactions and self-organisation should replace simplistic views of mechanical cause and effect in this regard. Medical training models should not employ reductionism as if humans are machines comprising of separate body parts. An organic view of the uniqueness of each evolving human being should replace obsolete reductionist and mechanistic views of healing.The essence of being human is embedded in a tapestry of dynamic relations. / AFRIKAANSE OPSOMMING: Die dehumanisering van die mens in hedendaagse westerse geneeskunde het aanleiding gegee tot hierdie studie. Verder het die meganistiese, reduksionistiese mensbeeld ‘n filosofiese herbesinning genoodsaak. Daar word geargumenteer dat westerse geneeskunde gebaseer is op onkritiese aannames afkomstig van onder andere Descartes se dualistiese antropologie en die meganistiese siening van die mens. Merleau-Ponty se wysgerige antropologie het die dualisme getransendeer deur sy filosofie van die mens as liggaamlikheid gesitueerd in sy leefwêreld. Kompleksiteitsdenke stem hiermee ooreen, maar voer die argument verder in die opsig dat dit die belangrikheid van relasies en voortdurende wisselwerking tussen die geheel en dele beklemtoon. Interafhanklike aspekte van dit wat ons mens maak, ontstaan as gevolg van relasies tussen ons leefwêreld, ons familie, vriende, tussen dit waaraan ons dink, wat ons voel, ervaar en glo. Ons siekte ervaring gaan meestal gepaard met ‘n diepgewortelde voorbewustelike soeke na sin en betekenis. Die kompleksiteitsperspektief beskou siekwees nie as ‘n statiese toestand wat teenoor gesondwees staan nie, maar eerder ‘n wanbalans in dinamiese interaksies van verskeie sfere van menswees. Enkelvoudige kousaal-meganiese oorsaak en gevolg moet plek maak vir veelvuldige kousaliteit wat geleë is in talle dinamiese interaksies en selforganisering. Mediese opleidingsmodelle behoort die mens nie te objektiveer tot aparte organe, soos die van ‘n masjien nie. Die verontmensliking van die masjien gedrewe model van genesing behoort plek te maak vir ‘n meer organiese siening van die mens wat rekening hou met die unieke menslikheid van die mens. Menslikheid impliseer ‘n tapisserie van relasies.
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The impact of materialistic monism and suffering on medical students :a critique of the biomedical and biopsychosocial model of medical schoolsKuehne, Jan (Jan Cavan) 12 1900 (has links)
Thesis (MPhil)--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: On entry to medical school, students are confronted with a worldview that can be typified as materialistic monism. The student progressively becomes a materialistic monist, not only because of the teaching, but also because medical schools fail to address the question of suffering. One would expect the biopsychosocial model to surmount the limitations of the biomedical model, but it in itself has to deal with both suffering and materialistic monism. Suffering cements the collapse into materialistic monism in the way the student practises medicine. What life strategies would transcend this materialistic monism? This thesis examines potential educational interventions that might help the student to analyse the philosophy of medical school and find ways of dealing with the question of suffering. / AFRIKAANSE OPSOMMING: Met toelating tot mediese skool word studente gekonfronteer met ’n wêreldsiening wat as materialistiese monisme beskryf kan word. Die student verander progressief in ’n materialistiese monis, nie slegs as gevolg van die onderrig nie, maar ook omdat mediese skole nie daarin slaag om die kwessie van lyding aan te spreek nie. ’n Mens sou verwag dat die biopsigies-sosiale model die beperkinge van die biomediese model sou oorkom, maar instede moet dit self beide lyding en materialistiese monisme aanspreek. Lyding moedig die verval in materialistiese monisme in die wyse waarop die student geneeskunde beoefen aan. Watter soort lewensstrategieë is nodig om hierdie materialistiese monisme te transendeer? Hierdie tesis ondersoek die opvoedkundige intervensies wat die student kan help om die mediese skool se filosofie te analiseer en wyses te vind om die kwessie van lyding te hanteer.
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The justfiable limitations of patient autonomy in contemporary South African medical practiceAnthony, John 12 1900 (has links)
Thesis (MPhil (Philosophy))--University of Stellenbosch, 2009. / ABSTRACT: The European Enlightenment secured man’s freedom from doctrinal
thought. Scientific progress and technological innovation flourished in
the 18th Century, radically changing the lives of all. Man’s mastery and
transformation of his environment was matched by revolutionary
political reform, resulting in the dissolution of empire and the transfer
of power into the hands of the people. Social transformation saw the
city-states of pre-modern man supplanted by a globalized community
whose existence grew from time and space distantiation facilitated by
the new technologies and the development of symbolic forms. These
sweeping social, political and ideological changes of the 18th Century
fostered the belief that man’s transformative authority was indeed his
to command. Man believed he had a right to self-governance and to
autonomous decision-making. Kant described moral autonomy as the
freedom men have to show rational accountability for their actions and
he saw in men a dignity beyond all price because of this moral
autonomy. Personal autonomy is seen as the expression of the free will
of individuals and is justifiably constrained by the need to respect the
interests and agency of others. The principle of autonomy, in the
context of medical practice, was not clearly articulated until the early
20th century. Prior to this, the ethical practice of medicine relied upon
the beneficent intentions of the practitioners. The limits to patient
autonomy have been delineated largely by issues of social justice
based upon the need to share scarce resources fairly among members
of society. However, autonomy remains a dominant principle and is
most clearly exemplified by the process of informed consent obtained
prior to any medical intervention. This thesis provides a conceptual
analysis of autonomy in the context of informed consent. Following
this, several different clinical scenarios are examined for evidence of
justifiable limitations to patient autonomy. Each scenario is examined in the light of different moral theories including deontology,
utilitarianism, communitarianism and principlist ethical reasoning.
Kantian ethical reasoning is found to be resilient in rejecting any
limitation to the autonomy principle whereas each of the other theories
allow greater scope for morally-justified curtailment of individual
autonomy. The thesis concludes with reflection on post-modern society
in which the radicalization of what began with the European
Enlightenment sees the transformation of pre-modern society into a
global community in which epistemological certainty is no longer
available. In this environment, the emerging emphasis on global
responsibility requires ethical accountability, not only when individuals
secure transactions between one another but also between individuals
and unknown communities of men and women of current and future
generations. The thesis concludes that patient autonomy is justifiably
limited in South African medical practice because of issues related to
social justice but that the impact of the new genetic technologies and
post-modernity itself may in future set new limits to individual patient
autonomy. / OPSOMMING: Die Europese Verligting het die mensdom bevry van verstarde,
dogmatiese denke. Wetenskaplike en tegnologiese ontwikkelinge het
tydens the 18de Eeu die lewens van almal radikaal verander. Die
mens se bemeestering en transformasie van sy omgewing het gepaard
gegaan met revolusionêre politieke hervormings wat gelei het tot die
ontbinding van tradisionele politieke ryke en die oordrag van mag aan
die mens. Sosiale transformasie het veroorsaak dat die politieke
ordeninge van voor-moderne mense deur ‘n globale gemeenskap
vervang is wat ontstaan het as gevolg van onder meer die
ontkoppeling van tyd en plek (Giddens), en wat deur nuwe
tegnologiese ontwikkelings en die ontstaan van simboliese vorms
moontlik gemaak is. Hierdie uitgebreide ontwikkelinge het die idee laat
ontstaan dat niks vir die 18de Eeuse mens onmoontlik is nie. Die mens
het geglo dat hy ‘n reg het op self-bestuur en outonome besluite. Kant
het die morele outonomie van die mens beskou as sy vryheid om
verantwoordlikheid te neem vir sy eie rasioneel-begronde handelinge
en verder het hy ‘n besondere waardigheid in die mens geïdentifiseer
vanweë sy morele outonomie. Omdat ‘n mens hierdie eienskap besit,
beskik hy oor ‘n hoër waardigheid as alle alle ander lewensvorme.
Persoonlike outonomie is die uitoefenimg van die vrye wil van die
individu en word om geregverdigde redes beperk deur die regte van
ander mense. Die beginsel van outonomie met verwysing na mediese
etiek het nie voor die begin van die 20ste eeu prominent geword nie.
Voor hierdie tyd het mediese etiek staatgemaak op die goeie voorneme
van die praktisyn. Die grense van individuele outonomie word nou
bepaal deur die noodsaak van sosiale geregtigheid. Al is dit die geval,
bly die beginsel van outonomie die belangrikste beginsel in die etiese
debat en word meestal gesien as ‘n deel van die proses van ingeligte
toestemming. Hierdie tesis verskaf ‘n omvattende ontleding van outonomie met betrekking tot ingeligte toestemming. Daarna word
verskillende kliniese gevalle beskryf en ontleed, en verskeie etiese
teorieë gebruik om die wyse waarop pasiënt outonomie reverdigbaar
ingekort behoort te word, te bespreek. Die teorie van Kant is in staat
om enige inkorting van outonomie in alle gevalle the weerstaan.
Elkeen van die ander teorieë verskaf redes waarom die outonomie van
individuele pasiënte legitiem ingekort mag word. Hierdie werk sluit af
met besinning oor die post-moderne gemeenskap wat ‘n globale
samelewing moet aanvaar sowel as die ontoereikenheid van enige
kenteoretiese sekerheid. Die ontwikkelende verantwoordelikheid vir die
totale mensdom in hierdie wêreld veroorsaak dat individue nie meer
slegs moet besluit oor die morele verhouding met sy medemens nie,
maar ook oor sy verhouding met mense van gemeenskappe wat geskei
is in tyd en ruimte, insluitend sy verhouding met die mense van
toekomstige generasies. Hierdie werk sluit af met die gevolgtrekking
dat pasiënt outonomie regverdigbaar beperk word in die Suid
Afrikaanse mediese praktyk deur die noodsaaklikheid van sosiale
geregtigheid. Die verwagte impak van nuwe genetiese tegnologieë en
die ontwikkeling van ‘n post-moderne gemeenskap mag nuwe
beperkings bring vir pasiënt outonomie.
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Ethical considerations surrounding Voluntary Medical Male Circumcision (VMMC) in South Africa as an intervention for HIV preventionMay, Robyn Walker 04 1900 (has links)
Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: In efforts to combat the global HIV/AIDS pandemic, the WHO/UNAIDS published the Joint Strategic Action Framework to Accelerate the Scale-up of Voluntary Medical Male Circumcision for HIV Prevention in Eastern and Southern Africa which outlines the aim of a VMMC (voluntary medical male circumcision) prevalence of 80% among males 15-49 year old in 14 countries by 2016 (WHO/UNAIDS, 2011). In line with this directive, South Africa has launched a national VMMC campaign. However, a lot of ethical issues remain unaddressed surrounding VMMC. These can be categorised as individual considerations (autonomy and informed consent; non-maleficence and unintentional, unforeseen harm; risk compensation in circumcised men; risk of undermining current HIV prevention strategies; age of circumcision), community considerations (cultural considerations; justice: the gender divide and female subjugation; distributive justice; social stigmatisation as a result of VMMC), national considerations (adverse events and complications on a macro level; cost saving and unforeseen expenditure of VMMC; the implications of international funding for VMMC; the public health ethics of VMMC; risks of “de-medicalisation” of a surgical procedure; the ever present danger of corruption), global considerations (female genital mutilation; non-sexual HIV transmission; a dangerous shift in focus) and other considerations (a statistical perspective on VMMC; circumcision technique; lack of ethical awareness; dealing with medical uncertainty). Finally, I shall consider neonatal circumcision, which is in itself a contentious issue, and has no role to play in VMMC.
The unresolved issues raised by these ethical considerations cast doubt on the moral status of VMMC and I conclude that the VMMC campaign as it stands in South Africa currently is morally indefensible. There is, undeniably, a pressing need for HIV/AIDS prevention strategies in South Africa and other developing countries but the role of circumcision has been overemphasised to the detriment of more holistic approaches. While there are no easy answers to any of the ethical dilemmas presented in this thesis, it is imperative to raise ethical awareness surrounding VMMC. / AFRIKAANSE OPSOMMING: In ‘n poging om die globale MIV/VIGS-pandemie te bekamp, het die WHO/UNAIDS in 2007 die Joint Strategic Action Framework to Accelerate the Scale-up of Voluntary Medical Male Circumcision for HIV Prevention in Eastern and Southern Africa gepubliseer wat ‘n aksie-plan is wat poog om ‘n voorkoms van VMMC (vrywillige mediese manlike besnyding) van 80% in 14 lande onder 15-49 jaar oue mans in 2016 (WHO/UNAIDS, 2011) te bewekstellig. In ooreenstemming met dié riglyn, het Suid-Afrika 'n nasionale VMMC veldtog geinnisiëer. Maar baie van die etiese kwessies verbonde aan VMMC is nie bevredigend aangespreek nie. Hierdie kwessies kan geklassifiseer word onder individuele oorwegings (outonomie en ingeligte toestemming; nie-kwaadwilligheid en onbedoelde, onvoorsiene skade; risiko vergoeding in mans wat besny is; VMMC ondermyn die huidige MIV-voorkoming strategieë; ouderdom van besnyding), gemeenskap oorwegings (kulturele oorwegings; geregtigheid: die oorweging van die geslag verdeel en vroulike onderdanigheid; distributiewe geregtigheid; sosiale stigmatisering as gevolg van VMMC), nasionale oorwegings (newe-effekte en komplikasies op 'n makro-vlak; kostebesparing en onvoorsiene uitgawes van VMMC; die implikasies van internasionale befondsing vir VMMC; die openbare gesondheid etiek van VMMC; risiko's van "de-medikalisering" van 'n chirurgiese procedure; die alomteenwoordige gevaar van korrupsie), globale oorwegings (vroulike genitale verminking; nie-seksuele oordrag van MIV; 'n gevaarlike verskuiwing in fokus) en ander oorwegings ('n statistiese perspektief op VMMC; besnyding tegniek; die gebrek aan bewustheid van hierdie etiese kwessies; die hantering van mediese onsekerheid) bespreek.
Ten slotte, sal ek neonatale besnyding ondersoek, wat op sigself 'n omstrede kwessie is, en geen rol behoort te speel in VMMC nie.
Die onopgeloste kwessies wat deur hierdie etiese oorwegings aan die lig gebring word veroorsaak twyfel oor die morele status van VMMC. Ek lei dus af dat die VMMC veldtog soos dit tans bestaan in Suid-Afrika moreel onverdedigbaar is. Daar is ongetwyfeld 'n dringende behoefte vir MIV/VIGS- voorkoming strategieë in Suid-Afrika en ander ontwikkelende lande, maar die rol van besnydenis word oorbeklemtoon ten koste van ‘n meer holistiese benadering. Hoewel daar geen maklike antwoorde op enige van die etiese dilemmas wat in hierdie skripsie verken is nie, is dit noodsaaklik dat etiese bewustheid rondom VMMC verhoog word.
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