Thesis (MPhil (Philosophy))--University of Stellenbosch, 2005. / This study seeks to give a philosophical account of, and justification for the intuition that subjectivity is not a stable “Archimedean point” on the basis of which an intersubjective relation can be founded, but is instead profoundly affected by each different “Other” with which it enters into a relation. As a preliminary to the positive philosophical account of how this might work in Part II of the thesis, there is an attempt to critique certain of the classical accounts of intersubjectivity found in phenomenology, in order to show that these positions cannot give a satisfactory account of the type of intersubjective relation which gives rise to the abovementioned intuition. The thesis therefore starts off by examining the account of intersubjectivity in Husserl’s Cartesian Meditations (especially the Fifth Meditation). Husserl is there engaged in an attempt to overcome the charge of solipsism that might be levelled at phenomenology, since phenomenology is concerned with experience as, by definition, the experience of the subject. We try to show that Husserl cannot give a satisfactory account of the Other because he tries to derive it from the Subject, and hence reduces the Other to the Same. We then turn to two other phenomenological thinkers – Merleau-Ponty and Levinas, both of whom are themselves critical of Husserl – to examine whether they provide a better account, but conclude that (although each represents a certain advance over Husserl), neither are able to provide a decisively better account, since each is still too caught up in phenomenology and its focus on consciousness. In Part II of the thesis, we then turn to a non- (or even anti-) phenomenological thinker, namely Gilles Deleuze, to try and find an alternative theory that would be able to provide the account we seek. Our contention is that Deleuze, by seeking to give an account of the constitution of the subject itself, simultaneously provides an account of the constitution of the Other as arising at the same time as the Subject. Crucial to this account is the inversion of priority between the poles of a relation and the relation itself. Deleuze argues that a relation is “external to its terms”, and precedes these terms. Hence, by returning to a level which precedes consciousness and the order of knowledge – that is, by returning to the level of the virtual multiplicities and singular events that underlie and precede the actualization of these events and multiplicities in distinct subjects and objects – we argue that Deleuze shows that, contra phenomenology, there is in fact no primordial separation between subject and Other. The contention is therefore that the problem of intersubjectivity as posed by phenomenology is a false one that can be eluded by means of Deleuze’s philosophy. This philosophy is not based on the subject, but instead shows the subject to be the product of an underlying network of relations. Finally, we turn to Deleuze’s appropriation of Nietzsche to trace out the transformation of “ethics” that result from adopting a position like that of Deleuze.

Thesis (MPhil (Philosophy))--University of Stellenbosch, 2006. / This study constitutes a conceptual analysis and critique of the notion of the subject, and the concomitant notion of responsibility, as it has developed through the philosophical history of the modern subject. The aim of this study is to present the reader with a critical notion of responsibility. This study seeks to divorce such a position from the traditional, normative view of the subject, as typified by the Cartesian position. Following Derrida, a deconstructive reading of the subject’s conceptual development since Descartes is presented. What emerges from this reading is that, despite various re-conceptualisations of the subject by philosophers as influential and diverse as Nietzsche, Heidegger and Levinas, their respective positions continue to affirm the subject as human. The position presented in this study challenges this notion of the subject as human, with the goal of opening-up and displacing the ethical frontier between human and non-human. It is argued that displacing this ethical frontier introduces complex responsibilities. These complex responsibilities resist the violence inherent to normative positions that typically exclude the non-human – particularly the animal – from the sphere of responsibility.

Thesis (MA (Philosophy))--University of Stellenbosch, 2008. / The practice of abortion continues to provoke controversy and disagreement. However, within the context of this wider debate, a greater level of consensus appears to have been reached as to the moral acceptability of the practice of prenatal screening, and selective abortion following the detection of foetal abnormality. This study seeks to interrogate whether justifications of this practice lend credence to the moral permissibility of selective abortion. In particular, it considers whether justifications for this practice amount to, or perpetuate, discrimination on the basis of the characteristic of disability, as selective abortion entails choosing against a particular foetus because of its characteristics. This study poses this question in two contexts – where the moral permissibility of selective abortion is regarded as an exception to the general moral impermissibility of abortion, and where selective abortion is regarded as one distinct justification within the context of the general moral permissibility of abortion. This study attempts to show that while justifications of selective abortion are directly discriminatory in the former case, they are not necessarily discriminatory in the latter case. This latter conclusion, however, recommends maintaining vigilance against the possibility that such justifications could rely upon or perpetuate prejudice, or restrict reproductive autonomy. These conclusions are considered within the South African context; in particular, with regard to their application to the Choice on Termination of Pregnancy Act of 1996.

Thesis (MA)--Stellenbosch University, 2001. / ENGLISH ABSTRACT: The problem explored in this study concerns authenticity, and can be formulated as the question: 'How does one become oneself? In order to answer this query, related issues must be addressed, for example: the nature of consciousness/ self-awareness; the individual's relationship to society; the meaning of existence, and so forth. The reply's of three thinkers, Kierkegaard, Sartre and Jung, will be discussed in this investigation. They have been selected for several reasons: Each of their respective theories addresses issues that are generally pertinent in contemporary society, such as: the alienation and dissociation of individuals from each other and themselves through mass-mindedness and the impersonal nature of state and religious institutions; the anxiety that many experience due to, firstly, a lack of confidence in the abovementioned institutions and, secondly, a loss of trust in existing (political, religious, moral, social) life-strategies, because these often fail to give a convincing sense of meaning and purpose to life. Each of the three thinkers places the 'self at the center of their philosophy, and addresses many similar themes which share between them a family resemblance that admits of comparison. The theories are presented in an order that · allows for a dialectical approach to the problem of self: Kierkegaard's fundamentally Christian theory is presented as thesis, and Sartre's atheistic position as anti-thesis. Jung's theory of the psyche is presented as synthesis, because it is antimetaphysical, but nevertheless claims to prove empirically that a convincing religious/ spiritual experience is the key ingredient for authenticity. The outcome of the enquiry will show that the three thinkers point from different directions towards the same basic conceptualization of the 'self: The self is both a project and a goal or, to put it differently, a journey and a destination, the goal/destination being the synthesis of the various disparate and conflicting elements that influence or make up the personality. The study as a whole echoes the three individual approaches in describing the condition of modem man as a malady or sickness, which is the lack of authenticity, of which the symptoms are falsehood, anxiety, alienation, crippled relationships, lack of responsibility and adaptibility, and perhaps, on a larger scale, issues such as social/ political injustice and conflict. The cure for this malady is an enhancement of consciousness/ awareness that is known as 'the self. The self is seen as a 'becoming' and a choice, a dynamic synthesis, something which is not given and cannot be taken for granted, but must be actively striven for. The study outlines and explores the nature and value of such a project towards the self. / AFRIKAANSE OPSOMMING: Hierdie studie beskou die probleem van outentisiteit, wat as die vraag, 'Hoe word ek myself?', gestel kan word. Om hierdie vraag te beantwoord, moet verdere kwessies, soos byvoorbeeld die aard van (self)bewussyn, die verhouding waarin die indivudu tot die samelewing staan, en die betekenis van 'bestaan' ( eksistensie ), ook aangespreek word. Die voorstelle van drie denkers, Kierkegaard, Sartre and Jung, word bespreek in hierdie tesis. Die drie is vir verskeie redes uitgesoek: Elkeen van hulle spreek pertinente kwessies rondom die modeme samelewing aan, byvoorbeeld: individue se vervreemding en verwydering van hulself en ander weens die massa-mentaliteit en onpersoonlike aard van staats- en godsdienstige instellings; die angs en spanning wat baie ervaar as gevolg van 'n gebrek aan vertroue in bogenoemde instellings, asook 'n gebrekkige geloof in bestaande (politiese, godsdienstige, more le, so si ale) lewensstrategiee wat nie meer daarin slaag om sin of rede aan die lewe te gee nie. Elkeen van die drie denkers plaas die 'self sentraal tot hulle filosofie, en spreek temas aan wat onderling familie-ooreenkomste vertoon, en daarom onderlinge vergelyking toelaat. Die teoriee word aangebied in 'n volgorde wat 'n dialekti~se aanslag tot die probleem moontlik maak: Kierkegaard se Christelike teorie word as tese aangebied, en Sartre se ateistiese posisie as anti-tese. Jung se teorie van die psige word as sintese voorgehou, want, alhoewel dit geen metafisiese aansprake maak nie, beskou dit 'n oortuigende religieuse/ geestelike ervaring as die hoofbestandeel vir outentisiteit. Die gevolgtrekking van die ondersoek sal wys dat die drie denkers vanuit verskillende rigtings na dieselfde konsepsie van die 'self wys: Die self is sowel 'n projek as 'n doel, of, anders gestel, 'n reis en 'n bestemming. Die doel/ bestemming is 'n sintese van die verskillende, onderling botsend~ elemente waaruit die self bestaan en waardeur dit beinvloed word. Die studie in geheel volg die voorbeeld van die drie denkers deur die modeme mens se 'toestand' as 'n soort siekte te beskryf. Die simptome van hierdie siekte, of gebrek aan outentisiteit, is valsheid, angs, vervreemding, gebrekkige verhoudings, die afwesigheid van persoonlike verantwoordelikheid en aanpasbaarheid, en ook miskien kwessies soos sosiale en politiese onreg en konflik. Die remedie vir so 'n siekte is die 'self: 'n verheldering en intensifisering van bewussyn, wat gesien kan word as 'n 'wording' en 'n keuse, 'n dinamiese sintese, iets wat nie as voor-die-hand-liggend beskou kan word nie, maar wat aktief nagestreef moet word. Hierdie studie ondersoek die aard en waarde van so 'n projek gerig op die self

99 leaves printed on single pages, preliminary pages and numberd pages 1-87. Includes bibliography. Digitized at 600 dpi grayscale to pdf format (OCR), using a Bizhub 250 Konica Minolta Scanner. / Thesis (MPhil (Philosophy))--University of Stellenbosch, 2000. / ENGLISH ABSTRACT: Death is a universal phenomenon and each culture develops its own ways of coping with it. The reaction of people to death also involves a complex network of relationships. To appreciate their responses to this phenomenon requires an understanding of the socio-cultural context in which these responses occur because they influence the individual's responses to issues of life and death. In the African context and indeed in the Zulu culture, death is a continuation of life in the world hereafter. The deceased renews his relationship with his ancestral relatives. Various rites and ceremonies are performed to mark his reunion with his ancestral relatives. For the living, the rites and ceremonies mark a passage from one phase of life to another requiring some readjustment. The belief in the existence of life after death also affects the nature of these rites and ceremonies, the social definition of bereavement and the condition of human hope. The belief in the existence of the ancestors forms an integral part African religion and its importance cannot be over-estimated. This belief flows from the strong belief in the continuation of life after death, and the influence the deceased have on the lives of their living relatives. The contact between the living and the living dead is established and maintained by making offerings and sacrifices to the ancestors. The ancestors, therefore, become intermediaries with God at the apex and man at the bottom of the hierarchical structure. However, for the non-African, the relationship seems to indicate the non-existence of God and the worshipping of the ancestors. Women play a pivotal role in issues of life and death, because African people recognize their dependence and the procreative abilities of women to reconstitute and to extend the family affected by the death of one of its members.Social change and Westernisation have affected the way the African people view death. Social changes have been tacked onto tradition. A contemporary trend is to observe the traditional and Christian rites when death has occurred. The deceased is then buried in accordance with Christian, as well as traditional rites. The belief in the survival of some element of human personality is a matter of belief and faith. It lessens the pain and sorrow that is felt upon the death of a loved one by giving the believer hope that one day he will be reunited with his loved one and thereby easing the fear and anxiety of death. Thus, the purpose of this investigation is to critically analyse the African perception of death and its implications with special reference to the Zulu people. The objective is to expose the complexities, diversities and the symbolism of death. The essence is to demystify the African perception of death and to indicate that the perception of death is not necessarily unique to African people in general and to the Zulu people in particular. Other groups like Christians have perceptions of death particularly with regard to the world hereafter. The aim of the investigation of the topic is to reveal some of the underlying cultural beliefs in death, enhance those beliefs that are beneficial to society and discard those that are anachronistic. Since culture is dynamic, not everything about African tradition will be transmitted to the future generation; there is bound to be cultural exchange. / AFRIKAANSE OPSOMMING: Die dood is 'n universele fenomeen en elke kultuur ontwikkel sy eie manier om daarmee om te gaan. Mense se reaksie op die dood geskied binne 'n komplekse netwerk van verhoudinge. Om mense se reaksie op hierdie fenomeen te begryp, is 'n verstaan van die sosio-kulturele konteks nodig waarin hierdie reaksies plaasvind, aangesien dit die individu se reaksie op lewe en dood beinvloed. In die Afrika-konteks en ook in die Zulu-kultuur word die dood beskou as die kontinuasie van lewe in die hiermamaals. Die oorledene hernu sy verhouding met sy voorouers. Verskeie rituele en seremonies vind plaas om hierdie gebeurtenis te identifiseer. Vir die oorlewendes is die rituele en seremonies die oorgang van een lewensfase na 'n ander en vereis dus 'n mate van aanpassing. Die geloof in die lewe na die dood beinvloed die aard van hierdie rituele en seremonies, die sosiale defenisie van rou en die toestand van menslike hoop. Die geloof in die bestaan van die voorvaders vorm 'n integrale deel van Afrika-religie en die belangrikheid daarvan kan nie oorskat word nie. Die geloof vloei voort uit die sterk geloof in die hiermamaals en die geloof aan die invloed wat oorledenes op hulle lewende nasate het. Die kontak tussen die lewendes en die lewende oorledenes word daargestel en onderhou deur offerandes aan die voorvaders. Die voorvaders word dus gesien as intermediere skakel in 'n hierargie met God aan die bokant en die mens aan die onderkant. Maar, vir nie-Afrikane, dui hierdie struktuur op die nie-bestaan van God en die aanbidding van die voorvaders. Vroue speel 'n deurslaggewende rol in kwessies van lewe en dood aangeslen Afrikane hul afhanklikheid besef van vroue se voortplantingsbekwaamhede om die famile wat deur die dood geaffekteer is te herkonstitueer en te vergroot. Sosiale veranderinge en verwestering affekteer Afrikane se houding teenoor die dood. Sosiale veranderinge is bo-oor tradisie geplaas. 'n Hedendaagse neiging is om Christelike sowel as tradisionele rituele na te volg na 'n sterfte. Die oorledene word begrawe in ooreenstemming met sowel tradisionele as Christelike praktyke. Die geloof in die oorlewing van elemente van die menslike persoon is 'n kwessie van geloof. Dit verminder die pyn en lyding na die afsterwe van 'n geliefde deur aan die gelowige oorlewende die hoop van 'n herontmoeting te bied - en verminder dus die vrees en angs wat met die dood gepaard gaan. Dus is die doel van hierdie ondersoek om 'n kritiese analise te maak van die Afrika-siening van die dood en die implikasies daarvan, met spesiale verwysing na die Zulu-nasie. Daar word probeer om die kompleksiteite, verskeidenhede en simbolisme van die dood aan te toon. Die essensie hiervan is om die Afrika-houding teenoor die dood te de-mistifiseer en te wys dat die siening van die dood nie noodwendig uniek van Afrikane in die algemeen en spesifiek van die Zoeloes is nie. Ander groepe soos Christene het beskouinge oor die dood met spesifieke verwysing na die hiernamaals. Die doel van die ondersoek is om sekere onderliggende kulturele oortuiginge aangaande die dood te onthul, om die beskouinge wat voordelig is, te versterk en om die anachronistiese beskouinge aan die kaak te stel en so te diskrediteer. Aangesien kultuur dinamies is, sal nie alles wat betref die Afrika-tradisie oorgedra word aan toekomstige generasies nie; daar sal noodwendig kulturele interaksie wees.

Thesis (DPhil (Philosophy))--University of Stellenbosch, 2006. / This thesis gives an historical overview of some of the issues connecting philosophy of mind and philosophy of langauge in the twentieth century, especially with regard to the relevance of both disciplines to theories of cognition. Specifically, the interrelation between the theories of Peirce,Chomsky, Derrida, and Deacon are discussed. Furthermore, an overview of twentieth century views on mind in both philosophy and the cognitive sciences is given. The argument is made that many of the apparently insurmountable issues that plague theories on mind and cognition today can be traced back to the metaphysical mould into which the philosophical questions at issue here were cast. Also, despite current resistance to the idea from many philosophical quarters, a case is made for approaching language and mind in terms of neo-Darwinist evolutionary theory.

Thesis (DPhil (Philosophy))--University of Stellenbosch, 2005. / The purpose of this thesis twofold: first, to develop an account of modernity as a “loss of the world” which also entails the “death” of the human as a meaningful philosophical, political or moral category, and second, to explore the possibility of recovering a sense of the world in us and with it, a sense of what it means to be human. This argument is developed by way of a sustained engagement with the work of Friedrich Nietzsche and Hannah Arendt, whose analogous critiques of modernity centre on the problem of the connection between humanity and worldliness. My argument consists of three parts, each of which spans two chapters. Part one of the thesis sets out the most important aspects of Nietzsche’s and Arendt’s respective critiques of modernity. Chapter one focuses on modernity as a rupture of a philosophical, political and religious tradition within which existence in the world could be experienced as unquestionably meaningful. Following arguments developed by Nietzsche and Arendt, chapter two establishes that the loss of this tradition results in a general crisis of meaning, evaluation and authority that can be designated as “modern nihilism”. The second part of the thesis deals with what may be called the “anthropological grounds” of the critique of modernity developed in part one. To this end, chapter three focuses on Nietzsche’s portrayal of the human as “the as-yet undetermined animal” who is neither the manifestation of a subjective essence nor the product of his own hands, but who only exists in the unresolved tension between indeterminacy and determination. This is followed in chapter four by an inquiry into Arendt’s conception of “the human condition”, which in turn points to the conditionality of being human. What is clearly demonstrated in both cases is that, in so far as the predicament of modernity is incarnate in modern human beings themselves, any attempt at overcoming this predicament would somehow have to involve re-thinking or transcending our present-day humanity. The third part of the thesis examines the way in which the reconceptualisation of the human as advocated by Nietzsche and Arendt transforms our understanding of “world”. The more specific aim here is to demonstrate that both thinkers conceive of a reconciliation between self and world as a form of redemption. In chapter five I explore their respective attempts to resurrect the capacity for judgement in the aftermath of the death of God as the first step in this redemptive project, before turning to a more in-depth inquiry into the “soteriology” at work in Nietzsche’s and Arendt’s thinking in chapter six. This inquiry ultimately makes clear that there is a conflict between the Nietzschean conception of redemption as amor fati (love of fate) and Arendt’s notion of redemption as amor mundi (love of the world). I conclude the thesis by arguing that what is at stake here are two conflicting notions of reconciliation: a worldly – or political – notion of reconciliation (Arendt), and a much more radical, philosophical notion of reconciliation (Nietzsche), which ultimately does away with any boundary between self and world. However, my final conclusion is not that we face an inevitable choice between these two alternatives, but rather that the struggle between these two dispositions is necessary for an understanding of what it means to be human as well as for the world in which our humanity is formed.

Thesis (MPhil)-- University of Stellenbosch, 2000 / ENGLISH 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. / AFRIKAANSE OPSOMMING: Dit is algemeen bekend dat Afrika suid van die Sahara die gebied is met die hoogste voorkoms van MIV/vIGS. Die MIV/VIGS-pandemie het dus ons siekte geword. Dit is vir baie van ons moeilik om hierdie feit te aanvaar, en ons reaksies is dikwels bevooroordeeld. Onkunde en onverdraagsaamheid oor MIV/vIGS word trouens wereldwyd aangetref. Hierdie verhandeling Ie klem op die feite van MIV/VIGS, en konfronteer sodoende hierdie wanopvattings terwyl daar gefokus word op die diepgaande dilemmas waarmee die samelewing gekonfronteer word. President Thabo Mbeki se woorde "Vennootskap teen MIV/VIGS" verwoord myns insiens die enigste oplossing vir die MIV/VIGS-pandemie. Die President doen in sy toespraak 'n beroep op al1e Suid-Afrikaners, in private en openbare sektore, om met groter determinasie saam te veg teen MIV-infeksie en VIGS; Hierdie toespraak, gelewer op 9 Oktober 1998, toe die regering klaarblyklik nog rigting gehad het en op die voorfront was in die styd teen MIV/VIGS, was moontlik President Thabo Mbeki se beste ooit oor die onderwerp MIV/VIGS. Die titel van hierdie verhandeling is "Etiese perspektiewe ten opsigte van waarnemende en voorkomende strategiee vir MIV/VIGS in Suid-Afrika". Die Suid-Afrikaanse regering, by monde van die Ministerie van Gesondheid, oorweeg dit tans sterk om VIGS 'n aanmeldbare mediese kondisie te verklaar. Die ernstige etiese en regsimplikasies van so 'n daadwerklike en kontroversiele stap sal in die verhandeling bespreek word. Behoort die rnetgesel1e van MIV-positiewe persone ingelig te word? Indien wei, wie moet hulle in kennis stel? Daar sal ook gekyk word na die etiese verpligting van gesondheidsorgwerkers om MIV/VIGS-pasiente te behandel ten spyte van hul1e vrees om per ongeluk besmet te word. Indringende vrae moet gevra word. Behoort gesondheidsorgwerkers ingelig te word oor die MIV-status van elke pasient wat hul1e behandel? Aan die ander kant vrees sornmige pasiente dat hul1e deur MIV-positiewe gesondheisorgwerkers besmet kan word. Die fundamentele etiese aangeleenthede rakende vertroulikheid, privaatheid en die reg tot mediese behandeling sal ook bespreek word. Suid-Afrika is verdeeld oor hierdie kwessies. Etiese waardes, soos die beginsel van vertroulikheid, respek vir outonomie en ingeligte goedkeuring is direk betrokke by besluite oor etiese kwessies. Die regering kan nie hierdie aangeleenthede implementeer sonder om die fundamentele etiese vereistes in ag te neem nie. VIGS-entstofproefnemings is'n verdere etiese kwessie wat ter sprake kom. Hierdie proefnemings word grotendeels deur "ontwikkelde" lande uitgevoer, tewyl die proefpersone van "derdewereldse" of "ontwikkelende" lande afkomstig is. Die etiese kwessies hierby betrokke is: hoe sal ingeligte goedkeuring beskerm word, veral wanneer proefpersone onopgevoed is en nie die tersaaklike terme verstaan nie? Wat is die kosteeffektiwiteit of voordele van hierdie proefnemings? Watter risiko's is betrokke? Die etiese debat oor die markprys van medisyne, wat heel bekostigbaar vir ryk lande, maar duur vir armer lande is, word ook aangeraak. Hierdie verhandeling dek nie alle relevante kwessies wat betref MIV/VIGS nie. Tog hoop ek dat dit 'n bydrae sal lewer tot mense se bewuswording van die etiese dilemmas wat MIV/VIGS inhou.

Thesis (MA (Philosophy))--University of Stellenbosch, 2005. / This study sets out to document the culture and environmental ethic of the Pokot tribe of Laikipia, Kenya. This is done in order to find the wisdom this culture contains and to seek alternative ways for conservation and development in Africa.

Thesis (DPhil)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Human participant research raises a conflict between medical progress as a societal good and the protection of participants as an individual good. Prior to 1960 the discretionary authority for the protection of participants resided in the hands of individual investigators. However, a wave of research atrocities from Tuskegee in 1932 to the Beecher expose in 1966 stimulated a change to a principle based system of regulation. Research Ethics Committees (RECs) and Institutional Review Boards (IRBs) were henceforth charged with the responsibility of human participant protection. Since 1966, this system of research review was established internationally and at one institution in South Africa. In 1997, placebo-controlled HIV vertical transmission trials in a number of developing countries including South Africa raised unprecedented controversy in research ethics internationally and nationally. In 2000, the fraudulent breast cancer trials conducted by Dr Bezwoda at Baragwanath Hospital drew international attention to research ethics in South Africa. However, the events that called into question the efficiency of the system of ethical review most poignantly were the recent deaths of volunteers in research at centres of excellence in the United States. It was charged that if there were deficiencies in the research ethics review system in developed countries, these were more likely to be present in developing countries. Around the same time the Interim National Health Research Ethics Committee (INHREC) was established in South Africa to explore and regulate the ethical review system in South Africa. Cognisant of these issues, the current study was undertaken to establish the various structural, procedural and substantive ethical challenges facing justifiable and ethical review of research in South Africa. A combination of conceptualphilosophical reflection and empirical research was employed in this dissertation. The empirical work employed both quantitative and qualitative research methodology. The quantitative survey explored the composition of RECs reviewing clinical trials research in South Africa with an emphasis on committee composition and structure as well as the review process. The qualitative research was conducted using semi-structured interviews of ten REC Chairpersons in South Africa to explore complex substantive issues like informed consent, standards of care and participant remuneration, inter alia. While the review system in South Africa is functioning at a reasonable level, there is wide variation from one REC to the next. RECs are geographically distant and function in isolation without opportunity to communicate and share ideas. Amongst institutional RECs, there is a stark contrast between historically disadvantaged institutions and historically advantaged institutions. REC membership, ten years into democracy remains white male dominated. Community representation is inadequate. Most RECs are dominated by scientists and clinicians. The review process is widely variable with delays in review ranging from ten days to ten weeks. Procedural and bureaucratic demands impact on the ability of REC members to engage in debate on important substantive ethics issues like standards of care, informed consent and participant remuneration. Research ethics training and educational needs vary widely across the country. Serious attention must be paid to the way in which RECs are constituted in South Africa. Restructuring of RECs with a view to improving representation in terms of race, gender and religion must be prioritized. There is a need for community representation and non-scientific membership to be explored. RECs in South Africa need to revisit the question of whether they should be conducting both scientific and ethics review or ethics review alone. The review process requires a paradigm shift in emphasis from adverse event reporting to monitoring, from informed consent forms to a culturally relevant informed consent process. Aparadigm shift is indicated to shift the focus from informed consent to a more comprehensive review framework. Policies regarding standards of care and participant remuneration must be clarified and articulated. Although the role of RECs in human participant protection has been questioned, it is clear that in the vast majority of cases, they are fulfilling an important role. Their function could certainly be enhanced. This is being facilitated by training programs and an electronic newsletter. However, responsibility for human participant protection does not reside in the domain of the REC alone. A collective responsibility shared by researchers, institutions, research ethics committees, sponsors and participants is integral to human participant protection and the generation of new, valid and relevant scientific knowledge. / AFRIKAANSE OPSOMMING: Navorsing op menslike subjekte gee aanleiding tot ‘n konflik tussen mediese vooruitgang as ‘n voordeel vir die samelewing en die beskerming van deelnemers as iets waarby die individu direkte belang het. Voor 1960 het die diskresionêre gesag vir die beskerming van deelnemers by die individuele navorsers berus. ‘n Golf van navorsingsvergrype, van Tuskegee in 1932 tot die Beecher onthulling in 1966, het egter veranderinge in die rigting van ‘n stelsel van beginsel-gebaseerde regulasie gestimuleer. Navorsingsetiekkomitees (NEKs) en Institusionele Beoordelings- en toesigrade (IBRs) is gevolglik belas met die verantwoordelikheid om toe te sien dat mense wat deelneem, sover moontlik beskerm word. Sedert 1966 is hierdie stelsel van navorsingshersiening en -toesig internasionaal tot stand gebring – ook, aanvanklik, by een instansie in Suid-Afrika. In 1997 het plasebo-beheerde HIV-vertikale oordrag-proewe in ‘n aantal ontwikkelende lande, insluitend Suid-Afrika, tot ongekende kontroversie op die terrein van navorsingsetiek aanleiding gee, internasionaal en nasionaal. In 2000 het die bedrog met borskankerproewe, uitgevoer deur dr Bezwoda by Baragwanath Hospitaal, internasionale aandag op navorsing in Suid-Afrika gevestig. Hierdie gebeure het egter die effektiwiteit van die stelsel van etiese toesig in Suid-Afrika en elders in die wêreld bevraagteken. Die mees kommerwekkende onlangse insident was die dood van navorsingsvrywilligers by sentra van uitmuntendheid in die Verenigde State. Daar is beweer dat as daar tekortkominge in die navorsingsetiektoesigsisteem in ontwikkelende lande is, daar ‘n groter moontlikheid bestaan dat dit ook (en moontlik meer) in ontwikkelende lande voorkom. Ongeveer dieselfde tyd is die Interim Nasionale Gesondheidsnavorsings-etiekkomitee (INGNEK) [Interim National HealthResearch Ethics Committee (INHREC)] in Suid-Afrika gestig om die etiekoorsigstelsel in Suid-Afrika te ondersoek en te reguleer. Met dit in gedagte is die huidige studie onderneem om die verskillende strukturele-, prosedurele- en substantiewe etiese uitdagings wat regverdigbare en etiese oorsig van en toesig oor navorsing in Suid-Afrika in die gesig staar, vas te stel. Daar is van ‘n kombinasie van konseptuele, filosofiese refleksie en empiriese navorsing in hierdie proefskrif gebruik gemaak. Die empiriese werk maak gebruik van sowel kwantitatiewe as kwalitatiewe navorsingsmetodes. Die kwantitatiewe opname bestudeer die samestelling van NEKs wat toesig hou oor kliniese proewe in Suid-Afrika, met die klem op komiteesamestelling, -struktuur en die toesigproses. Die kwalitatiewe navorsing is gedoen met behulp van van semi-gestruktureerde onderhoude van tien NEK-voorsitters in Suid-Afrika om die komplekse substantiewe aspekte, soos onder andere ingeligte toestemming, standaard van versorging en deelnemervergoeding, te ondersoek. Terwyl die etiek-toesigstelsel in Suid-Afriks op ‘n redelike vlak funksioneer, is daar ‘n groot verskil tussen verskillende NEKs. NEKs is geografies verspreid en funksioneer dikwels in isolasie sonder ‘n geleentheid om te kommunikeer en idees te deel. Ten opsigte van die institusionele NEKs bestaan daar ‘n duidelike kontras tussen histories benadeelde instansies en histories bevoordeelde instansies. NEK-lidmaatskap word, tien jaar na demokrasie, steeds gedomineer deur blanke mans. Gemeenskapsverteenwoordiging is onvoldoende. Die meerderheid NEKs word gedomineer deur wetenskaplikes en klinici. Die toesig- en hersieningsprosesse in die verskillende komitees verskil grootliks, met vertragings wat wissel van 10 dae to 10 weke. Prosedurele- en burokratiese vereistes het ‘n impak op die vermoëns van NEK-lede om by debatte oor belangrike substantiewe etiese aangeleenthede betrokke te raak, soos byvoorbeeld die standaard van versorging, ingeligte toestemming en deelnemervergoeding. Opleiding en opvoedkundige behoeftes verskil wyd oor die land.Ernstige aandag moet geskenk word aan die wyse waarop NEKs in Suid-Afrika saamgestel is. Herstrukturering van NEKs met ‘n visie op verbeterde verteenwoordiging in terme van ras, geslag en geloof is ‘n prioriteitsvereiste. Gemeenskapsverteenwoordiging en lidmaatskap van nie-wetenskaplikes moet verder ondersoek word. NEKs in Suid-Afrika moet die vraag of hulle sowel wetenskaplike- as etiektoesig moet uitvoer, of sl slégs etiektoesig, opnuut ondersoek. Die nasiensproses vereis ‘n paradigmaskuif, vanaf ‘n klem op rapportering van gebeurtenisse, na monitering van ingeligte toestemmingsvorms sowel as na ‘n kultureel toepaslike ingeligte toestemmingsproses. ’n Paradigmaskuif is noodsaaklik ten einde die fokus te verskuif vanaf ingeligte toestemming na ‘n meer omvattende toesig- en nasiensraamwerk. Beleid rakende standaard van versorging en deelnemervergoeding moet verduidelik en geartikuleer word. Alhoewel die rol van NEKs in die beskerming van menslike deelnemers aan navorsing bevraagteken word, is dit duidelik dat NEKs in die meerderheid van gevalle wel ‘n belangrike rol vervul. Hul funksie kan natuurlik uitgebrei word. Dit sal gefasiliteer word deur opleidingsprogramme en ‘n elektroniese nuusbrief. Verantwoordelikheid vir die beskerming van mense wat deelneem aan navorsing berus egter nie uitsluitlik by NEKs nie. ‘n Kollektiewe verantwoordelikheid, gedeel deur navorsers, instellings, navorsingsetiekkomitees, borge en deelnemers is ‘n integrale vereiste vir hierdie beskerming sowel as vir die verwerwing van nuwe, geldige en relevante wetenskaplike kennis.