M.MSc.(Med.), Bioethics and Health Law, Faculty of Health Sciences, University of the Witwatersrand, 2011 / Keeping information a patient has given in confidence to his or her doctor is a fundamental value in each individual doctorpatient relationship. However, when a medical professional is faced with disclosing confidential information in the face of competing public interests (or other ethically compelling reasons) he or she faces an ethical dilemma. In the context of the HIV/AIDS epidemic in South Africa, the dilemma to keep medical confidences or to disclose information to identifiable third parties is frequently faced by doctors and other healthcare professionals. This research report highlights the duty of medical confidentiality identifying its importance both as an ‘absolute’ principle in healthcare practice as well as suggesting that there are contexts in which it should be considered as a relative duty. In keeping, this format of this research report will present current data concerning the HIV/AIDS epidemic, interrogate the idea of medical confidentiality, explore some professional guidelines associated with HIV/AIDS disclosure, as well as raise some ethical– legal considerations concerning healthcare professionals and the problem of disclosure of their patient’s HIV positive status to identifiable third parties.

MSc (Med), Bioethics and Health Law, Faculty of Health Sciences, University of the Witwatersrand / Purpose There is limited literature available in South Africa concerning the interaction of doctors with the pharmaceutical industry. The purpose of this research report was to establish what South African doctors believe to be acceptable and appropriate incentives from the industry, highlight what they consider reasonable compensation for professional activities performed on behalf of the industry; and whether they perceive interaction with the industry’s marketing apparatus to be a significant influence on their prescribing habits. Methods A questionnaire was emailed to all active doctors in South Africa with email addresses from the Medpages® database. The survey was conducted in March 2009 - April 2009. The desired sample size was 500 General Practitioners (GPs) and Specialists in private practice. Results A final sample of 400 valid responses was analysed, representing 80% of desired sample. Majority of the respondents were male (74%) with an almost equal split between GPs (51.5%) and specialists (48.5%). The study revealed that 92% of the respondents accepted branding items whilst 60% of the respondents accepted personal gifts from the industry. The results revealed that 85% of the respondents felt that doctors should be paid for speaking at CMEs, and just over v half the sample (52%) felt they wanted to be paid their own rate as opposed to the industry rate. The investigation revealed that 77% of the respondents felt that their interaction with the industry influenced their prescribing habits and suggesting that such influence to be more pervasive with their colleagues, specifically 95% felt their colleagues are influenced by their interaction with industry (p< 0.001). About three quarters of the respondents (73%) believe patient management may be compromised if doctors’ prescribing habits are influenced by their interaction with the industry. Most respondents (72.5%) were either not aware or did not know of any regulations or guidelines with regards to acceptance of gifts by doctors from the industry. Conclusion This study demonstrated that perverse incentives continued to be given to doctors, and doctors have not shown a distinct aversion to accepting these perverse incentives and gifts. These perverse interactions have been shown in existing literature and in this research report to influence prescribing habits. Doctors do not seem to operate within their guidelines and legal framework, as stipulated by the HPCSA, when accepting these potentially harmful perquisites. What legal and ethical considerations are the doctors employing when accepting ‘incentives’ from industry is the question; and what is the doctor’s role in protecting his/her patients? Ignorance of the guidelines, as the study indicates to be the case, does not justify involvement in perverse relationships. Doctors have professional and personal moral responsibilities to ensure they familiarise vi themselves with guidelines regulating their professional conduct and ultimately protect the patients.

A research Report submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Arts, Applied Ethics for Professionals Johannesburg, 2016 / The standard conception of adversary advocacy postulates that lawyers be partisan towards clients, within the limits of law, and be unaccountable for the client’s lack of integrity. Thus, lawyers owe duties to both clients and judges. Partisanship requires lawyers to conceal from judges confidential information received from clients and to advance arguments they believe are incorrect. Thus, say critics, the standard conception permits lying and cheating. This essay refutes that proposition. It is argued that truth-seeking is merely instrumental in the legal system and what is sought is ‘proof.’ The standard conception is defended, albeit with a corrective emphasis on balancing partisanship with duties to promote effective judicial decision-making. Counsel’s role is defined as a licensed fiduciary intermediary, who by non-disclosures and insincere arguments acts morally because such practises promote the legitimacy of the legal system and uphold client dignity. The contending views of leading proponents and antagonists of the standard conception are examined.

When there is scarcity of educational position, we need a just system of distribution that decides who's to be admitted to said position. In this text I argue that the common system of using grades and test results as merit to distribute educational opportunities is unjust. The reason being that we simply cannot assign grades that are neither fully reliable or valid. I describe a generalized education system that we have today distributing educational opportunities. The system is characterized by having a compulsory basic education that distributes its educational opportunities strictly egalitarian. Later introducing grades and standardized tests to progress into higher education creating a meritocratic distribution. Furthermore I introduce Nozickian libertarianism and a version of Rawls distributional principles including affirmative action policies. All of which have their merits and drawbacks, which is why I lastly put forth my own proposed approach. The proposal consists of the fundamental right that every person with the adequate knowledge and skills to succeed in referred education is entitled to it. The building blocks for this education system and its distribution of educational opportunities is compulsory basic education, specialized admission tests and lottery accompanied by a queue system.

This dissertation both surveys contemporary work in metanormativity and argues for a position that I call moderate normative skepticism. I begin by evaluating efforts to characterize the normative domain and conclude that while some normative concepts and properties are amenable to naturalistic programs of reduction and analysis, other normative concepts and properties are not. I proceed to clarify accounts of reasons, reasoning, and rationality; this establishes argumentative room to maneuver for my moderate normative skepticism. Next, I evaluate moral error theories, which I count as close cousins of my own thesis, and I note how these error theories have more profound implications than their authors realize. I claim that, understood properly, these error theories extend to the domain of normative reasons in general. I accept and defend the extension of error theory as a viable position. In the final chapter of my dissertation, I defend my position against charges of self-defeat and attempt to anticipate and defuse potential criticisms. / A Dissertation submitted to the Department of Philosophy in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Fall Semester 2017. / November 08, 2017. / Error theory, Metaethics, Metanormativity, Normativity, Reasons, Skepticism / Includes bibliographical references. / Alfred Mele, Professor Directing Dissertation; Martin Kavka, University Representative; Piers Rawling, Committee Member; Randolph Clarke, Committee Member.

Keung-lap Chan. / Bibliography: leaves 119-126 / Thesis (M.Ph.)--Chinese University of Hong Kong, 1986

The pursuit of sustainability of governance and development has become a major challenge in contemporary times because of increasing realization that: various ecological and social systems are interconnected; and the complexity of our natural and constructed environs requires holistic approaches to avoid catastrophic fissures in the systems on which humans depend. As regional governments such as the East African Community (EAC) become important in Africa (and other regions), they present opportunities to generate cross-national approaches to achieving sustainability albeit success in that direction is limited and sporadic. In order to mitigate the underlying causes of that situation, we need to reconceptualize and reconstruct sustainability thinking and policy. From an applied ethics perspective, the study set out to explicate the value of and constructively generate a more viable conceptualization of sustainability in relation to the EAC. The study used qualitative methodology; designed as an atypical regionalization case-study and an analytical-constructive research; compatible research tools were employed in interrogating and analyzing secondary sources relating to member states of the EAC and the research was executed between 2011 and 2014. The research found a divergence between the two main conceptual approaches to sustainability in Africa, namely, the ‘Market inspired sustainability’ (MIS) logic and the ‘Traditional African sustainability’ (TAS) logic. The study also uncovered colonial Social Darwinism as a major underlying governance philosophy that motivated the EAC’s former colonial rulers; which became a key ingredient in the application of a colonial-functionalist approach to the region’s earlier integration project (EAC-1).This was traced as a major premise on which the unsustainabilities within the contemporary regionalization project (EAC-2) were crafted. The research also found some acceptable levels of competence in regional governance within the individual EAC member countries in terms of: i) hierarchical, ii) network, and iii) market styles of metagovernance. However, closer analysis revealed: i) an inverse relationship between transfer of capabilities from colonizers to natives (TCCN) and the sustainability of postindependence states (SPIS); and ii)a directly proportional relationship between colonial governance style (CGS) and the economic performance of post-colonial (EPPC) East African countries. It also revealed an ambitious but inadequately grounded drive to expand the EAC project without due attention being given to existing faultlines of possible disintegration such as: perpetuation of colonially-initiated injustices, citizens’ incapacity to partake of the benefits of the integration, and low levels of integrity, among others. The EAC faces a risk of turning into colonial victimization and villainization writ large; which is unsustainable due to the social laws of victim-disaffection (ViD) and villain-encumbrance (ViE). Further analysis showed that these faultlines of disintegration could be exasperated internally by the governance styles and stances taken by the ruling regimes of the core member states: Kenya’s Jubilee Alliance Party (JAP) has to balance between the forces of ethnically inspired devolution and multicultural capitalism; Tanzania’s Chama Cha Mapimduzi (CCM) still has to overcome a socialist single-party hangover and manage the political marriage between the mainland and the island; and Uganda’s National Resistance Movement (NRM) has chosen a governance philosophy of hybrid Marxism. From a justice point of view, the study advocates for establishing a Regional Basic Structure (RBS) that uses a ‘one-step original position’ as a mitigation measure. The RBS should befounded on universal egalitarianism so as to minimize misrepresentation and diminish the political elitist culture of betrayal of the electorate at all levels of representative leadership. In a reconstructive fashion, the research amplified the classical philosophical position that ethical values within society (the ethical fabric) provide the foundation on which other dimensions of sustainability are built. On the basis of that premise, the study generated and proposes the Comprehensive Ethical Sustainability (CES) frameworkas a scheme of axiomized ethical principles designed to be used towards the realization of the sustainability of systems and processes. The CES scheme is a principlistic recasting of selected intuitively valuable dominant approaches to development; designed to be convertible into a comprehensive program of action (or sets of regional policies) towards the attainment of governance and development sustainability in an integrated EAC. The CES framework is fashioned as a reorganized, multi-dimensional cocktail of i) compound, ii) compatible and iii) complimentary principles of: i) Justice, ii) Capabilities, iii) Ubuntu and iv) Integrity, whose application would make the regional bloc sustainable. These principles are considered and proposed as pillars in the: i) theorization of sustainability; and ii) policy formulation, structural arrangements and individual action aimed at sustainability.

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This thesis provides a broad reading of the writings of Jacques Ellul focused on presence as a driving theme of his theological-ethical works. Drawing on numerous rare, unpublished and untranslated primary sources, this reading suggests that presence was a central and guiding theme of his work from its inception in the mid-1930s to its planned conclusion in La raison d'être (1987). Focusing on presence further elucidates a personal crisis which Ellul underwent in the late 1960s, described in the opening pages of L'espérance oubliée (1972). Part one, Architecture, focuses on some of Ellul's major theological and sociological sources as providing material structuring Ellul's understanding of the present. Chapter one treats Ellul's 1987 book Reason for Being: Meditations on Ecclesiastes, in which Ellul reads his two chief theological sources, the book of Ecclesiastes and the Danish thinker Søren Kierkegaard, through each other. The result is first, that Kierkegaard's chief focus on contemporaneity with Christ is modified, stripped of its philosophical fixity; this provides the model for Ellul's time. Second, Kierkegaard's irony is challenged by Ecclesiastes' rigorous seriousness towards words; this informs Ellul's more serious irony. Time, language, and humanity are linked in this approach to the present. Chapter two focuses on Karl Marx and Ellul's early understanding of institutions. Synthesizing from books made from his courses on Marx, Ellul's Marxist reasons for opposing philosophical fixity are displayed (complementing his theological reasons). Marx's influence is also noticeable in Ellul's time, language, and approach to humanity. This implies that rather than having one unified dialectical method between his sociology and theology, discerning which of these latter plays more heavily at a given moment is a matter of personal discernment. Part two, Movement, treats changes in Ellul' Chapter three establishes continuity in Ellul's use of presence from 1936—1964. 'Presence' describes a mutually implicating three-part dialogue: first, a communicative dialogue between sign and presence; second, an incarnational dialogue between body and spirit; and third, a dialogue between time and space. This dialogue is evident in all of Ellul's major theological-ethical works. It unites time, language, and humanity, grounding an ethic of signification. Focusing on presence offers a fresh understanding of Ellul's theological-ethical vision. Chapter four highlights crises in Ellul's life and thought, and in French society. In the 1960s, France was transitioning from an extended period of institutional and cultural stability to a time of crises, from an intellectual atmosphere of 'critical humanism' to one of 'theoretical antihumanism.' The latter is visible in the rise to popularity of structuralism—a term encompassing diverse projects united by a Nietzschean critique of presence, including critiques of the human, of language, and of history. Ellul engaged deeply with at least one major work employing this critique, Michel Foucault's Les mots et les choses (1966). Ellul's reaction to this critique is clearly visible in his texts from this era; read in the context of other events in French society and Ellul's life, the structuralist critique of presence certainly would have contributed to, if not constituted, a crisis for Ellul. Chapter five treats Ellul's response to this crisis. First, Ellul offers sociological criticism of structuralism. Second, he questions presence theologically, suggesting that in the moment of God's abandonment on the cross, Christ's hopeful, communicative address to God is God's presence. Against structuralist views of language as violent, in the new, image-saturated societal context, language is perhaps the only non-violent means of expression; the fragility of linguistic presence is humanity's only hope for true community. Ellul's theology of presence changes to hope as its new mode, and his ethics of signification shifts from a Barthian approach to signs and institutions to a Kierkegaardian incognito. The conclusion uses Ellul's response to these critiques to respond to questions from the introduction, drawing on scripture to propose a protestant theological response to structuralism. Ellul gave an early, in-depth, and original response to this critical moment of thought with subsequent global influence. His is a suggestive proposal for those interested in formulating contemporary theological ethics of media and communication for the postmodern age.