Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: This thesis discusses ethical dilemmas faced by district surgeons in South Africa.
District surgeons render clinical forensic services, which means that they deal mainly
with detainees and victims of crime. The main functions of district surgeons are the
collection of forensic evidence from patients and the care of detainees. So the focus
is to assist in the administration of justice rather than improvement of patient
wellbeing.
The district surgeon may therefore find himself in a situation where patients’ interests
are in conflict with those of law enforcement agencies. Being a medical practitioner
in clinical forensic medicine, the district surgeon has an obligation to assist in the
administration of justice, as opposed to the traditional obligation to care for patients
and put patient’s interests first. This allegiance to both administration of justice as
well as patient wellbeing lead to an ethical dilemma of dual loyalties. A dual
obligations presents an ethical dilemma for the district surgeon, especially if they are
in conflict and mutually exclusive. I discuss the detention and subsequent death of
Steve Biko to illustrate how dual obligations can lead to serious human rights
violations and even death.
Dual obligations are however not limited to detainees and police custody settings,
and I demonstrate this by discussing three other scenarios commonly encountered
by district surgeons. There is a lack clear guidance for district surgeons who are faced with a conflict of
obligations. I explore several ethical theories including consequentialism, deontology
and virtue ethics, in search of an ethical framework suitable for resolving conflicts in
clinical forensic medicine. I therefore argue that a duty based ethical framework is
central to clinical forensic medicine and the resolution of loyalty conflicts. I
recommend the resolution of conflicts by using an approach developed by Benjamin
(2006). This approach involves weighing -up the different duties in conflict, applying
philosophical reasoning and then amelioration. By adopting a structured and wellreasoned
ethical framework, district surgeons will be able to deal with conflicts of
obligations better. / AFRIKAANSE OPSOMMING: Hierdie tesis bespreek etiese dilemmas wat in die gesig gestaar word deur
distriksgeneeshere in Suid-Afrika. Distriksgeneeshere lewer kliniese forensiese
dienste, wat beteken dat hulle handel hoofsaaklik oor die gevangenes en slagoffers
van misdaad. Die belangrikste funksies van distriksgeneeshere is die insameling van
forensiese getuienis van pasiënte, en die sorg van gevangenes. Met hierdie
benadering is die fokus om te help met die administratiewe doeleindes van
geregtigheid, eerder as die verbetering van die pasiënt se welstand.
Die distriksgeneesheer kan hom dus in 'n situasie vind waarby die pasiënte se
belange in konflik is met dié van wetstoepassingsagentskappe. As 'n geneesheer in
kliniese forensiese geneeskunde, het die distriksgeneesheer 'n verpligting om te
help met die administrasie van geregtigheid, in teenstelling met die tradisionele
verpligting om te sorg vir hul pasiënte, en hul welstand eerste te plaas. Hierdie
getrouheid gaan gepaard met beide regspleging, sowel as die welstand van die
pasiënt, wat kan lei tot 'n etiese dilemma van dubbele lojaliteit. Dubbele verpligtinge
bied 'n etiese dilemma vir die distriksgeneesheer, veral as hulle in konflik en
wedersyds uitsluitend is. Ek bespreek die aanhouding en die daaropvolgende dood
van Steve Biko om te illustreer hoe dubbele verpligtinge kan lei tot ernstige skending
van menseregte en selfs die dood.
Dubbele verpligtinge is egter nie beperk tot die gevangenes en polisie-aanhouding
instellings nie, en ek demonstreer dit deur die bespreking van drie ander “scenario's”
wat oor die algemeen eervaar word deur distriksgeneeshere. Daar is 'n gebrek aan duidelike riglyne vir distriksgeneeshere wat 'n botsing van
verpligtinge in die gesig staar. Ek verken verskeie etiese teorieë insluitende
konsekwensialisme, deontologie en deugde-etiek, op soek na 'n etiese raamwerk
geskik vir die oplossing van konflikte in kliniese geregtelike geneeskunde. Ek
argumenteer dus dat 'n pligsgebaseerde etiese raamwerk sentraal is tot kliniese
forensiese geneeskunde, en die resolusie van lojaliteit konflikte. Ek beveel die
oplossing van konflikte deur die gebruik van 'n benadering wat ontwikkel is deur
Benjamin (2006). Hierdie benadering behels 'n gewigsoorweging tussen die
verskillende pligte in konflik, die toepassing van filosofiese redenasie en verbetering. Deur die aanneming van 'n gestruktureerde en beredeneerde etiese raamwerk, sal
distriksgeneeshere dus in staat wees om konflikte van verpligtinge beter te hanteer.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/86537 |
| Date | 04 1900 |
| Creators | Lukhozi, Sipho Michael |
| Contributors | Horn, Lyn, Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 95 p. : ill. |
| Rights | Stellenbosch University |
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