Thesis (M.Phil.)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: AIDS is the most important threat to world health. Recent years have seen a dramatic
spread of HIVand AIDS in South Africa. Health education directed at modifying risk
behaviour appears to be the only way in which the disease can be contained. Controlling
AIDS is not only by controlling the virus, but also involves tackling social, economic and
political issues and putting AIDS into the broader context of sexuality and gender roles.
This requires a broader understanding of this aspect of HIV-AIDS ranging from
population dynamics, through to research on individual behaviour and its socio-economic
impact; so that we can dispel the myths and rumours that surround AIDS and answer
searching questions that will be asked by the community.
In South Africa, HIV-AIDS remains a stigmatized disease. There have been calls from
courageous and influential people for those who are living with HIV-AIDS to be open
about their status and to destigmatise the disease. Institutions too have been drawn into
the controversy about whether to remain silent or speak out. Southern African Anglican
bishops, as well as some politicians declared their intention to undergo testing for HIV
status in order to sensitise the public to the seriousness of the epidemic.
Were AIDS not regarded as intolerable, the entire issue of confidentiality would fall
away. Calls to destigmatise the disease through openness cannot stand alone.
Government must put effective treatment programmes in place. In the absence of
treatment, AIDS may represent only frustration and hopelessness to those who test
positive; and fear, danger and resultant animosity to those who are HIV negative.
The text is in four chapters. Chapter 1 focuses on confidentiality as an important
principle in the management of disease. In HIV -AIDS, confidentiality is a more sensitive
issue as AIDS is particularly viewed as a social stigma, accompanied by discrimination
and harassment. The chapter also addresses HIV infection, transmission, counseling and
screemng.
Chapter 2 deals with the principles of biomedical ethics namely, autonomy, to enable the
patient to determine his/her course of treatment; informed consent, designed to protect
the interests of patients from exploitation and harm, and encourage health professionals
to act responsibly; beneficence and nonmaleficence, to protect the welfare of others; and
justice, to ensure access to health care for all. It also highlights the aspects
of and limitations to confidentiality.
Chapter 3 discusses broadly the ethical dilemmas pertammg to professional-patient
relationships, women and HIV-AIDS, religion, prisoners and employer-employee
relationships. When the AIDS epidemic started, very few people suffered from the
disease, and the disease was treated with great caution and confidentiality. Today, AIDS
is a pandemic and emphasis should shift from the ethic of autonomy and confidentiality,
to a social ethic, which emphasizes the responsibility of minimizing the risk of spread of
infection. The chapter also examines the role of the Department of Health, the
participation of health professional bodies and the legal aspects relating to confidentiality
in HIV-AIDS.
Chapter 4 attempts to construct an argument to destigmatise HIV-AIDS by arguing the
responsibility of the government to make sufficient resources available for the treatment
and control of the pandemic. Health professionals are challenged to engage their
expertise and skills in the service of the sick with dignity and respect. The community is
encouraged to support the drive towards controlling the spread of HIV infection and
enable people living with AIDS to disclose their status without fear of harassment. / AFRIKAANSE OPSOMMING: Vigs is die gevaarlikste bedreiging van wéreldgesondheid. Die afgelope paar jaar het 'n
dramatiese verspreiding van mv en VIGS in Suid-Afrika plaasgevind.
Gesondheidsopvoeding wat gemik is op die verandering van risiko-gedrag is skynbaar
die enigste metode wat die siekte kan beheer. Die kontrolering van VIGS is nie net die
kontrolering van die virus nie, maar dit betref ook herbesinning oor sosiale, ekonomiese
en politiese en geslagsrolle. Dit vereis 'n omvattender verstaan van hierdie aspek van
HIV-VIGS, wat strek vanaf van bevolkingspatrone tot by die navorsing oor individuele
gedrag en die sosio-ekonomiese impak van 19. So kan ons hopelik help om die mites
rondom VIGS te besweer.
In Suid-Afrika bly mV-VIGS 'n gestigmatiseerde siekte. Daar rus 'n
veranbtwoordelikheid op invloedryke mense wat met mV-VIGS leef en wat as
rolmodelle sou kon dien, om hul mv -status te openbaar en sodoeonde te help om die
siekte te destigmatiseer. Instansies is ook by hierdie twispunt betrek om vas te stelof die
mense moet praat of swyg. Suider-Afrikaanse Anglikaanse Biskoppe, asook somige
politici het hulle intensies aangekondig om die mv -toets te ondergaan om sodoende die
publiek te help opvoed oor die gevaar van hierdie epidemie.
Oproepe om die siekte te destigmatiseer deur openbaarheid kan nie in isolasie
funksioneer nie. Die staat moet effektiewe kuratiewe en voorkomingsprogramme hier
rondom loods en kontinueer. In die afwesigheid van 'n geneesmiddel, sal VIGS slegs
frustrasie, hopeloosheid, en vrees skep by diegene wat positief getoets is, sowel as
vyandigheid onder diegene wat nie mv positief is nie.
Die teks het vier hoofstukke. Hoofstuk 1 fokus op vertroulikheid as 'n belangrike
beginsel in die bestuur van die siekte. In mV-VIGS is vertroulikheid 'n meer sensitiewe
beginsel aangesien VIGS in die besonder as 'n sosiale skandvlek, aangevreet deur
diskriminasie, gesien word. Die hoofstuk bespreek ook mv -infeksie, transmissie,
raadgewing en toetsing.
Hoofstuk 2 gaan oor die beginsels van die biomediese etiek, naamlik, outonomie,
waaronder ingeligte toetstemming, ontwerp om die belange van die pasiente te beskerm
teen eksploitasie en gevaar: om gesondheids professionele aan te moedig om hulle op 'n
verantwoordelike manier te gedra. Ander beginsels is goedwilligheid en niekwaadwiligheid
om die welsyn van ander te beskerm, asook geregtigheid, om toegang tot
gesondheidshulp vir almal te verseker. Dit beklemtoon ook die aspekte verwant aan
beperkinge tot vertroulikheid.
Hoofstuk 3 bespreek breedweg die etiese dilemmas met betrekking tot die verhouding
tussen pasiënye en professionele gesondheidswerkers, vrouens en mV-VIGS, godsdiens,
gevangenes en werkgewer-werker verhoudings. Toe die VIGS-epidemie begin het, het min mense aan die siekte gely, en die siekte is met groot sorg en vertroulikheid behandel.
Vandag is VIGS 'n pandemie en die klem moet geskuif word vanaf outonomie en
vetrouilikheid na 'n sosiale etos wat verantwoordlikheid en die vermindering van die
risiko van die verspreiding van die infeksie beklemtoon. Die hoofstuk kyk ook na die
rolle van gesondheidsdepartmente, deelname van gesondheids professionele organisasies
en die juridiese aspekte met betrekking tot vertroulikheid van HIV-VIGS.
Hoofstuk 4 poog om 'n argument te ontwikkel wat daartoe sou kon bydra dat HIV-VIGS
gedestigmatiseer sal word. Klem word gelê op die verabtwoordelikheid van die staat om
soveel moontlike bronne beskikbaar te stel vir die behandeling van en beheer oor hierdie
pandemie. Gesondheids professionele word uitgedaag om hulle deskundigheid en
bekwaamheid in die diens van die siekes met waardigheid en respek te gebruik. Die
gemeenskap word aangemoedig om die poging tot die beheer van die verspreiding van
die HIV -infeksie te ondersteun en om die mense wat met VIGS leef in staat te stelom hul
status sonder die dreigement van stigmatisering bekend te maak.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/51663 |
| Date | 12 1900 |
| Creators | Mkosi, Barbara Nomsa |
| Contributors | Van Niekerk, A. A., 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 | 66 p. |
| Rights | Stellenbosch University |
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