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Three broad categories of ethics exist:

Three broad categories of ethics exist:. THEORIES. Libertarian theory Communitarian theory Egalitarian theories (Deontology) Consequentialism (Utilitarianism) Principilism. PRINCIPILISM. AUTONOMY. Autonomy = Greek autos (self) and nomos (rule)

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Three broad categories of ethics exist:

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  1. Three broad categories of ethics exist: 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  2. THEORIES Libertarian theory Communitarian theory Egalitarian theories (Deontology) Consequentialism (Utilitarianism) Principilism 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  3. PRINCIPILISM 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  4. AUTONOMY Autonomy = Greek autos (self) and nomos (rule) The argument of autonomy Kantian philosophy (_________) Immanuel Kant, all persons have unconditional worth, the capacity to determine their moral destiny and individual rights 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  5. BENEFICENCE General desire for the good of others, and disposition to act so as to further that good. The obligation to give benefit, to prevent and remove harm, and to weigh and balance an action’s possible good against its cost and possible harm. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  6. NON-MALEFICENCE Primum non nocere First, do no harm 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  7. JUSTICE Allocation of limited resources and setting possible priorities. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  8. NEGLIGENCE The Concept of Negligence • Negligence refers to the blameworthy attitude or conduct of someone who has acted wrongfully. • The blameworthiness is to be found therein that on account of carelessness, thoughtlessness or imprudence the person failed to adhere to the standard of care legally required of him. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  9. REASONABLE PERSON In the case of an expert, such as a health care professional, negligence is established by finding an answer to the question how areasonable expert (reasonable person) would have acted in the same circumstances. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  10. Proof of Negligence The ordinary rule concerning the burden of proof is that such burden rests with the plaintiff. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  11. Vicarious (Indirect) Liability The principle of indirect or vicarious liability, that is liability for the wrongful act of another by virtue of the doctrine of respondeat superior, is well established in the modern law of delict. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  12. Vicarious (Indirect) Liability First, a person can be held delictually liable if he ordered or authorised another to commit a wrongful act. A health care professional who instructed his professional assistant to perform an unlawful operation cannot later seek refuge in the excuse that he did not perform the operation/give the medication with his own hands. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  13. EMPLOYEE-EMPLOYER A relationship of employment whereby one person (employer) stands in a position of authority vis-a-vis another (employee) in terms of which the former is legally capable of exercising control over the latter's actions. Partners do not stand in such a relationship: by law they are equals 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  14. VICARIOUS LIABILITY A person is not vicariously liable, however, for the wrongful act of an independent contractor engaged by him. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  15. Unprofessional conduct ``Unprofessional conduct'' is defined in the Health Professions Act 56 of 1974 as ``improper or disgraceful or dishonourable or unworthy conduct which, when regard is bad to the profession of a person who is registered in terms of the Act, is improper or disgraceful or dishonourable or unworthy''. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  16. PROFESSIONAL BOARDS A professional board has the power to institute an inquiry into any complaint, charge or allegation of unprofessional conduct against persons registered under the Act. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  17. PROFESSIONAL BOARDS Professional conduct committees are also known as ``disciplinary committees'' 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  18. PENALTIES A professional board may, where a professional practitioner is found guilty of unprofessional conduct, impose one of the following penalties: (1) a caution or reprimand, or a reprimand and caution (2) suspension for a specified period from practising or performing acts specially pertaining to a practitioner's profession (3) removal of a practitioner's name from the register (4) a fine not exceeding R10 000 (5) a compulsory period of COMMUNITY service (6) payment of the costs of the proceedings or a restitution 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  19. Restrictions on impaired students or practitioners ``Impaired'' means ``a mental or physical condition, or the abuse of or dependence on chemical substances, which affects the competence, attitude, judgment or performance of a student or person registered in terms of [the] Act''. Suspension / removal (even during investigation) 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  20. THE PATIENTS’ RIGHTS CHARTER The right of access to health care services as guaranteed in the Constitution (section ??????) 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  21. THE PATIENTS’ RIGHTS CHARTER This Charter is subject to the provisions of any law operating within the Republic of South Africa and to the financial means of the country. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  22. THE PATIENTS’ RIGHTS CHARTER A healthy and safe environment • Everyone has the right to a healthy and safe environment that will ensure their physical and mental health or well-being, including adequate water supply, sanitation and waste disposal as well as protection from all forms of environmental danger, such as pollution, ecological degradation or infection. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  23. THE PATIENTS’ RIGHTS CHARTER Participation in decision-making • Every citizen has the right to participate in the development of health policies and everyone has the right to participate in decision-making on matters affecting one’s health. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  24. THE PATIENTS’ RIGHTS CHARTER Access to healthcare Everyone has the right of access to health care services that include: • receiving timely emergency care at any health care facility that is open regardless of one's ability to pay; • treatment and rehabilitation that must be made known to the patient to enable the patient to understand such treatment or rehabilitation and the consequences thereof; provision for special needs in the case of newborn infants, children, pregnant women, the aged, disabled persons, patients in pain, person living with HIV or AIDS patients; 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  25. THE PATIENTS’ RIGHTS CHARTER Access to healthcare Everyone has the right of access to health care services that include: • counselling without discrimination, coercion or violence on matters such as reproductive health, cancer or HIV/AIDS; • palliative care that is affordable and effective in cases of incurable or terminal illness; • a positive disposition displayed by health care providers that demonstrate courtesy, human dignity, patience, empathy and tolerance; and • health information that includes the availability of health services and how best to use such services and such information shall be in the language understood by the patient. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  26. THE PATIENTS’ RIGHTS CHARTER Knowledge of one’s health insurance / medical aid scheme • A member of a health insurance or medical aid scheme is entitled to information about that insurance or medical aid scheme and to challenge, where necessary, the decisions of such health insurance or medical aid scheme relating to the member. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  27. THE PATIENTS’ RIGHTS CHARTER Choice of health services • Everyone has the right to choose a particular health care provider for services or a particular health facility for treatment provided that such choice shall not be contrary to the ethical standards applicable to such health care providers or facilities, and the choice of facilities in line with prescribed service delivery guide lines. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  28. THE PATIENTS’ RIGHTS CHARTER Be treated by a named health care provider • Everyone has the right to know the person that is providing health care and therefore must be attended to by clearly identified health care providers. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  29. THE PATIENTS’ RIGHTS CHARTER Confidentiality and privacy • Information concerning one’s health, including information concerning treatment may only be disclosed with informed consent, except when required in terms of any law or an order of the court.

  30. THE PATIENTS’ RIGHTS CHARTER Informed consent • Everyone has the right to be given full and accurate information about the nature of one’s illnesses, diagnostic procedures, the proposed treatment and the costs involved, for one to make a decision that affects anyone of these elements. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  31. THE PATIENTS’ RIGHTS CHARTER Refusal of treatment • A person may refuse treatment and such refusal shall be verbal or in writing provided that such refusal does not endanger the health of others. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  32. THE PATIENTS’ RIGHTS CHARTER Be referred for a second opinion • Everyone has the right to be referred for a second opinion on request to a health provider of one’s choice.

  33. THE PATIENTS’ RIGHTS CHARTER Continuity of care • No one shall be abandoned by a health care professional worker or a health facility which initially took responsibility for one’s health. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  34. THE PATIENTS’ RIGHTS CHARTER Complain about health services • Everyone has the right to complain about health care services and to have such complaints investigated and to receive a full response on such investigation. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

  35. PATIENT’S RESPONSIBILITY Every patient or client has the following responsibilities: • to advise the health care providers on his or her wishes with regard to his or her death. • to comply with the prescribed treatment or rehabilitation procedures. • to enquire about the related costs of treatment and/or rehabilitation and to arrange for payment. • to take care of health records in his or her possession. • to take care of his or her health. • to care for and protect the environment. • to respect the rights of other patients and health providers. • to utilise the health care system properly and not abuse it. • to know his or her local health services and what they offer. • to provide health care providers with the relevant and accurate information for diagnostic, treatment, rehabilitation or counselling purposes. 2009 ETHICS AND JURISPRUDENCE Dr N Nortje

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