Access to health care in South Africa: an ethical and human rights obligation

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dc.contributor.author Meyer, Ellenore Dorette
dc.date.accessioned 2010-10-15T09:53:53Z
dc.date.available 2010-10-15T09:53:53Z
dc.date.issued 2010-10-15
dc.identifier.uri http://hdl.handle.net/10539/8832
dc.description MSc (Med), (Bioethics and Health Law), Faculty of Health Sciences, University of the Witwatersrand en_US
dc.description.abstract Access to health care is a constitutionally recognized right, under section 27 of the South African Constitution. Fifteen years post the first democratic election in South Africa the realization of this right is the focus of this research report. In 1997 the South African Human Rights Commission (SAHRC), a statutory body assigned to evaluate the realization of access to health care, held a public enquiry into the matter. The report was released in early 2009. The public health care system was found to be in a „lamentable state‟. South Africa faces a number of challenges that complicate the progressive realization of access to health care . For example, the country is currently in recession; the HIV / AIDS statistics is among the highest in the world placing a huge burden on public health; South Africa has the highest income inequality globally and the gap between public and private health care, with regards to affordability and quality of service remains a great concern. A way of addressing this problem is to engage ethical principles such as beneficence, non-maleficence, autonomy and (distributive) justice. Each of these in application can argue a case for the moral obligation to initiate a more effective national health care system. Rawls1 (1999) emphasized the centrality of justice in consideration of the bio-medical principles. 1 Rawls, J. 1999. A Theory of Justice. Revised edition. Cambridge, Mass.: Harvard University Press., 1971. Oxford: Clarendon Press, 1972. The principle of justice and its derivative, distributive justice, is of importance when making a moral argument for equal access to health care for all. Farmer and Campos (2004:28) rightly asks2: “What does it mean, for both bioethics and human rights, when a person living in poverty is able to vote, is protected from torture or from imprisonment without due process, but dies of untreated AIDS? What does it mean when a person with renal failure experiences no abuse of his or her civil and political rights, but dies without ever having been offered access to dialysis, to say nothing of transplant?” There is a need for ethicists to become more involved in arguments pertaining to the inequalities in distribution of social goods. Legislation and case law in South Africa also affirm the right to access health care services and have as their grounding normative ethical tenets. The recommendations made by the SAHRC, together with the planned national health insurance aimed at addressing the gap between public and private health care, can only become a reality through successful implementation of a monitored process based on ethical principles. There is a need for a practical implementation of current ethico-legal and human rights principles through every phase of the health care system to serve as monitors to ensure the success of this guaranteed right that so few people have genuinely seen realized. The findings of the SAHRC, together with the response from the Department of Health, serve as a basis for planning towards successful 2 Farmer, P. and Campos, N.G. 2004. Rethinking Medical Ethics: A view from below. In: Developing World Bioethics, 4 (1), 17-41 implementation of an equitable health service system that is of an excellent standard. To aid in this process an ethical framework could be of use to assess the policies formed along the way as well as the practical implementation thereof. This research report is an analysis of current literature and data available on access to health care in South Africa in light of human rights and ethical arguments for its provision. The aim is to reflect on the realization of greater access to health care since 1994, identifying current hampering factors in achieving this and proposing a broad set of guidelines that can be applied to the reform process already underway in South African health care. en_US
dc.language.iso en en_US
dc.subject health care en_US
dc.subject human rights en_US
dc.title Access to health care in South Africa: an ethical and human rights obligation en_US
dc.type Thesis en_US


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