3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Assessing litigation risks in patient-doctor interactions at Helen Joseph hospital(2017) Smith, Stephen DavidIntroduction: Medical malpractice lawsuits continue to be filed at an alarming rate, with billions of dollars being paid out across the globe. Most of these claims, defendable or not, are settled out of court. These uncontrolled medical claims continue to push up the costs of medical liability insurance, which in turn pushes up the cost of health care. These pressures are felt most by the "high risk" specialties namely, Obstetrics and Gynaecology, Neurosurgery and Orthopaedics. South Africa has not escaped the wave of medico-legal lawsuits, and may be headed towards greater challenges than its first world counterparts. With the introduction of the new Consumer Protection Act, and having one of the world's most enlightened constitutions, makes the South African medical fraternity an easy target. Litigation involving South African orthopaedic surgeons suggests that the majority of claims filed are due to poor patient-doctor interaction, accounting for 13.35% of all claims. Methodology: A prospective study conducted at Helen Joseph Hospital 2014. Using a tailored patient satisfaction questionnaire, post operative orthopaedic patients were able to give insight into their satisfaction regarding their personal patient-doctor interactions. Each question was correlated to an area of patient-doctor interaction, that in the past had led to litigation. This was used to asses which areas of patient-doctor interactions were lacking in a typical resource starved state hospital. Results: Nearly 20% of patients are considering legal action at point of discharge, with no demographic data playing any significant role in this decision. All areas of patient-doctor interactions showed a significantly lower score, in those considering litigation versus those who were not. The two highest risk areas were related to doctor availability and consent taking. This study emphasizes the importance of proper communication between doctors and patients in preventing litigation, and the need for doctors to focus on improving their individual doctor-patient relationships.Item Litigation and radiology: medicolegal cases involving diagnostic radiology in South Africa(2015-03-27) Segwe, AobakweINTRODUCTION: Litigation may involve radiology personnel radiological reports and imaging studies as evidence and therefore influences clinical practice. Litigation is implicated in defensive radiology practices. There are no publications addressing litigation and radiology specifically for South Africa. AIM: To determine the number of legal cases involving radiological personnel and radiological investigations in South Africa and frequency of citing of these within the law reports. METHOD: The search engine attached to The Southern African Legal Information Institute (SAFLII) website was searched systematically for the period 2001 to 2010 with keywords relating to radiologists, radiographers and equipment / imaging modalities using a frequency ‘citation’ score. RESULTS: 114 legal cases involving radiological personnel and radiological investigations in South Africa were identified (0.5% of all cases reported). Few radiologists have been sued in medicolegal lawsuits, but nearly a quarter of all radiology medicolegal reports, involved radiologists providing expert opinion and reports. In addition to being the commonest imaging investigation to feature in medicolegal reports (in over two thirds), plain X-rays also had the highest citation scores. CONCLUSIONS: Very few radiologists have been the accused in medicolegal suits, yet radiologists were involved in nearly a quarter of reports, predominantly providing expert opinion and reports. Plain X-rays were the commonest imaging investigation to feature but CT scanning featured in 20% of reports. This is of particular concern because this is considered an advanced technology, not widely available in South Africa.Item Stained judgments, tarnished judges, tainted desire: The rhetoric of sexual orientation in South African judgments 1926-1999(2008-03-18T09:12:01Z) Montgomery, John HenryAbstract This is a study of law and language; in particular an investigation into the language of judgments. The focus is on judgments as texts authored by judges. The main thinkers chosen as the theoretical basis are not experts in law – Michel Foucault, Mikhail Bakhtin, Norman Fairclough and Hayden White, for example. The reason for this choice is to consider the language of law from insights outside of law. Topics such as rhetoric, narrative, critical discourse analysis, intertextuality, interpretive communities, the monologic voice, oppositional reading, and power relations are seldom found in mainstream legal literature. The position taken is that judgments are texts which are no more privileged (simply because they are legal texts) than any others that a society creates. However, judgments are viewed by some as being special societal texts, coated with a patina of mystique because they are dealing with inviolate legal principles. The patina is removed enough to suggest that judges use various linguistic processes to shape their judgments in ways no different from other authors, notwithstanding that they are writing about ‘the law’. Judges are rhetoricians who use rhetoric to shape the facts, choose the most expedient legal principle, and incorporate views of society expedient to their opinion. The thrust of this study is to locate rhetoric at work within a specific sphere. The corpus consists of forty-four cases over a seventy-five year period dealing with sexual orientation. This area of law was chosen for a number of reasons. It is self-contained and lends itself to detailed examination. The topic is emotive which means more rhetorical techniques are at play than in a fairly technical area of law. There have been significant changes in the way sexual orientation has been treated in law over the years. It is interesting to trace how rhetoric facilitated that change. Lastly, we see how a judicial hegemony deals with an apolitical, splintered minority. Any categorical conclusions are impossible in an exploration of this kind. The findings, however, indicate that judges are not as restricted as is generally considered and that their judgments are shaped by employing linguistic techniques available to writers of both fact and fiction. The intention is to provide a fresh way of reading judgments, where observations gleaned in one area can be applied to other areas of law.