A proposed framework for the legal protection of premature and critically-ill neonates in the context of South African child law
| dc.contributor.advisor | Oosthuizen, H. | |
| dc.contributor.advisor | Verschoor, T. | |
| dc.contributor.advisor | Kruger, J. M. | |
| dc.contributor.author | Van der Westhuizen, Catharina Susanna | |
| dc.date.accessioned | 2016-01-07T09:31:32Z | |
| dc.date.available | 2016-01-07T09:31:32Z | |
| dc.date.issued | 2012-07 | |
| dc.description.abstract | English: Until relatively recently extremely premature babies and critically-ill neonates would not have survived because medical science was insufficiently advanced to save them. Infanticide was a common practice among the Greeks and Romans as a form of birth control and a means of disposing of malformed offspring. Certain indigenous South African tribes also committed infanticide to rid society of deformed infants. Gradually the law came to take a stricter view of infanticide, and with the rise of Christianity it was regarded as murder. The advancement in medical technology, skills and expertise increased the need to take account of biomedical ethics, since this is the framework within which critical care decisions should be made. The principal ethical theories, namely deontology, utilitarianism and virtue ethics, are discussed, as well as the principles of biomedical ethics, namely beneficence, non-maleficence, autonomy and justice. Since actions for wrongful life and wrongful birth also touch on the sanctity of life and quality of life principle, these aspects are briefly discussed. Various international human rights instruments not only guarantee the right to life, but also prescribe a high standard of health care to member states. The right of access to health care, the right to emergency medical treatment and the best interests of the child are entrenched in the Constitution of the Republic of South Africa, 1996. The best interests of the child are of paramount importance in all matters concerning the child and this concept runs like a golden thread through all cases in which children’s rights are considered. In terms of the National Health Act 61 of 2003, free health services are offered to children below the age of six years. Section 129 of the Children’s Act 38 of 2005 specifically deals with medical treatment of children, while section 11 deals with children with disabilities and chronic illnesses. A legal comparative study was undertaken in which the legal position in England and Wales, as well as that of the Netherlands, was considered in order to formulate a framework of legislation for the protection of premature babies and critically-ill neonates. The position in England and Wales can best be determined by studying the judgments delivered in court cases. A comprehensive report, “Critical care decisions in fetal and neonatal medicine: ethical issues”, was compiled by the Nuffield Council on Bioethics. This report was drafted by a multi-disciplinary working party and provides guidelines regarding the medical treatment of neonates. In the Netherlands euthanasia is legal, but then the person requesting it must be above the age of sixteen years. Since neonates cannot request euthanasia, the preferred term is “end-of-life decisions”. The Groningen Protocol was drafted by paediatricians assisted by the public prosecutor coroner to prevent a physician from being criminally prosecuted if the guidelines in the Protocol are adhered to in the case of end-of-life decisions. In the thesis three recommendations are made: Guidelines that would be suitable for South African conditions should be drafted by a multidisciplinary team along the lines of the Nuffield Council on Bioethics. When cases concerning whether treatment should be withheld or withdrawn reach a South African court, it is recommended that the cases adjudicated in England and Wales be used as a precedent. It is recommended that mediation be considered as an option when there is disagreement regarding the treatment of critically-ill neonates between health care professionals and parents, or between parents. Since the High Court is the upper guardian of all minors, the outcome of the mediation should be made an order of court. | en_ZA |
| dc.description.abstract | Afrikaans: Tot redelik onlangs sou uiters premature babas en kritiek-siek neonate nie kon oorleef nie, weens ʼn gebrek aan mediese kennis. Kindermoord was ʼn algemene praktyk onder die Grieke en Romeine. Dit is gedoen as ʼn vorm van geboortebeperking en om die samelewing van wanskape kinders te verlos. Om dieselfde rede het sekere inheemse Suid- Afrikaanse stamme ook kindermoord gepleeg Die reg het geleidelik meer onsimpatiek teenoor kindermoord geword, en met die opkoms van die Christendom, is dit as moord beskou. Die tegnologiese vooruitgang op mediese gebied, noodsaak die oorweging van biomediese etiek, aangesien dit die raamwerk waarbinne kritiese sorg-besluite geneem moet word, voorsien. Die vernaamste etiese teorieë, naamlik, reëlgebaseerde etiek, utilisme en deugetiek word bespreek, sowel as die beginsels van biomediese etiek, naamlik om goed te doen, om nie skade te doen nie, outonomie en regverdigheid. Aangesien aksies vir “ongeoorloofde lewe” en “ongeoorloofde geboorte” raakpunte met die “heiligheid van lewe” en “kwaliteit van lewe” beginsels het, word hierdie aksies ook kortliks bespreek. Verskeie internasionale menseregte handveste waarborg nie alleen die reg op lewe nie, maar skryf ook ʼn hoë standaard van gesondheidsorg aan lidlande voor. Dit is opgeneem in die Millennium Ontwikkelingsdoelwitte nommer 4, wat die afname in die getal kindersterftes as doelwit het. Die reg van toegang tot gesondheidsorg, die reg op geneeskundige noodbehandeling en die beste belang van die kind word beskerm in die Grondwet van die Republiek van Suid-Afrika, 1996. Die beste belang van die kind is van die uiterste belang in alle sake rakende die kind en dit loop soos ʼn goue draad deur sake waarin kinderregte ter sprake is. Ingevolge die National Health Act 61 van 2003 moet gratis mediese behandeling aan kinders onder die ouderdom van ses jaar verskaf word. Artikel 129 van die Children’s Act behandel die mediese behandeling van kinders, terwyl artikel 11 handel oor gestremde kinders, asook kinders wat aan chroniese siektes ly. ’n Regsvergelykende studie is onderneem waarin daar oorweging geskenk is aan die regsposisie in Engeland en Wallis, sowel as die regsposisie in Nederland, sodat ʼn raamwerk vir die beskerming van premature babas en kritiek-siek neonate voorgestel kan word. Die regsposisie in Engeland en Wallis blyk uit hofbeslissings oor die onderwerp. Die Nuffield Council on Bioethics het ʼn baie omvattende verslag getiteld, “Critical care decisions in fetal and neonatal medicine: ethical issues” opgestel. Hierdie verslag is deur ʼn multidissiplinêre komitee saamgestel en verskaf riglyne oor die mediese behandeling van neonate. In Nederland is eutanasie wettig, op voorwaarde dat die persoon wat dit versoek, ouer as sestien jaar moet wees. Dit beteken dat neonate nie kan kwalifiseer vir eutanasie nie, maar die term wat in hulle geval gebruik word, is einde-van-lewe besluite. Die Groningen Protokol is deur pediaters, in samewerking met die staatsaanklaer opgestel. Die oogmerk van hierdie Protokol is om te verhoed dat ʼn dokter strafregtelik vervolg word, in die geval van einde-van-lewe besluite indien daar aan die riglyne in die Protokol voldoen word. In die tesis word drie aanbevelings gemaak: Daar behoort riglyne deur ʼn multidissiplinêre komitee opgestel word. Die voorbeeld van die Nuffield Council on Bioethics behoort gebruik te word, maar die riglyne moet spesifiek toepaslik vir Suid- Afrikaanse omstandighede wees. Daar word aanbeveel dat indien sake of mediese behandeling weerhou of gestaak moet word, die sake wat in Engeland en Wallis beslis is, as presedent gebruik word. Mediasie moet oorweeg word in gevalle waar daar ʼn dispuut tussen mediese praktisyns en ouers, of tussen ouers is, rakende die mediese behandeling van neonate. Aangesien die hoë hof die oppervoog van alle minderjariges in Suid-Afrika is, moet die uiteinde van die mediasie ʼn bevel van die hof gemaak word. | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11660/2038 | |
| dc.language.iso | en | en_ZA |
| dc.publisher | University of the Free State | en_ZA |
| dc.rights.holder | University of the Free State | en_ZA |
| dc.subject | Thesis (LL.D. (Criminal and Medical Law))--University of the Free State, 2012 | en_ZA |
| dc.subject | Newborn infants -- Legal status, laws, etc. -- South Africa | en_ZA |
| dc.subject | Infanticide | en_ZA |
| dc.subject | Newborn infants -- Medical care | en_ZA |
| dc.subject | Children (International law) | en_ZA |
| dc.subject | Informed consent (Medical law) | en_ZA |
| dc.subject | Children's rights | en_ZA |
| dc.title | A proposed framework for the legal protection of premature and critically-ill neonates in the context of South African child law | en_ZA |
| dc.type | Thesis | en_ZA |