Substantive equality in South African health care: the limits of law

The article considers the scope and limits of law as an instrument for facilitating equitable access to health care in South Africa. The focus is on exploring the extent to which the notion of substantive equality in access to health care services that is implicitly guaranteed by the Constitution and supported by current health care reforms, is realisable for patients seeking treatment. The article highlights the gap between the idea of substantive equality in the Constitution and the resources at the disposal of the health care sector and the country as a whole. It is submitted that though formal equality in access to health care services has been realised, substantive equality is currently unattainable, if it is attainable at all, on account of entrenched structural inequality, general poverty and a high burden of disease.     

Prescribing privacy: the uncertain role of the physician in the protection of patient privacy

Because medical records are now more comprehensive than ever before, they increasingly are being demanded for uses both inside and outside of the medical profession. Mr. Gellman contends that existing ethical and legal guidance is inadequate to aid physicians in dealing with the confidentiality issues raised when patient information is requested or demanded from them, and supports this contention by examining the dilemmas faced by physicians presented with such requests or demands. He concludes that ethical and judicial guidance will continue to be inadequate, and that the only practical way to develop suitable guidance is through legislation.     

AIDS-related risks in the health care setting: HIV testing of health care workers and patients

Do patients and health care workers have the legal right to know each other's HIV status? Professor Flanagan argues that they do not. Given that with appropriate precautions the risk of transmitting HIV in the health care setting is extremely small and that the discriminatory consequences of HIV disclosure can be extremely high, it is suggested that the right of a patient or a health care worker not to disclose their HIV status must outweigh the other's "right to know."     

Stretching the limits of "rights talk": securing health care entitlements for children

Health care rights by their very nature have to be considered not only in a traditional legal context structured around the ideas of human autonomy but in a new analytical framework based on the notion of human interdependence. "A healthy life depends upon [social] interdependence: the quality of air, water, and sanitation which the [state] maintains for the public good; the quality of one's caring relationships, which are highly correlated to health; [as well as] the quality of health care and support furnished officially by medical institutions and provided informally by family, friends, [and the community]."     

Stretching the limits of "rights talk": securing health care entitlements for children

Health care rights by their very nature have to be considered not only in a traditional legal context structured around the ideas of human autonomy but in a new analytical framework based on the notion of human interdependence. "A healthy life depends upon [social] interdependence: the quality of air, water, and sanitation which the [state] maintains for the public good; the quality of one's caring relationships, which are highly correlated to health; [as well as] the quality of health care and support furnished officially by medical institutions and provided informally by family, friends, [and the community]."