A. Dhai - Academia.edu (original) (raw)

Papers by A. Dhai

South African Journal of Science, 2019

South African Journal of Bioethics and Law, Dec 19, 2023

South African Journal of Bioethics and Law

Submitted in fulfilment of the degree of Doctor of Philosophy (PhD) in Bioethics and Health Law, ... more Submitted in fulfilment of the degree of Doctor of Philosophy (PhD) in Bioethics and Health Law, Steve Biko Centre for Bioethics, University of the Witwatersrand. Johannesburg, November 2014

Best Practice & Research Clinical Obstetrics & Gynaecology, 2013

Australian and New Zealand Journal of Public Health, 2012

South African Journal of Bioethics and Law

South African Journal of Bioethics and Law, 2020

Managed healthcare has become the cornerstone of health service delivery in the private sector in... more Managed healthcare has become the cornerstone of health service delivery in the private sector in South Africa and the world over. As a result, managed care organizations and medical aid schemes have had to draw up recommended treatment protocols in accordance with the rules and regulations of the Council for Medical Schemes (CMS). T he protocols are rigid, do not always consider each case on its own merit and do not always benefit the members of the respective schemes . The purpose of the protocols is to determine which treatment options constitute essential medical care, costeffective treatment and which ones do not. The article examines the fiduciary duties of the medical aids and the existing relationship between the managed healthcare company and the members in a trustee-beneficiary duty of loyalty.

South African Journal of Bioethics and Law, 2015

This article is a second article emanating from a larger study titled: Reflecting on professional... more This article is a second article emanating from a larger study titled: Reflecting on professionalism: An analysis of Bachelor of Clinical Medical Practice (BCMP) students' portfolios during clinical rotations. An article is already published as open access by BMC: Medical Education. [1] The aim of this article is to report on the experiences of professionalism as reflected on by final year BCMP students' during clinical rotations. The professional standards expected of individuals who commit to the practice of medicine require that they possess character traits that are consistent with and reflect the core values, principles and competencies of the medical profession. [2] As medicine is no longer considered only as a profession par excellence, the humanistic element is critical in the development of a professional identity. [3] Health sciences students are not yet professionals, but rather are professionals in training, and should be trained in the same environment in which they will practise. [4] As today's healthcare provision is patientcentred, the requirement to maintain professional standards must be facilitated and modelled in the training environment to simulate a real setting, maintained and sustained in all heathcare facilities for the good of the patient. [5] This exposure allows students to meet the expectations of their patients and also be afforded an opportunity to simulate professional behaviour that is modelled on the conduct of their supervisors in the clinical setting. [6,7] This understanding of the attainment of professionalism not as an event but rather as a process obligates both the academic and the clinical environment to engage students in the attainment of a sound and professional ethic that will benefit patients and society. [5] Further to this, universities are required to meet the standards of professional education and training as prescribed by the Health Professions Council of South Africa (HPCSA) and prepare students for professional practice. [8] This was true for the BCMP programme which accepted its first cohort of students at the University of the Witwatersrand (Wits) in January 2009. [1] With a unique and integrated curriculum, the students are based in District Education Campuses in urban and/or underserved facilities in Gauteng or in rural facilities in the North West Province. On completion of their studies, these healthcare practitioners are known as Clinical Associates and are based in district hospitals where they work under the supervision of a family physician. [1] Contextual attributes of professionalism-also referred to as core elements by the HPCSA-are attributes or domains that constitute a spectrum of behaviours that should be exhibited by all categories of healthcare practitioners (HCPs) at the end of the training period. [10] They are the desired qualities in any doctor-patient relationship that need to be displayed in the contexts in which they practise and are associated with the physician as a healer in society. [5,6] In this study, the contextual attributes were assessed in terms of the thirteen core values of professionalism as described by the HPCSA, namely: respect for persons; beneficence; non-maleficence; human rights; autonomy; integrity; truthfulness; confidentiality; compassion; tolerance; justice; professional competence and selfimprovement, and community. [10] Methods Hatem's [9] definition of professionalism (Box 1) adopted as a working definition for the BCMP programme was the stimulus that

South African Journal of Science, 2018

South African Medical Journal, 2017

This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) have had a ... more The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) have had a considerable impact on society.1 South Africa has an estimated 5.7 million adults and children living with HIV, and an estimated 350 000 AIDS-related deaths in 2007.2 The initial focus of risk in the medical setting was on health care workers (HCWs) (and surgeons in particular),3 but the emergence of HIV-positive HCWs resulted in concerns that also included patient safety. The perceived risk to patients appeared to have been overstated, especially in view of the advent of antiretrovirals that reduce viral load and infectivity.4 Following initial reports of HCW-to-patient HIV transmission, the Centers for Disease Control and Prevention (CDC) issued guidelines in 1991 for HIV-positive HCWs. These guidelines, specific to the prevention of transmission of HIV and hepatitis B virus,5 were criticised for numerous reasons, not least of which was that they seemed to discriminate against practiti...

Human biological material (HBM) is an invaluable resource in biomedical research. Although resear... more Human biological material (HBM) is an invaluable resource in biomedical research. Although research ethics committees (RECs) are guided by international guidelines and frameworks, some RECs might not be fully informed about local ethical and regulatory requirements regarding the use, collection, storage, ownership, transfer and benefit-sharing of HBM in collaborative research.

OBJECTIVES The HIV status of surgeons, in the context of the informed consent obtained from their... more OBJECTIVES The HIV status of surgeons, in the context of the informed consent obtained from their patients, is a contentious matter. We surveyed the views of practising surgeons in South Africa regarding aspects of HIV and its impact on surgeons. DESIGN A cross-sectional survey of surgeons who were members of the Association of Surgeons of South Africa, regarding their attitudes to the preceding issues. RESULTS The salient findings included the view that a patient-centered approach requiring HIV status disclosure to patients would be discriminatory to surgeons and provide no clear benefit to patients, and that HIV-positive surgeons should determine their own scope of practice. CONCLUSION Patient-centered approaches and restrictive policies, related to this issue, do not accord with clinician sentiment. In the absence of comparable local or international data, this study provides clinicians' views with implications for the development of locally relevant policies and guidelines.