South African Journal of Bioethics and Law
type: channel
description: SAJBL is an online, tri-annual, peer reviewed journal that covers matters related to ethics, law, human rights and related matters for the health professions.
publisher: South African Medical Association
language: en
publication name: South African Journal of Bioethics and Law
issn: 1999-7639
copyright: The SAJBL is published under an Attribution-Non Commercial International Creative Commons Attribution (CC-BY-NC 4.0) License. Under this license, authors agree to make articles available to users, without permission or fees, for any lawful, non-commercial purpose. Users may read, copy, or re-use published content as long as the author and original place of publication are properly cited. Exceptions to this license model is allowed for UKRI and research funded by organisations requiring that research be published open-access without embargo, under a CC-BY licence. As per the journals archiving policy, authors are permitted to self-archive the author-accepted manuscript (AAM) in a repository.
items: CPD
items: SAHPRA issues guidance on of Artificial Intelligence and Machine Learning-enabled medical devices
items: A little less conversation, a little more action: The crisis of statutory rape – is it the law, implementation, or culture?
items: Genocide as a bioethical crisis: Healthcare, reproduction and the findings of the UN commission of inquiry
items: Failing to protect the climate could violate international law
items: Considerations to be made in the constitution of the Health Professions Council of South Africa to commence its term in November 2025: Law v. practice law
items: https://www.samajournals.co.za/index.php/sajbl/article/view/3975
items: The National Health Research Ethics Council 2024 Guidelines – suspended in part, legally precarious in whole
items: Limpopo provincial health research committee outcomes: Implications for ethics practice and future research
items: Can we do less but care – fully?
items: Pandemics, public health and the limitation of the right to privacy: Legal compliance and public trust
items: https://www.samajournals.co.za/index.php/sajbl/article/view/3649
items: From prohibition to protection: Rethinking the ethics of non-medical preimplantation sex selection
items: The matter between the State and Professor Peter Beale
items: Denying the right to healthcare: South Africa’s unemployed doctors at the centre of this crisis
items: ‘Encore, encore!’ – secondary use of health data for research: A practical guide to POPIA
items: The cautionary tale of USAID cuts: Resources for HIV treatment and prevention programmes
items: Ensuring public safety and professional integrity: The vital role of healthcare regulators in South Africa
items: Using artificial intelligence in healthcare – some ethical and legal considerations
items: Early Online
items: In machina: A cursory consideration of artificial wombs and the South African ethico-legal landscape
items: Practical guidance in understanding the nuance of benefit sharing and what this means for South African health research ethics committees: Part 2
items: Practical guidance in understanding the nuance of benefit sharing and what this means for South African health research ethics committees: Part 1
items: Facilitating a framework for managing rare diseases in South Africa: Comparative insights from the UK and Italy
items: Advancing gender equity in HPV vaccination: A rule utilitarian case for including boys in South Africa’s national programme
items: The Universal Declaration of Bioethics and Human Rights – a provisional perspective on surrogacy introduction
items: Irregular appointment of the NHREC: Implications for legitimacy and the path forward for South Africa’s health research ethics guidelines

CPD
type: item
description: -
subject: CPD
  topic: section
creator: Claudia Naidu
rights: Copyright (c) 2025 Claudia Naidu https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-18
publication date: 2025-12-18
starting page: e4635
ending page: e4635
doi: 10.7196/

SAHPRA issues guidance on of Artificial Intelligence and Machine Learning-enabled medical devices
type: item
description: -
subject: Editorial
  topic: section
creator: A Dhai
rights: Copyright (c) 2025 A Dhai https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-18
publication date: 2025-12-18
starting page: e4634
ending page: e4634
doi: 10.7196/

A little less conversation, a little more action: The crisis of statutory rape – is it the law, implementation, or culture?
type: item
description: -
subject: Editorial
  topic: section
subject: Mandatory reporting obligations
  topic: keywords
subject: Statutory rape crisis
  topic: keywords
subject: Sexual Offences and Related Matters Act (SORMA)
  topic: keywords
subject: Adolescent vulnerability
  topic: keywords
subject: Blesser–Blessee relationships
  topic: keywords
subject: Unintended consequences of criminalisation
  topic: keywords
subject: Trauma-informed interventions
  topic: keywords
subject: Portfolio Committee public hearings
  topic: keywords
subject: Mandatory reporting obligations
  topic: subjects
subject: Statutory rape crisis
  topic: subjects
subject: Sexual Offences and Related Matters Act (SORMA)
  topic: subjects
subject: Adolescent vulnerability
  topic: subjects
subject: Blesser–Blessee relationships
  topic: subjects
subject: Unintended consequences of criminalisation
  topic: subjects
subject: Trauma-informed interventions
  topic: subjects
subject: Cultural norms and systemic barriers
  topic: subjects
subject: Portfolio Committee public hearings
  topic: subjects
subject: Ethical–legal complexities in healthcare
  topic: subjects
subject: criminal law
  topic: disciplines
subject: Health Law & Policy
  topic: disciplines
subject: Public health
  topic: disciplines
subject: Public Health Policy
  topic: disciplines
subject: Sexual Reproductive Health
  topic: disciplines
creator: S Bhamjee
creator: A Strode
creator: S Goosen
creator: Z Essack
rights: Copyright (c) 2025 S Bhamjee, A Strode, S Goosen, Z Essack https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-18
publication date: 2025-12-18
starting page: e4498
ending page: e4498
doi: 10.7196/SAJBL.2025.v18i3.4498

Genocide as a bioethical crisis: Healthcare, reproduction and the findings of the UN commission of inquiry
type: item
description: -
subject: Scientific letters/short reports
  topic: section
subject: Genocide
  topic: keywords
subject: International Law
  topic: keywords
subject: Healthcare
  topic: keywords
subject: Starvation as a Weapon
  topic: keywords
subject: Bioethics
  topic: keywords
subject: Genocide
  topic: subjects
subject: Bioethics
  topic: subjects
subject: Healthcare
  topic: subjects
subject: Reproductive Rights
  topic: subjects
subject: International law
  topic: subjects
subject: Law
  topic: disciplines
subject: Bioethics and health law
  topic: disciplines
creator: S Soni
rights: Copyright (c) 2025 S Soni https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-18
publication date: 2025-12-18
starting page: e4236
ending page: e4236
doi: 10.7196/SAJBL.2025.v18i4.4236

CPD
type: item
description: -
subject: CPD
  topic: section
creator: Claudia Naidu
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-04
publication date: 2025-09-04
doi: 10.7196/

Failing to protect the climate could violate international law
type: item
description: -
subject: Editorial
  topic: section
creator: A Dhai
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-04
publication date: 2025-09-04
starting page: e4193
ending page: e4193
doi: 10.7196/

Considerations to be made in the constitution of the Health Professions Council of South Africa to commence its term in November 2025: Law v. practice law
type: item
description: -
subject: Editorial
  topic: section
subject: Constitution, Law, Practice
  topic: keywords
subject: Appointments
  topic: subjects
subject: Designations
  topic: subjects
subject: Professional Boards
  topic: subjects
subject: the Council
  topic: subjects
subject: Law
  topic: subjects
subject: Practice
  topic: subjects
subject: Lacuna
  topic: subjects
subject: Law and Ethics
  topic: disciplines
creator: M A Kwinda
rights: Copyright (c) 2025 M A Kwinda https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-18
publication date: 2025-12-18
starting page: e4113
ending page: e4113
doi: 10.7196/SAJBL.2025.v18i3.4113

https://www.samajournals.co.za/index.php/sajbl/article/view/3975
type: item
title: Caster Semenya succeeds in an important case for athletes around the world at the European Court of Human Rights regarding the right of athletes to a fair hearing during fundamental rights disputes between themselves and their sport governing bodies
description: In the case of Semenya v Switzerland, the European Court of Human Rights held that when athletes complain to their sport’s governing bodies regarding regulations that undermine their human rights, which such bodies claim are compatible with substantive public policy, the arbitration or reviewing bodies must rigorously – and not restrictively – examine the breaches of the athletes’ fundamental rights before deciding a case. This decision should result in important changes to the governance of international sport.
subject: Correspondence
  topic: section
creator: D J McQuoid-Mason
rights: Copyright (c) 2025 D J McQuoid-Mason https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-04
publication date: 2025-09-04
starting page: e3975
ending page: e3975
doi: 10.7196/SAJBL.2025.v18i2.3975

The National Health Research Ethics Council 2024 Guidelines – suspended in part, legally precarious in whole
type: item
description: -
subject: Editorial
  topic: section
subject: appeals
  topic: keywords
subject: ASSAf
  topic: keywords
subject: benefit sharing
  topic: keywords
subject: data ownership
  topic: keywords
subject: governance
  topic: keywords
subject: health data
  topic: keywords
subject: NHREC
  topic: keywords
subject: POPIA
  topic: keywords
subject: procedural irregularity
  topic: keywords
subject: research ethics
  topic: keywords
creator: D Thaldar
rights: Copyright (c) 2025 D Thaldar https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-04
publication date: 2025-09-04
starting page: e3953
ending page: e3953
doi: 10.7196/SAJBL.2025.v18i2.3953

Limpopo provincial health research committee outcomes: Implications for ethics practice and future research
type: item
description: Background. Various institutional or organisational ethics research bodies are responsible for approving, safeguarding and monitoring strict adherence to the ethical research conduct of researchers seeking approval and conducting research, which is crucial for rational science, particularly in biomedical and allied health research involving humans. Understanding the profiles and outcomes of research submissions and reviews by ethics research bodies informs research direction and better practice. Objective. The objective of this study was to evaluate the profile, types of studies, and outcomes of research proposals submitted to the Limpopo Provincial Health Research Committee (LPHRC) of the Department of Health, Limpopo Province, South Africa, from January 2014 to July 2024. Methods. A retrospective, cross-sectional analytical study of all research proposals submitted to the LPHRC was conducted from January 2014 to July 2024. The data were analysed using descriptive statistics. Results. Of the 2 066 research proposals submitted to the LPHRC within the review period, the majority were in the years 2020 and 2022, accounting for 17.3% and 13.5%, respectively. About 30.8% were not funded, and 21% were self-funded by the researchers. Few research proposals were funded by organisations (9.7%), the government (4.0%) and companies (1.5%). Notably, 28.7% of the research proposals were rejected for various reasons, probably owing to non-compliance with LPHRC principles. About 46% of the proposals did not specify study designs. Intriguingly, infections (9.3%), mental health (8.9%), respiratory conditions including tuberculosis, and injuries and accidents, were among the least studied research areas in Limpopo Province. Conclusion. The study identified critical areas needing improvement in research practices, particularly concerning incomplete information on submissions to the LPHREC. Research focusing on national health research priorities, and particularly mental health, warra…
subject: Research Articles
  topic: section
subject: Research proposal, profiles, research outcomes, Health Research Ethics Committee.
  topic: keywords
subject: Ethics
  topic: subjects
subject: Health
  topic: disciplines
creator: L Muthelo
creator: J Ramalivhana
creator: S Matlala
creator: M Kharivhe
creator: N Muvhango
creator: T Tshitangani
creator: T Malatji
creator: M Sono
creator: K Netshisaulu
creator: C Nesamvuni
creator: D Goon
creator: M Ngwenya
creator: P Mabotha
creator: O Segura Sardiñas
creator: M Masilela
rights: Copyright (c) 2025 L Muthelo, J Ramalivhana, S Matlala, M Kharivhe, N Muvhango, T Tshitangani, T Malatji, M Sono, K Netshisaulu, C Nesamvuni , D Goon, M Ngwenya, P Mabotha, O Segura Sardiñas, M Masilela https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-18
publication date: 2025-12-18
starting page: e3663
ending page: e3663
doi: 10.7196/SAJBL.2025.v18i3.3663

Can we do less but care – fully?
type: item
description: -
subject: Opinion
  topic: section
subject: Moral distress
  topic: keywords
subject: Patient care
  topic: keywords
subject: Virtues
  topic: keywords
subject: Moral distress
  topic: subjects
subject: Patient care
  topic: subjects
subject: Virtues in medicine
  topic: subjects
subject: Ethics,
  topic: disciplines
creator: H Matisonn
creator: J De Vries
creator: J Hoare
creator: B Hodkinson
creator: S Opperman
rights: Copyright (c) 2025 H Matisonn, J De Vries, J Hoare, B Hodkinson, S Opperman https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-18
publication date: 2025-12-18
starting page: e3886
ending page: e3886
doi: 10.7196/SAJBL.2025.v18i3.3886

Pandemics, public health and the limitation of the right to privacy: Legal compliance and public trust
type: item
description: The COVID‐19 pandemic highlighted the tension between protecting public health and safeguarding individual rights, particularly the right to privacy. In South Africa (SA), privacy is both a constitutional right and a statutory obligation under the Protection of Personal Information Act (POPIA). However, during public health crises, this right may be limited by legal measures such as surveillance, mandatory reporting and data processing under POPIA, the National Health Act and the Disaster Management Act. These instruments collectively define the conditions under which the right to privacy may be limited in the interest of public health. This article examines whether SA’s legal framework allows for the lawful, necessary and proportionate limitation of privacy during disease outbreaks, drawing on key legislation and case law. To assess SA’s compliance with international human rights standards, a benchmarking of domestic provisions against the International Covenant on Civil and Political Rights and the Siracusa Principles is also undertaken. These instruments offer guidance on how states may justifiably limit rights during public health emergencies. The article further briefly examines whether adhering to constitutional and statutory requirements translates into public trust during pandemics. Lastly, it also provides recommended requirements to guide future limitations on privacy that uphold constitutional values while enabling effective public health responses.
subject: Research Articles
  topic: section
subject: Disease outbreaks
  topic: keywords
subject: limitation of rights
  topic: keywords
subject: pandemics
  topic: keywords
subject: privacy
  topic: keywords
subject: public health
  topic: keywords
subject: regulatory framework
  topic: keywords
subject: Disease outbreaks
  topic: subjects
subject: limitation of rights
  topic: subjects
subject: pandemics
  topic: subjects
subject: privacy
  topic: subjects
subject: public health
  topic: subjects
subject: Regulatory Frameworks
  topic: subjects
subject: Health law
  topic: disciplines
subject: Pandemic preparedness
  topic: disciplines
subject: Public health
  topic: disciplines
creator: L Prinsen
rights: Copyright (c) 2025 L Prinsen https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-18
publication date: 2025-12-18
starting page: e3773
ending page: e3773
doi: 10.7196/SAJBL.2025.v18i3.3773

https://www.samajournals.co.za/index.php/sajbl/article/view/3649
type: item
title: Lifestyle choice or sex work? The criminality or otherwise of blesser-blessee relationships within the context of the 2021 amendments to the Sexual Offences and Related Matters Act, and the implications for healthcare providers and researchers
description: This article critically examines the phenomenon of ‘blesser-blessee’ relationships – arrangements in which older, financially secure individuals (blessers) provide material support to younger individuals (blessees) in exchange for companionship or intimacy. While these relationships have become increasingly visible in South Africa, they are not typically classified as sex work, despite their transactional nature. The analysis is situated within the framework of the 2021 amendments to the Sexual Offences and Related Matters Amendment Act, which introduced a new category of ‘vulnerable persons’. This includes students and trainees <25 years old residing in institutional accommodation, raising complex legal questions about the potential criminalisation of blesser relationships. The article explores the implications of mandatory reporting obligations imposed on healthcare professionals and researchers, who are now required to report suspected sexual offences involving consenting adults. This may inadvertently encompass blesser-blessee relationships, particularly where the exchange of material benefits is interpreted as exploitative or coercive. The legal ambiguity surrounding these relationships is further compounded by the lack of clear statutory definitions, which risks conflating consensual arrangements with criminal conduct. We present a balanced discussion of the competing perspectives on criminalisation. Advocates argue that blesser relationships reinforce harmful gender norms and contribute to gender-based violence. In contrast, critics caution against overly broad interpretations of the law, noting that such relationships may also involve genuine emotional intimacy and mutual agency. Ultimately, the article concludes that while the legislative intent may not have been to criminalise blesser relationships per se, the imprecise drafting of the amendments creates a legal grey area. We call for clearer statutory guidance and interpretive direction from the Departmen…
subject: Research Articles
  topic: section
subject: Mandatory reporting
  topic: keywords
subject: Blesser
  topic: keywords
subject: Blessee
  topic: keywords
subject: Transactional Sex
  topic: keywords
subject: Vulnerable Persons
  topic: keywords
subject: Commercial Sex
  topic: keywords
subject: Female Students
  topic: keywords
subject: Sexual Offence
  topic: keywords
subject: Criminalisation
  topic: keywords
subject: Blesser
  topic: subjects
subject: Blessee
  topic: subjects
subject: Commercial sex work
  topic: subjects
subject: Transactional sex
  topic: subjects
subject: Vulnerable person
  topic: subjects
subject: Sexual Offences
  topic: subjects
subject: Mandatory Reporting
  topic: subjects
subject: Researchers
  topic: subjects
subject: Healthcare providers
  topic: subjects
subject: Vulnerable Persons
  topic: subjects
subject: Female Students
  topic: subjects
subject: Criminal Offence
  topic: subjects
subject: Law
  topic: disciplines
subject: Policy
  topic: disciplines
subject: Sexual Reproductive Health
  topic: disciplines
subject: Research Ethics
  topic: disciplines
subject: Criminal Law
  topic: disciplines
creator: S Bhamjee
creator: A Strode
creator: S Goosen
rights: Copyright (c) 2025 S Bhamjee, A Strode, S Goosen https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-18
publication date: 2025-12-18
starting page: e3649
ending page: e3649
doi: 10.7196/SAJBL.2025.v18i3.3649

From prohibition to protection: Rethinking the ethics of non-medical preimplantation sex selection
type: item
description: In 2012, South African (SA) regulations imposed a blanket prohibition on non-medical preimplantation sex selection. A decade later, the Pretoria High Court declared the prohibition unconstitutional on the basis that it unjustifiably infringed reproductive autonomy under the Constitution. This article critically analyses the ethical reasoning underpinning the court’s decision, using the judgment as an organising framework. It evaluates the key normative concerns traditionally raised in debates about sex selection – including demographic imbalance, sex stereotyping, child welfare, and the moral status of the embryo – and situates these within relevant empirical evidence and ethical scholarship. The analysis demonstrates that although ethical objections to sex selection merit careful engagement, they lack the evidentiary grounding required to justify limiting constitutionally protected reproductive freedoms. Permitting non-medical preimplantation sex selection is therefore not an ethical anomaly but a principled extension of SA’s rights-based approach to reproductive decision-making. The article further notes that the March 2025 revised edition of Booklet 8, issued by the Health Professions Council of South Africa, has removed the previous prohibition on non-medical sex selection, bringing professional ethical guidance into alignment with the constitutional framework established by the High Court.
subject: Research Articles
  topic: section
subject: assisted reproduction
  topic: keywords
subject: bioethics
  topic: keywords
subject: constitutional rights
  topic: keywords
subject: preimplantation sex selection
  topic: keywords
subject: reproductive autonomy
  topic: keywords
creator: D Thaldar
rights: Copyright (c) 2025 D Thaldar https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-18
publication date: 2025-12-18
starting page: e3581
ending page: e3581
doi: 10.7196/SAJBL.2025.v18i3.3581

The matter between the State and Professor Peter Beale
type: item
description: -
subject: Editorial
  topic: section
creator: A Dhai
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-04-25
publication date: 2025-04-25
starting page: e3537
ending page: e3537
doi: 10.7196/

CPD
type: item
description: -
subject: CPD
  topic: section
creator: A Dhai
rights: Copyright (c) 2025 A Dhai https://creativecommons.org/licenses/by-nc/4.0
date: 2025-04-25
publication date: 2025-04-25
starting page: e3536
ending page: e3536
doi: 10.7196/

Denying the right to healthcare: South Africa’s unemployed doctors at the centre of this crisis
type: item
description: The public sector provides healthcare access to 84% of patients in South Africa (SA). However, it is severely understaffed, with only 0.3 doctors per 1 000 people – far below the World Health Organization’s recommended ratio of 2.5 per 1 000. While the public sector struggles with numerous challenges, including a critical shortage of healthcare personnel, SA has a high number of medical doctors who have completed their mandatory community service yet remain unemployed. The shrinking health budget, rising salaries and high number of medicolegal claims are some of the reasons why the National Department of Health (NDoH) cannot afford to employ these professionals. In addition, corruption has severely impacted available resources, creating dangerous conditions in public hospitals. During the State of the Nation Address, the SA President announced the development of new healthcare facilities, but buildings alone do not deliver healthcare – people do. If the NDoH is already struggling to fill posts in the public sector, how can communities trust that adequate human resources have been budgeted for new facilities? Without proper staffing, these new facilities could exacerbate existing workforce shortages. The fundamental right to access healthcare is affirmed in the Constitution; however, its implementation is riddled with impediments. Although the issue of unemployed doctors is part of a bigger crisis within the SA healthcare sector, it is imperative that it is tackled first in order to avoid the further collapse of the healthcare system. This article highlights the government’s constitutional imperatives to the people of SA with regard to the right to access healthcare. It also brings to light certain factors that have accounted for the current state of healthcare in SA, and offers some recommendations toward urgent intervention. The article concludes by highlighting the need for strategic interventions that result in the integration of unemployed qualified doctors into…
subject: Research Articles
  topic: section
subject: right to access healthcare, unemployed doctors, South Africa, fundamental rights.
  topic: keywords
subject: right to access healthcare, unemployed doctors, South Africa, fundamental rights
  topic: subjects
subject: ethico-legal
  topic: disciplines
creator: S Mahomed
creator: A V Adeleke
rights: Copyright (c) 2025 S Mahomed, A V Adeleke https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-04
publication date: 2025-09-04
starting page: e3522
ending page: e3522
doi: 10.7196/SAJBL.2025.v18i2.3522

‘Encore, encore!’ – secondary use of health data for research: A practical guide to POPIA
type: item
description: Health data hold immense potential for advancing medical science and informing public health strategies; however, their secondary use for research purposes has been poorly exploited, partly due to uncertainty and compliance concerns brought about by the Protection of Personal Information Act (POPIA). Researchers often assume that re-consent is the only option for secondary use. Yet POPIA provides several lawful grounds for processing special personal information, which includes health data, without necessarily obtaining re-consent. The present article serves as a practical guide for researchers navigating POPIA’s requirements for the secondary use of health data for research. A systematic approach is recommended: first, researchers should establish whether the original consent encompasses the intended secondary use. If it does not, they should determine which lawful grounds for processing special personal information best suit their context and can be relied upon. Options include obtaining re-consent, relying on a research purpose, or seeking authorisation from the Information Regulator. In addition, researchers may consider de-identifying the dataset, which would exempt it from the ambit of POPIA. Situations where pseudonymisation might achieve a similar outcome are also unpacked. By taking proactive, well-documented steps, researchers can better capitalise on existing health datasets to advance vital health research in South Africa.
subject: Review Articles
  topic: section
subject: health research
  topic: keywords
subject: POPIA compliance
  topic: keywords
subject: secondary use of data
  topic: keywords
subject: de-identification
  topic: keywords
subject: pseudonymisation
  topic: keywords
subject: Data protection
  topic: subjects
subject: POPIA
  topic: subjects
subject: secondary use of data
  topic: subjects
subject: Law; Data Law
  topic: disciplines
creator: A Edgcumbe
creator: D Thaldar
rights: Copyright (c) 2025 A Edgcumbe, D Thaldar https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-18
publication date: 2025-12-18
starting page: e3550
ending page: e3550
doi: 10.7196/SAJBL.2025.v18i3.3350

The cautionary tale of USAID cuts: Resources for HIV treatment and prevention programmes
type: item
description: The recent United States Agency for International Development (USAID) cuts have affected South Africa (SA)’s HIV prevention and treatment programmes. The consequences of these cuts affect the lives of millions of people, given the reliance on this foreign aid to supplement government resources for the provision of HIV treatment. The cuts are the result of a changing geopolitical landscape, in which diplomatic relations can be considered unstable. This article contends that the constitutional obligation to realise socioeconomic rights within ‘available resources’ should therefore not necessarily be interpreted as including foreign aid. Given current global politics and the fragility of diplomatic relations, such an interpretation is arguably unreasonable. SA should seek to ensure that its HIV treatment and prevention programmes are self-sufficient, so that provision of treatment for HIV can be consistent and reliable, and lives are not lost due to disruptions in treatment resulting from diplomatic relations.
subject: Research Articles
  topic: section
subject: HIV
  topic: keywords
subject: Antiretrovirals
  topic: keywords
subject: USAID
  topic: keywords
subject: Reasonableness
  topic: keywords
subject: Available resources
  topic: keywords
subject: Socio-economic rights
  topic: keywords
subject: HIV
  topic: subjects
subject: Antiretrovirals
  topic: subjects
subject: USAID
  topic: subjects
subject: Socio-economic rights
  topic: subjects
subject: Reasonableness
  topic: subjects
subject: Resources
  topic: subjects
subject: Law and HIV
  topic: disciplines
creator: M Brotherton
rights: Copyright (c) 2025 M Brotherton https://creativecommons.org/licenses/by-nc/4.0
date: 2025-04-25
publication date: 2025-04-25
starting page: e3321
ending page: e3321
doi: 10.7196/

Ensuring public safety and professional integrity: The vital role of healthcare regulators in South Africa
type: item
description: Healthcare regulation is often misunderstood as burdensome, yet it serves a critical function in safeguarding public health and maintaining professional integrity. The first objective of the present article is to explore the essential role of healthcare regulators in South Africa, with a focus on the Health Professions Council of South Africa (HPCSA). Established under the Health Professions Act 56 of 1974, the HPCSA oversees a broad mandate encompassing the registration, licensing and regulation of healthcare practitioners to ensure ethical and competent service delivery. The Council also establishes practice standards, evaluates educational programmes, promotes continuous professional development, and investigates complaints to ensure upholding public trust and safety. The second objective of the article is to clarify common misconceptions about healthcare regulation, including concerns about fee structures and registration suspension policies. It also aims to highlight the benefits that regulation offers healthcare professionals, such as enhanced credibility, legal compliance, and improved employment opportunities. The HPCSA’s dual mandate to protect the public and guide professions is examined through its legislative framework and relevant case law such as HPCSA v Grieve. As healthcare evolves, regulators such as the HPCSA must adapt to emerging challenges, ensuring the sector remains safe, ethical and effective. The third objective is to underscore the indispensable value of regulation in preserving both public safety and the integrity of the healthcare profession.
subject: Research Articles
  topic: section
subject: HPCSA
  topic: keywords
subject: regulation
  topic: keywords
subject: public safety
  topic: keywords
subject: healthcare standards
  topic: keywords
subject: health regulation
  topic: subjects
subject: public safety
  topic: subjects
subject: professional integrity
  topic: subjects
subject: ethical oversight
  topic: subjects
subject: Regulatory Frameworks
  topic: subjects
subject: Bioethics
  topic: disciplines
subject: Bioethics and health law
  topic: disciplines
subject: law
  topic: disciplines
creator: S Sobuwa
creator: N Sipeka
rights: Copyright (c) 2025 S Sobuwa, N Sipeka https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-04
publication date: 2025-09-04
starting page: e3034
ending page: e3034
doi: 10.7196/SAJBL.2025.v18i2.3034

CPD
type: item
description: -
subject: CPD
  topic: section
creator: Claudia Naidu
rights: Copyright (c) 2024 https://creativecommons.org/licenses/by-nc/4.0
date: 2024-12-05
publication date: 2024-12-05
doi: 10.7196/

Using artificial intelligence in healthcare – some ethical and legal considerations
type: item
description: -
subject: Editorial
  topic: section
creator: A Dhai
rights: Copyright (c) 2024 https://creativecommons.org/licenses/by-nc/4.0
date: 2024-12-05
publication date: 2024-12-05
starting page: e2919
ending page: e2919
doi: 10.7196/

Early Online
type: item
description: -
subject: Scientific letters/short reports
  topic: section
subject: international law
  topic: keywords
subject: international humanitarian law
  topic: keywords
subject: international courts
  topic: keywords
subject: healthcare, Gaza, medical apartheid, protection heathcare workers and patients
  topic: keywords
subject: International Law
  topic: subjects
subject: Palestine/ Gaza
  topic: subjects
subject: medical ethics
  topic: subjects
subject: Healthcare
  topic: subjects
subject: Bioethics and health law
  topic: disciplines
subject: International Law
  topic: disciplines
subject: International Criminal Law
  topic: disciplines
creator: S Soni
rights: Copyright (c) 2024 S Soni https://creativecommons.org/licenses/by-nc/4.0
date: 2024-12-06
publication date: 2024-12-06
starting page: e2874
ending page: e2874
doi: 10.7196/

In machina: A cursory consideration of artificial wombs and the South African ethico-legal landscape
type: item
description: Preterm birth, defined by the World Health Organization as any birth occurring before 37 weeks of gestation, remains a significant global health challenge, contributing to high rates of neonatal mortality and long‐term complications. In this context, artificial womb technology – or ectogenesis – offers a transformative intervention capable of sustaining extra‐uterine gestation and improving outcomes for extremely preterm infants. This article explores the legal, ethical and societal implications of introducing artificial wombs in South Africa, where existing laws regulating pregnancy, birth and personhood are ill‐equipped to address this technological shift. In particular, the definitional limits of the Choice on Termination of Pregnancy Act, the conditional nature of the nasciturus fiction, and the ambiguity surrounding parental authority and legal guardianship over gestatelings, is analysed. I argue for the development of a bespoke legal framework to regulate ectogenesis, rather than amending existing pregnancy or birth legislation, and propose a set of principles to guide future regulation. Additionally, I highlight how access to artificial wombs may reinforce healthcare inequality if limited to private medical settings. By proactively addressing the legal and policy challenges posed by ectogenesis, South Africa can advance a rights‐based approach to reproductive healthcare while preparing for the ethical and legal complexities of this emerging technology. This article utilised a qualitative, doctrinal research methodology based on desktop analysis. The research involved the critical examination of primary legal sources such as constitutional provisions, statutes and relevant South African case law. Secondary sources included scholarly articles in medical law, bioethics and reproductive justice, particularly those addressing emerging technologies, e.g. ectogenesis. Comparative perspectives from jurisdictions such as the United Kingdom, the Netherlands, and the Un…
subject: Research Articles
  topic: section
subject: Reproductive rights
  topic: keywords
subject: artificial wombs
  topic: keywords
subject: medical ethics
  topic: keywords
subject: neonatal care
  topic: keywords
subject: bioethics
  topic: keywords
subject: reproductive rights
  topic: subjects
subject: medical ethics
  topic: subjects
subject: biotechnology
  topic: subjects
subject: Bioethics and health law
  topic: disciplines
creator: S Soni
rights: Copyright (c) 2025 S Soni https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-04
publication date: 2025-09-04
starting page: e2818
ending page: e2818
doi: 10.7196/SAJBL.2025.v18i2.2818

Practical guidance in understanding the nuance of benefit sharing and what this means for South African health research ethics committees: Part 2
type: item
description: This article examines benefit sharing within health research, a subject of growing importance in South African regulatory and ethical frameworks. With reference to the National Health Act (NHA), this article builds on previous discussions about defining key terms in benefit sharing and offers health research ethics committees (RECs) in South Africa guidance in evaluating benefit-sharing provisions. It navigates three critical legislative frameworks – the Intellectual Property Rights from Publicly Financed Research and Development Act (IPRA), the Indigenous Knowledge Act (IKA) and the National Environmental Management: Biodiversity Act (NEMBA) – interpreting each for REC evaluation of research protocols involving publicly funded research, indigenous knowledge and non-human biological materials. The article also addresses the implications of section 60(4) of the NHA on benefit sharing for human participant research, dissecting questions around permissible forms of benefits to participants and research institutions. Through a decision-making diagram and two hypothetical scenarios, this article provides practical tools to help RECs assess and regulate benefit sharing in line with ethical and legal standards, ultimately promoting fair research practices.
subject: Research Articles
  topic: section
subject: benefit sharing
  topic: keywords
subject: legal position
  topic: keywords
subject: nuanced understanding
  topic: keywords
subject: practical guidance
  topic: keywords
subject: research ethics committee
  topic: keywords
subject: South Africa
  topic: keywords
subject: Health Research
  topic: subjects
subject: Benefit sharing
  topic: subjects
subject: Ethical Guidelines
  topic: subjects
subject: Legal Framework
  topic: subjects
creator: L Prinsen
rights: Copyright (c) 2025 L Prinsen https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-04
publication date: 2025-09-04
starting page: e2815
ending page: e2815
doi: 10.7196/SAJBL.2025.v18i2.2815

Practical guidance in understanding the nuance of benefit sharing and what this means for South African health research ethics committees: Part 1
type: item
description: Benefit sharing in health research is a complex and contentious topic, raising practical challenges. This article examines preferred terminologies and the roles of various stakeholders at multiple levels, providing critical insights for South African Research Ethics Committees (RECs). It explores the terminological clarity needed in defining ‘benefit’ and ‘benefit sharing’, particularly through the framework suggested by the DS-I Africa Law group. The article highlights significant deficiencies within the National Department of Health Guidelines, which lack specificity in addressing benefit sharing, creating regulatory confusion. Additionally, it analyses the relevance of four South African Acts – the Intellectual Property Rights from Publicly Financed Research and Development Act (IPRA), the Indigenous Knowledge Act (IKA), the National Environmental Management: Biodiversity Act (NEMBA) and the National Health Act (NHA) – each addressing benefit sharing in varying contexts. These legislative frameworks are discussed to assist RECs in ensuring ethical benefit sharing practices and to clarify the legality and applicability of benefit sharing. In conclusion, this article recommends the implementation of the terminology and differentiation offered here. By offering a foundational understanding, this article aims to support RECs in their critical role of navigating benefit sharing complexities within the South African research landscape.
subject: Research Articles
  topic: section
subject: benefit sharing
  topic: keywords
subject: legal position
  topic: keywords
subject: nuanced understanding
  topic: keywords
subject: practical guidance
  topic: keywords
subject: research ethics committees
  topic: keywords
subject: South Africa
  topic: keywords
subject: Health Research
  topic: subjects
subject: Benefit sharing
  topic: subjects
subject: Ethical Guidelines
  topic: subjects
subject: Legal Framework
  topic: subjects
creator: L Prinsen
rights: Copyright (c) 2025 L Prinsen https://creativecommons.org/licenses/by-nc/4.0
date: 2025-04-25
publication date: 2025-04-25
starting page: e2814
ending page: e2814
doi: 10.7196/

Facilitating a framework for managing rare diseases in South Africa: Comparative insights from the UK and Italy
type: item
description: Managing and treating rare diseases is a global concern, largely because of their rarity and the complexities associated with their care. Robust ethico-legal frameworks governing rare diseases are essential as they establish coordinated guidelines that ensure patients receive the care and support which they require. This article examines and compares the existing frameworks for rare diseases in the United Kingdom and Italy, with those in South Africa (SA), highlighting the differences and similarities in how they operate, towards facilitating a national framework that suits our context. The recommendations offer proposed solutions to add to the ongoing dialogue regarding the current lack of governance for rare diseases in SA. The article further calls for a coherent national framework to better address and represent the needs and rights of individuals affected by rare diseases. SA requires a systematic approach, with clear guidelines for diagnosing, treating and funding rare diseases. This approach would establish a basis for efficient resource allocation and equitable access to essential treatments.
subject: Research Articles
  topic: section
subject: Rare diseases, prescribed minimum benefits, orphan drugs, medical law, healthcare, medicine, national health insurance, human rights, access to healthcare.
  topic: keywords
subject: 1. Comparative Analysis
  topic: subjects
subject: Rare diseases
  topic: subjects
subject: Access to healthcare
  topic: subjects
subject: Legal framework
  topic: subjects
subject: Medical law
  topic: disciplines
creator: S Pazaropoulos-Koot
creator: S Mahomed
creator: L Pienaar
rights: Copyright (c) 2025 S Pazaropoulos-Koot, S Mahomed, L Pienaar https://creativecommons.org/licenses/by-nc/4.0
date: 2025-04-25
publication date: 2025-04-25
starting page: e2805
ending page: e2805
doi: 10.7196/

Advancing gender equity in HPV vaccination: A rule utilitarian case for including boys in South Africa’s national programme
type: item
description: We examine whether South Africa’s human papillomavirus (HPV) vaccination programme aligns with rule utilitarianism principles, considering ethical and societal dimensions. From a rule utilitarian perspective, we argue that the current policy should be revised to include boys because this change would generate greater overall benefit than the current exclusionary model. Specifically, we advocate for universal access to free HPV vaccinations for all eligible adolescents in South Africa. By using a framework grounded in rule utilitarianism, we aim to highlight the perceived unfairness and ethical concerns associated with excluding boys from the current school-based, free HPV vaccination programme. We assert that this exclusion undermines the programme’s broader public health benefits and moral justifiability.
subject: Research Articles
  topic: section
subject: Ethics
  topic: keywords
subject: Benefit sharing
  topic: keywords
subject: equality
  topic: keywords
subject: health justice
  topic: keywords
subject: healthcare
  topic: keywords
subject: Public health
  topic: keywords
subject: South Africa
  topic: keywords
subject: Reproductive health
  topic: keywords
subject: South African healthcare system
  topic: subjects
subject: Ethics
  topic: subjects
subject: health justice
  topic: subjects
subject: Benefit sharing
  topic: subjects
subject: Bioethics
  topic: subjects
subject: Bioethics and health law
  topic: disciplines
creator: V C Scheepers
creator: J Gardner
rights: Copyright (c) 2025 V C Scheepers, J Gardner https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-04
publication date: 2025-09-04
starting page: e2782
ending page: e2782
doi: 10.7196/SAJBL.2025.v18i2.2782

The Universal Declaration of Bioethics and Human Rights – a provisional perspective on surrogacy introduction
type: item
description: Backgound. Surrogacy is a contentious reproductive technology that has garnered significant global attention, particularly following Pope Francis’ 2024 condemnation of it and his advocacy for a universal ban, amid its rising prevalence in high-income regions driven by factors such as advancing parental age and the reproductive aspirations of single men, same-sex couples, and transgender individuals. This article evaluates surrogacy through the framework of the Universal Declaration of Bioethics and Human Rights, a 2005 UNESCO-adopted document establishing 15 universal bioethical principles to guide discussions on medicine, life sciences, and associated technologies, emphasising its role in fostering global ethical discourse grounded in human rights. Objective. To assess the ethical dimensions of surrogacy by applying the principles of the UDBHR, determining whether the declaration adopts a neutral stance, merely offers procedural guidelines, or provides a substantive ethical judgment on the practice. This provisional analysis posits a central theoretical argument that the UDBHR creates an ethical paradox by simultaneously legitimising surrogacy through procedural mechanisms while posing significant moral challenges to its acceptability, with the study confined to evaluative purposes without extending to policy recommendations. Method. The methodology employed is evaluative, critically examining surrogacy against the UDBHR’s standards to gauge its ethical soundness, incorporating an interpretive analysis of how the declaration’s principles intersect with surrogacy’s ethical, legal and social facets. The approach begins with an explication of surrogacy’s types, processes, reasons, costs and controversies, followed by a principle- by-principle discussion under the UDBHR, drawing on limited existing literature such as the 2019 International Bioethics Committee (IBC ) Report, while maintaining a focus solely on ethical assessment. Results. The evaluation identifies a dua…
subject: Research Articles
  topic: section
subject: Surrogacy
  topic: keywords
subject: Universal Declaration of Bioethics and Human Rights
  topic: keywords
subject: Human Rights
  topic: keywords
subject: Global bioethics
  topic: keywords
subject: Bioethics
  topic: disciplines
creator: R Rheeder
rights: Copyright (c) 2025 R Rheeder https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-04
publication date: 2025-09-04
starting page: e2674
ending page: e2674
doi: 10.7196/SAJBL.2025.v18i2.2674

Irregular appointment of the NHREC: Implications for legitimacy and the path forward for South Africa’s health research ethics guidelines
type: item
description: Background. Transparency is a fundamental value in South Africa’s constitutional and ethical framework, particularly in the appointment of statutory bodies such as the National Health Research Ethics Council (NHREC). The integrity of such appointments is crucial for maintaining public trust and ensuring that decisions are legally and ethically sound. An additional fundamental value is that those appointed be suitably qualified to perform their designated tasks. A transparent process alone is insufficient – the purpose of the process itself must also be respected. Transparency is directly linked to this second objective. The appointment of the NHREC has contravened the transparency of the process by not publishing the process and it has also circumvented the purpose of the process by appointing persons who have not been subjected to scrutiny. Objectives. This article demonstrates that the NHREC was constituted in an irregular manner, with key procedural requirements, designed to promote transparency and the appropriateness of the appointees, being overlooked. The article also explores the possible impact of this irregular appointment on the authority and validity of the NHREC’s decisions. Methods. The article conducts a detailed analysis of the statutory requirements governing the appointment of the NHREC, followed by an examination of the irregularities in the appointment process. The prejudice to stakeholders and the broader implications for governance are also considered. Results. The investigation found that the NHREC’s appointment process did not follow statutory requirements, leading to a significant irregularity. This undermines the legitimacy of both the council and its decisions, as it denies stakeholders the right to participate in the nomination process, violating principles of participatory democracy. Additionally, the credentials and suitability of appointees were not properly evaluated. As a result, the third edition of the Ethics Guidelines (2024) is l…
subject: Research Articles
  topic: section
subject: Health Research, Transparency
  topic: keywords
subject: Health Research
  topic: subjects
subject: Bioethics
  topic: disciplines
creator: D Bellengere
creator: A Bellengere
rights: Copyright (c) 2025 D Bellengere, A Bellengere https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-04
publication date: 2025-09-04
starting page: e2660
ending page: e2660
doi: 10.7196/SAJBL.2025.v18i2.2660