Early benefits of improved burn-care capability at Kalafong Hospital.

The creation of an improved burn-care capability was a long-awaited dream at Kalafong Hospital, one of the two academic (tertiary referral) hospitals of the University of Pretoria. When this recently became a reality, a prospective analysis of cost-effective burn care was initiated. For patients with burns of less than 10% body surface area (BSA), hospital stay (healing time) was shortened from a mean of 4.1 d/% BSA burnt to 2.7 d/% BSA burnt (34% reduction; P = 0.01). For patients with burns greater than 10% BSA, hospital stay (healing time) decreased from 2.3 d/% BSA burnt to 1.4 d/% BSA burnt (39% reduction; P = 0.0095). The overall mortality rate declined from 16.2% to 11.2% over the 24-month period. Patients with the largest deep dermal burn injury to survive in our hospital improved from 35% BSA to 60%. It is concluded that the creation of better burn care facilities at our hospital has shortened the hospital stay of survivors by a mean of 35% and decreased the mortality rate by 30%. Hospital authorities should take note of the fact that better facilities not only improve cost-effective patient care but also survival figures.

A legal perspective of the concept of life.

The problem of defining life is discussed, using as foundation Herman Dooyeweerd's philosophy of the Cosmonomic Idea, which holds that life is indefineable. Contemporary legal and philosophical writings concerning the exact moments of life and death are explored. While conceding the importance of these in the determination of the precise beginning and end of legal personhood, the author concludes that the concept of life is unfathomable.

PIP: Law itself can not define life. Biology and psychology also fail to fully define life. Life defines itself. Utilizing logical reasoning to single out a particular moment in the process of prenatal development of the unborn when life in the sense of personhood actually commences has been inspired by ulterior motives, particularly the desire for a scientific base for a particular stand in the abortion debate. Science is being misused in an attempt to legitimize a pre-conceived bias against abortion. The ultimate view of medical-legal issues, like abortion and euthanasia, is embedded in pre-scientific moral perceptions and religious convictions, not science. On the other side is the fact that the law does not exist in a vacuum. It has territorial limits, it has a power structure, and a social setting. By the same reasoning, the law itself presupposes within its own structure the notion of life itself, that is, law regulates the actions of living persons. Law has a specific function in human society, the definitions of its concepts and the substance of it norms must remain subservient to its function.

The right to medical care.

The right to medical care, as a category of human rights, falls under the heading of Leistungsrechte; that is, rights of the individual that require of the state that it do something--in this instance to provide the services concerned. In South Africa the government's health care policy contemplated involves (a) differentiation based on race in the provision of health care services; and (b) privatization of such services. It is submitted that in developing societies, where private initiative cannot cope with the demands in respect of health care, privatization would be premature and existing inequalities in health care services provided for the different racial groups require greater government involvement, with a view to eliminating racial discrimination through programmes of affirmative action. Privatization, furthermore, requires government-sponsored incentives, such as tax concessions, that would inspire private persons to contribute financially towards health care services.