Broad consent for biobank research in South Africa - Towards an enabling ethico-legal framework.

Broad consent is permitted by the South African National Department of Health Ethics Guidelines but appears to be prohibited by section 13(1) of the Protection of Personal Information Act 4 of 2013. Additionally, the Act mandates that all personal data (including biobank sample data) be collected for lawful, explicit, and clearly defined purposes. There is possibility for ambiguity in interpretation because of this discrepancy between the two instruments. Given the association between the transfer of samples and data, the long-term nature of biobanking, which makes it impractical to provide too much or enough information because it is simply not available at the time of sample collection, and the various ways that the Protection of Personal Information Act 4 of 2013 have been interpreted, we aim to demonstrate that South Africa's current regulatory framework should appropriately permit broad consent use for biobank research where the transfer of samples and their associated data are contemplated. In summary, the proposed amendments include removing regulatory ambiguity regarding broad consent use, ensuring adequate safeguards for research participants by specifying rules for data access and personal information processing, and incorporating consent form information requirements into the national Consent Template.

Should Drinking during Pregnancy be Criminalised to Prevent Fetal Alcohol Spectrum Disorder?

The harmful effects of alcohol use during pregnancy have been well documented. Fetal alcohol spectrum disorder (FASD) is the collective term encompassing the various clinical diagnoses that can occur in a child who was exposed to alcohol prenatally. The affected child suffers a range of lifelong primary and secondary disabilities. There is no cure for FASD; but it is preventable if women do not drink during pregnancy. Should women be banned from; and/or punished for drinking during pregnancy for the sake of preventing fetal harm? This article considers the appropriateness of criminalising drinking during pregnancy as a means of preventing fetal harm and consequently FASD in children; and concludes that criminal approaches are unjustified; potentially discriminatory and likely to be ineffective

Nanotechnology in Medicine and Healthcare: Possibilities; Progress and Problems

"Nanotechnology or nanoscience covers the investigation; design; manipulation; precision placement; measurement; modelling or fabrication of matter; structures; devices and systems that exist at the nanoscale - essentially at the atomic and molecular size levels. Nanotechnology has the potential to change the way we address some of the world's most critical development problems. In 2005; the United Nations (UN) Millennium Project's Taskforce on Science; Technology and Innovation concluded that nanotechnology can contribute to the attainment of the Millennium Development Goals (MDGs); specifically; the goals to reduce child mortality; improve maternal mortality and combat HIV/AIDS; malaria and other diseases. Health; specifically improved primary healthcare; is one of six focus areas highlighted in South Africa's National Nanotechnology Strategy (NNS); where nanotechnology can offer the most significant benefits for the country. Nanotechnology can revolutionise the practice of medicine and the delivery and accessibility of health care. However; despite the significant benefits of nanotechnology; there are problems that could prevent it from being widely accepted. The qualities that make nanotechnology so appealing are also those that give rise for concern. In particular; there are uncertainties about its potential impact on human health; the environment and societies in general; along with the concern that nanotechnology; much like genetic engineering or modification; is ""messing"" with the building blocks of nature and is therefore ""unnatural"" even unethical. This article considers these concerns and concludes that there is nothing intrinsically good or bad about nanotechnology; but that its acceptability will depend largely on how it used and introduced into society. "

Parents' perceptions of HIV counselling and testing in schools: ethical, legal and social implications.

In view of the high prevalence of HIV and AIDS in South Africa, particularly among adolescents, the Departments of Health and Education have proposed a school-based HIV counselling and testing (HCT) campaign to reduce HIV infections and sexual risk behaviour. Through the use of semi-structured interviews, our qualitative study explored perceptions of parents regarding the ethico-legal and social implications of the proposed campaign. Despite some concerns, parents were generally in favour of the HCT campaign. However, they were not aware of their parental limitations in terms of the Children's Act. Their views suggest that the HCT campaign has the potential to make a positive contribution to the fight against HIV and AIDS, but needs to be well planned. To ensure the campaign's success, there is a need to enhance awareness of the programme. All stakeholders, including parents, need to engage in the programme as equal partners. 

Professionalism and the intimate examination - are chaperones the answer?

Complaints of sexual impropriety against healthcare practitioners are escalating. Professionalism in the practitioner-patient relationship and the role-based trust in health care do not allow crossing of sexual boundaries. Communication with patients is key to prevent erroneous allegations of sexual misconduct. The intimate examination is difficult to define. A chaperone present during an intimate examination protects the patient and practitioner and should be considered a risk reduction strategy in practice.