The South African Medico Legal Society

Dear Colleagues and Friends

On 02/03/2002 the Exco meeting of the South African Medico Legal Society took place and positive progress was made concerning targeting of medical specialist groups, law academics as well as personal and injury lawyers and bar advocates.

The seminar of 11/05/2002 was discussed. This is the 2nd Saturday in May. Please make note of this date to make sure that you will be there.

An interesting line-up of speakers will be approached, such as law academics, a representative of the Road Accident Fund, heads of legal departments of the big insurance companies, as well as senior medical specialists. A lot of time will be dedicated to discussion for persons participating in this seminar. Details about the program will follow later. The place will be Protea Hotel, Midrand, and the starting time will be 09:30. The seminar will continue until  13:00.

Good news for the members of the SAMLS is that the costs for this and other seminars are included in the membership fee, while non-members will have to pay an entrance fee of R 450,00 per seminar.

Further good news is that the seminar will be accredited with ethical CPD points for medical doctors.

Please take note as well that a general meeting for the South African Medico Legal Society members will take place just before the seminar to propose and accept new members that have applied for membership of our society.

The second seminar in October will deal with the subject of Expert Opinion and Expert Witness, which also promises to be interesting, as the practical court sessions for training purposes 2 weeks later will take place for SAMLS members.

The South African Medico Legal Society is busy developing its own website with the address www.samls.co.za. Please visit our website and give us your ideas about the development of this website to a proper and professional website we can be proud of. The idea was already aired that the website must also contain the newsletters and will in future also contain references to specific topics in the Medico Legal field concerning reading material and authoritive opinions.

The Executive Committee of the SAMLS wants to stress its language policy. English will be the language used at our meetings and seminars. Questions put to the panel during discussions can be in one of the other languages, but will be answered in the English language. The seminars are really meant to bring the different role players in the South African medico-legal field together and are meant to be a continued educational programme.

Finally we are grateful that Prof Pieter Carstens of the University of Pretoria's Department of Criminal Law has made his lecture available that he presented at the Annual General Meeting. It was not only an interesting speech, but is also lateral thinking necessary for our South African Medico Legal Society's future and a teaser for non SAMLS members to reconsider their status.

Address to the South African Medico Legal Society
02/02/2002 - Midrand

I have been asked to briefly address this meeting on the importance of a medico legal society in South Africa, by implication the question whether there is a need and/or purpose for such a society. It has been pointed out that this society has now been solidly founded since its inception a year ago. More pivotal, however, is the role of the Society in the medico legal field.

The Mission and Objections of the Society are as formulated in the Constitution and Rules of the Society. In essence the society is not only there to promote medico legal science with the aim of attracting medical and legal professionals as members, but its importance ultimately lies therein to provide high-quality scholarship, debate and critical thought, appropriate services and research to the community of professionals at the nexus of health care, ethics and law. The approach should thus be to provide opportunities for interdisciplinary education to its members and to promote continuing education in the area of legal medicine.

Ideally it is not an exclusive club for physicians or lawyers, but it should also strive to serve other health care professionals. In this respect the Society is comparable to societies like the American Society of Law, Medicine and Ethics and the British Medico-Legal Society. Important manifestations of these societies are for instance the publication of the highly regarded American Journal of Law and Medicine, the Journal of Law Medicine and Ethics and the influential The Lancet.

Unquestionably medical law is one of the fastest growing areas of legal studies. It is also one of the most exciting and challenging since it draws on a wide range of existing legal areas, eg the law of delict, criminal law, law of persons and the family, but does so in the context of certain unifying themes and concepts which demarcates medical law as a separate field of study. Add to this the fascination and difficulty of the host of problems posed for society by advances in medicine and medical technology, and the importance and attraction of the subject and rationale for such a society become clear: a question of whether the lawyer can keep up with the doctor (or vice versa) or whether both can keep up with the ever advancing technology, the information age and the concept of globalization - this all add to the international mobility of medical law - it has been said by Bernard Ficarra (a much revered medical doctor and lawyer in the USA) rightly or wrongly that the human body does not vary in ten thousand miles and neither should the practice of medicine - could this also hold true for the practice of law? If one has regard to research around in international medico-legal journals, one finds over and above the familiar themes health care quality and access, managed care, genetics, child/maternal health, reproductive health, informed consent, mental health care, human experimentation, end-of-life issues, ethics, HIV/Aids and public heath, also fascinating research with the following titles:

“Medical Malpractice in Cyberspace”; “The Advent of Cybermedicine”; “Telemedicine: The Invisible Legal Barriers to Health Care of the Future”; “Informed Consent in the Electronic Age”; “Ethical and Legal Issues in Technology: Xenotransplantation”, etc.

It is furthermore, like any area of law an intensely practical subject. The problems it poses exist as real problems for doctors, nurses, patients, administrators, relatives, indeed for all of us. It is therefore, a subject in which analysis must point to some sort of workable solution which satisfies the demands of legal reasoning, the practice of medicine and public policy - hence necessitating an interdisciplinary and allied approach and effort - underscoring once gain the need and importance for such a society.

We in South African now also live in a constitutional democracy where the constitution with a Bill of Rights is the supreme law of the land; a society in which a culture of human rights has to be fostered. The Bill of Rights also gives effect to the security of person (translating in the shift from medical paternalism to patient autonomy) to the right to health care - in respect our courts (most notably our Constitutional Court) give effect to these rights in their judgements affecting health care in South Africa (examples of access to generic drugs, Neviropene, etc). Through its interpretation clause the Bill of Rights links our law to important international human rights instruments and protocols relating to health and medical care, eg the universal declaration on the human genome and human rights (the first universal instrument in the field of bioethics and human rights adopted in 1997 by Unesco), the Helsinki Declaration, enhancing the importance of human rights in medical law - indicative of yet another dimension in medical law.

On my interpretation of recent literature the emphasis in medical law is on the following current issues:

1. Public health - research into emerging issues in public health law, policy, practice and ethics, the management of medical care resources, also in public health emergencies;
2. Health disparities: racial, ethnic and economic disparities in health status and access to health care - social security rights and health;
3. Patient safety and quality of medical care;
4. Biomedical science and research - biomedical science increasingly challenges what is considered established legal precedent.

Over and above what was said I refer to the presentation by Prof Strauss of the host of statutory laws and regulations impacting on the medico-legal field as yet another persuasive argument for a society.

The South African Medico Legal Society has the unique ability to bridge different professional groups. It can facilitate a much needed dialogue between those without a purely scientific background and those familiar with science/technology but unfamiliar with the legal implications of their work. A bridge with a common goal of serving the common good.

Prof PA Carstens.

Yours Sincerely

DR ANTON H VAN DEN BOUT
PRESIDENT SAMLS