Pieter Carstens

A good complaints system

Solutions to the growing number and severity of clinical negligence claims come in various forms. A key step in avoiding litigation is understanding what dissatisfied patients actually want following an adverse outcome. One way of doing this may be to establish a strong and comprehensive complaints system.

Extreme elective or cosmetic surgery and controversial patient choice : a constitutional analysis

Abstract The specific fundamental human rights protected in the Bill of Rights that come into play when patients make controversial requests for extreme forms of cosmetic surgery are discussed. The meaning of human dignity in South African constitutional law forms the focus of the first part of this article. By applying a constitutional conception of human dignity, the question is answered whether extreme forms of cosmetic surgery most likely promotes or impedes human dignity. In this regard, the relationship between autonomy and dignity and the question whether autonomous individuals should be prevented from participating in activities that might limit their dignity is addressed. The same enquiry is made concerning the other fundamental human rights that are applicable to extreme forms of cosmetic surgery. This includes the right to bodily integrity and the right to privacy. The limitation of these fundamental human rights in terms of s 36 of the Constitution is then addressed.

Can private obstetric care be saved in South Africa

This article examines the question of whether private obstetric care in South Africa (SA) can be saved in view of the escalation in medical and legal costs brought about by a dramatic increase in medical negligence litigation. This question is assessed with reference to applicable medical and legal approaches. The crux of the matter is essentially a question of affordability. From a medical perspective, it seems that the English system (as articulated by the Royal College of Obstetricians and Gynaecologists) as well as American perspectives may be well suited to the SA situation. Legal approaches are assessed in the context of the applicable medicolegal framework in SA, the present nature of damages and compensation with reference to obstetric negligence liability, as well as alternative options (no-fault and capping of damages) to the present system based on fault. It is argued, depending on constitutional considerations, that a system of damages caps for noneconomic damages seems to be the most appropriate and legally less invasive system in conjunction with the establishment of a state excess insurance fund.