Patients' rights in a Third World southern African country, with special reference to Bophuthatswana: is there any potential for privatisation?

ABSTRACT

PIP: The unique characteristics of patients' rights with respect to their doctor, the state, larger society and the world are discussed for the Republic of Bophuthatswana, a TBVC of South Africa. In this culture, the doctor has the added duty to keep both the patient and the family head informed, and to secure consent from both as well as the tribal doctor, all made more difficult because there are not Western-trained native doctors. These relationships are made more complex by AIDS, when the medical doctor has to decide whether to impose his ethical and scientific concepts on the patient, his family, and his tribe. The patients' relationship to society in Bophuthatswana is problematic because the population growth rate of 2.9% does not even permit implementation of primary preventive health care. The goal is to increase the doctor-patient ration to 1:10,000. Regarding AIDS, the author believes that legislation should be passed to restrict the freedom of HIV carriers to be sexually active, since patients have rights as a society. It is also argued that former colonial and other Western states should be obligated to aid newly independent third world nations, since they left without establishing a viable medical system. Policies and legal forms for instituting medical care insurance and privatization of hospitals and clinics in the TBVC states of South Africa are suggested. The only way to finance this new system is to fully integrate the Third World sector into the First World sector.