South Africa

Abstract

Bioethics in South Africa became a subject of pertinence and study relatively late in the twentieth century in comparison with Western nations such as the United States and most European countries. This burgeoning focus can be understood as having come about as a result of technological developments in medicine of which the first heart transplant performed in South Africa by Dr. Christiaan Barnard in 1967 is the pivotal example, as well as due to events that occurred in the context of South Africa’s system of apartheid, the clearest example being the maltreatment by medical personnel of the prominent activist Steve Biko resulting in his subsequent death. This chapter will discuss the complex history and current state of bioethics in South Africa in terms of its initial development against the background and influence of the system of apartheid and the far-reaching consequences thereof, still keenly felt in contemporary democratic South Africa. In keeping with South Africa’s highly progressive constitution, much progress has been made in terms of implementing policies and recognizing the pivotal importance of bioethics. However, in terms of the many health challenges facing South Africa, the possibilities opened up by the constitution are inadequate in themselves. Due to its position as one of the worst-affected areas in the world, particular attention will be paid in this chapter to the problem of HIV/AIDS in South Africa. In addition, there will be a discussion of beginning- and end-of-life concerns, the position of traditional medicine in South Africa, and the issue of access to healthcare.