SAJBL 269

Politics and ethics: Should the twain never meet?

M A Sathar, U Govind

 

Dr Mahomed Aslam Sathar is a medical scientist and bioethicist and author of the book Human Biological Materials in Collaborative Research-Ethical Issues. Dr Uttam Govind is a specialist physician in family medicine. Both are members of the Medical Rights Advocacy Network (MERAN).

 

Corresponding Author: M A Sathar (aslamsathar@gmail.com)

The manner in which the ‘case’ against Professor Cyril Karabus, a South African paediatric oncologist, was conducted in the United Arab Emirates was a travesty of justice. It drew not only worldwide protests and condemnation, but also public commentary that questioned the ethical conduct of medical doctors and healthcare organisations which boycotted the African Health Conference, in a matter some considered to be purely political.

S Afr J BL 2013;6(1):4-5. DOI:10.7196/SAJBL.269

There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy.’ – William Shakespeare, Hamlet

 

Professor Cyril Karabus, a South African paediatric oncologist, was tried in absentia in the United Arab Emirates (UAE), and convicted of manslaughter for the death of a 3-year-old Yemeni girl whom he treated 10 years ago for acute myeloid leukaemia; he was arrested on 12 August 2012.1 His trial in the UAE was a travesty of justice. 1 It drew worldwide protests from international organisations (including the World Medical Association, British Medical Association, American Medical Association, Amnesty International, Human Rights Watch, and the International Paediatric Association),2 national bodies (including the Health Professions Council of South Africa (HPCSA) and the South African Medical Association (SAMA))3 including the leaderships of the Universities of Cape Town4 and the Witwatersrand.5 All condemned the manner in which UAE authorities conducted themselves in this ‘case’. Although Professor Karabus was found not guilty, the UAE authorities held him ’captive’ for almost 9 months.

As a mark of protest against the ongoing unjust treatment of Professor Karabus and as a show of solidarity, both the HPCSA and SAMA, in exercising their professional and ethical responsibilities, called upon their affiliates and members in the healthcare sector to withdraw their participation in the African Health Exhibition.3 The congress was held by a Dubai-based company in Johannesburg between 7 and 9 May 2013, at which Professor Sylvester Chima, Head of the Programme of Bio & Research Ethics and Medical Law at the University of KwaZulu-Natal (UKZN), was a key speaker. In response, Professor Chima accused SAMA, its affiliates and its members of being ‘unethical, misguided and of double standards’.6 He said that ‘the legal process in the UAE, is just like any other legal process in many other jurisdictions around the world including South Africa,’6 and that ‘I consider it to be unethical and unprofessional for medical doctors to take sides or get involved in a political matter.’6 It is unfortunate and, as SAMA rightfully points out in its response, ‘regrettable that Professor Chima chose a public forum to state his position.’7

Professor Chima’s unfounded statements and allegations have elicited widespread criticisms and condemnations in both the ‘lay press’ and social media, from individuals (medical and healthcare workers as well as private individuals), national and international organisations and NGO groups, amongst others. They have questioned not only his credibility but also his credentials as an academic and ethicist. It is not our intent to question the latter. The matter is best dealt with by the professional bodies and the institute that employs Professor Chima.

There are differences of opinion amongst thinkers with regard to the relationship between politics and ethics. According to Plato ethics and politics are intimately related, Aristotle, on the other hand, differentiated between the two, while Machiavelli saw no connection between the two and considered the will of the ‘Prince’ (ruler) as law. Gandhi on the other hand, (who formulated passive resistance to apartheid in South Africa) advocated a high morality in politics. Concepts such as ‘justice’, ‘liberty’, ‘rights’ and ‘duty’ are equally important to both political thinkers and ethicists. Sometimes the only way to achieve an ethical goal is through collective action, i.e. politics.

Stephen Bantu Biko, a medical student (at the very same institute that currently employs Professor Chima) and the voice of our conscience, was detained, tortured and murdered by the apartheid regime, an act in which apartheid medicine was an accomplice. The findings of the Human Rights Violations Committee of the Truth and Reconciliation Commission (TRC) exposed the pervasive violations of human rights by apartheid medicine in the health sector. As South Africans we are in the enviable position to have four Nobel Peace Prize laureates, icons for human rights. We have a new political dispensation in South Africa that guarantees freedom, dignity, respect and autonomy to all. Healthcare workers and those in allied fields take their lead from the Bill of Rights, the National Health Act and the findings of the TRC, to ensure that the pervasive human rights abuses in the healthcare sector never happen again to our fellow countrymen and -women and to those in foreign lands. We are not like the UAE.

It is this rich political tapestry that directs our moral compass and to which the world looks. As South Africans we cannot remain silent when such gross violations of human rights are committed, not only against our colleagues but humanity at large. Yes, ethics in politics is possible: there is a mutual dependence between ethics and politics. We applaud and acknowledge our colleagues for their bold stand in solidarity with Professor Karabus. Although UKZN is our Alma Mater, we distance ourselves from the irresponsible outbursts of Professor Chima.

REFERENCES

    1. Lewis HH. The plight of Professor Karabus. S Afr J BL 2012;5(2):64. [http://dx.doi.org/10.7196/SAJBL.244]

    1. Lewis HH. The plight of Professor Karabus. S Afr J BL 2012;5(2):64. [http://dx.doi.org/10.7196/SAJBL.244]

    2.International Pediatric Association. Pediatrician held captive for eight months in the UAE. http://www.health.uct.ac.za/usr/health/calendar/notices/IPA-Karabus%2020130416.pdf (accessed 17 May 2013).

    2.International Pediatric Association. Pediatrician held captive for eight months in the UAE. http://www.health.uct.ac.za/usr/health/calendar/notices/IPA-Karabus%2020130416.pdf (accessed 17 May 2013).

    3.South African Medical Association. SAMA supports HPCSA in its Africa Health Conference stance. http://www.medicalchronicle.co.za/sama-supports-hpcsa-in-its-africa-health-conference-stance/ (accessed 17 May 2013).

    3.South African Medical Association. SAMA supports HPCSA in its Africa Health Conference stance. http://www.medicalchronicle.co.za/sama-supports-hpcsa-in-its-africa-health-conference-stance/ (accessed 17 May 2013).

    4.University of Cape Town. Professor Cyril Karabus; call by the leadership of the Faculty of Health Sciences to boycott UAE-supported exhibition. http://www.health.uct.ac.za/news/?id=35 &t=int (accessed 17 May 2013).

    4.University of Cape Town. Professor Cyril Karabus; call by the leadership of the Faculty of Health Sciences to boycott UAE-supported exhibition. http://www.health.uct.ac.za/news/?id=35 &t=int (accessed 17 May 2013).

    5.University of the Witwatersrand. Wits Ethics and Standards Committee calls for a boycott. http://www.wits.ac.za/alumni/alumni%20news%20items/alumni201304/19893/news_item_19893.html (accessed 17 May 2013).

    5.University of the Witwatersrand. Wits Ethics and Standards Committee calls for a boycott. http://www.wits.ac.za/alumni/alumni%20news%20items/alumni201304/19893/news_item_19893.html (accessed 17 May 2013).

    6.Chima SC. Prof Karabus: Comments on doctors boycotting Africa Health.http://www.medicalchronicle.co.za/prof-karabus-comments-on-doctors-boycotting-africa-health/ (accessed 17 May 2013).

    6.Chima SC. Prof Karabus: Comments on doctors boycotting Africa Health.http://www.medicalchronicle.co.za/prof-karabus-comments-on-doctors-boycotting-africa-health/ (accessed 17 May 2013).

    7.South African Medical Association. SAMA’s response to: Comments on doctors boycotting Africa Health. http//www.medicalchronicle.co.za/response-to-comments-on-doctors-boycotting-africa-health/ (accessed 17 May 2013).

    7.South African Medical Association. SAMA’s response to: Comments on doctors boycotting Africa Health. http//www.medicalchronicle.co.za/response-to-comments-on-doctors-boycotting-africa-health/ (accessed 17 May 2013).


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