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Biomedical subjects

S A Strauss

Publications and source records attributed to S A Strauss.

At least 19 recordsLinked to original sources
PubMed1998

An unusual case of wrongful pregnancy: liability of doctor resulting from misrepresentation.

A married woman and her husband recovered damages from a gynaecologist after the woman gave birth to a third and normal child. The couple's second child had been delivered by way of Caesarean section. Six days after its delivery the doctor made the statement (erroneously) that he had performed a tubular ligation on the woman, following a discussion on the advisability of sterilisation. In fact no such procedure had been performed. The woman became pregnant again. The doctor was held liable on the basis of a negligent misrepresentation.

Female↗
PubMed1996

'Wrongful conception', 'wrongful birth' and 'wrongful life': the first South African cases.

Internationally case law has developed in regard to actions which in due course were given the following labels. "Wrongful pregnancy" or "wrongful conception" for cases where a healthy but unwanted child is born, following negligent contraceptive advice by a doctor or a negligent sterilization or abortion procedure, and the parents claim damages; "wrongful birth" where such a claim is brought by the parents of an abnormal or disabled child; "wrongful life" where a claim is brought by or on behalf of the abnormal or disabled child itself. The first judgments in South Africa were handed down during the past seven years and are discussed in this article.

Abortion, Induced↗
PubMed1992

Circulating cytomegalovirus (CMV) neutralizing activity in bone marrow transplant recipients: comparison of passive immunity in a randomized study of four intravenous IgG products administered to CMV-seronegative patients.

Forty-two cytomegalovirus (CMV)-seronegative bone marrow transplant (BMT) recipients were randomized in a double-blind fashion to receive one of four commercially available intravenous Ig (IVIgG) products (Gamimmune N, Immune Globulin Intravenous, Gammagard, or Sandoglobulin) at a dose of 500 mg/kg every other week. The four treatment groups were similar in distribution of patient ages, weights, autologous versus allogeneic donor type, and underlying diseases. Every other week administration of IVIgG provided total serum IgG levels within the physiologic range for age. CMV titers by latex agglutination were stable (average geometric mean titer of 18.4 after the second IVIgG dose), with no statistically significant differences among the four product groups. CMV neutralizing activity (CMVNA) and CMV enzyme-linked immunosorbent assay (ELISA) titers were determined on a subset of sera from 27 study patients representing the four product groups. Patient serum samples obtained before IVIgG infusions and 2 weeks after the second IVIgG dose (ie, 3 weeks post-BMT) were assayed for CMVNA and CMV ELISA titers. Geometric mean titers of CMVNA and CMV ELISA varied among the product groups. The highest mean 50% CMVNA was 1:43 for product B, whereas the lowest mean 50% CMVNA was 1:14 for product A; two of the IVIgG product groups showed intermediate 50% mean titers of 1:27 (product C) and 1:26 (product D) for an overall P = .02. CMV ELISA titers (expressed as Paul Ehrlich International units [PEI U]) also showed the highest mean of 2.95 PEI U/mL for product B and the lowest mean of 1.34 PEI U/mL for product A. Intermediate mean values of 2.27 PEI U/mL and 2.03 PEI U/mL were obtained with products C and D, respectively (overall P = .003). The CMV ELISA titers show a minimal correlation (r = .566) to the observed CMVNA titers. We conclude that commercially available IVIgG products provide passive CMVNA, and that the level of circulating CMVNA is affected by the IVIgG product used.

Adolescent↗
PubMed1991

Legal questions surrounding hunger strikes by detainees and prisoners.

The 'right to die' is not of an absolute character but is subject to definite qualification. There are legal and social interests reflecting profound ethical values which militate against an absolute right on the part of a prisoner to die by means of a hunger strike. The declared policy of the South African authorities is that a prisoner who resorts to a hunger strike may not be subjected to force-feeding. This is in accordance with the 1975 Tokyo Declaration. Unfortunately the Declaration is silent on the question of whether a doctor may provide medical treatment once a hunger striker has reached the point where he is no longer capable of rational thought. In this article it is submitted that a doctor would be legally entitled to do so.

Dissent and Disputes↗
PubMed1989

Legal aspects of medical treatment of prisoners and detainees.

This paper deals with certain basic aspects of the medical treatment of detainees and prisoners. Emphasis is placed on the requirement that the responsible doctor should have the fullest possible degree of professional discretion. The rules pertaining to professional confidentiality are not suspended in the prison situation. The question as to whether a doctor should work in a situation which in general is not ethically acceptable to him is discussed. Reference is made to the Declaration of Tokyo and South African positive law is examined.

Confidentiality↗
PubMed1988

AIDS and South Africa--towards a comprehensive strategy. Part I. The world-wide experience.

In this, the first of a three-part series of articles in which we propose steps towards a comprehensive strategy for the control of HIV infection, we consider briefly the world-wide experience with the HIV epidemic. Our objective is to highlight the problems and controversial issues which are pertinent to strategies for the control of HIV infection. We focus on problems of case-definition, differences between 'African' and 'Western' AIDS and the implications for South Africa, and problems with sensitivity and specificity of tests used at present, particularly in the context of false positivity in a community with a low prevalence of HIV infection. We consider some of the ethical issues, including the need for adequate counselling, the need for informed consent before testing, and the centrality of confidentiality, particularly in the context of possible victimisation and neglect of HIV-positive individuals. Differences between 'notification' and 'reporting' are emphasised. Recommendations are made regarding these problems.

Acquired Immunodeficiency Syndrome↗
PubMed1988

AIDS and South Africa--towards a comprehensive strategy. Part II. Screening and control.

In this, the second of a three-part series of articles in which we propose steps towards a comprehensive strategy for the control of HIV infection, we consider controversies relating to screening for HIV, the indications for and desirability of mandatory testing of certain groups at risk, and the place of voluntary testing in the control of HIV transmission and infection. Key recommendations are that mandatory testing of donors of blood and other vital tissues, patients on haemodialysis and haemodialysis unit staff is justified, and that children put up for adoption may require testing. We make further recommendations regarding HIV testing as a prerequisite for life insurance and recommend that voluntary testing be offered, supported by adequate pre- and post-test counselling. We consider that all health care workers should accept as their moral obligation the care and management of HIV-infected individuals, and that they should be adequately educated and skilled in such work. These recommendations were reached largely by consensus, although there were occasions when individual authors condoned recommendations with which they did not personally agree.

Acquired Immunodeficiency Syndrome↗
PubMed1988

AIDS and South Africa--towards a comprehensive strategy. Part III. The role of education.

In this, the third of a three-part series of articles in which we emphasise the urgent need for and propose steps towards a comprehensive strategy for the control of HIV infection, we highlight the fundamental importance of an education campaign and the three critical essentials for a successful campaign. The first concerns the responsibility of the State in administering the programme, in providing adequate funds on an on-going basis and in delegating responsibility for the day-to-day activities to the appropriate local authorities and non-governmental organisations. The second relates to the need to establish a multidisciplinary AIDS group representative of groups at risk and of relevant scientific expertise to ensure that appropriate policies are developed and that changes to policy are made in response to changing circumstances, based on sound epidemiological, managerial and educational principles. These must take particular account of circumstances peculiar to South Africa, such as the migrant labour system, which may promote both promiscuity and homosexuality. Thirdly, the need to ensure open, appropriate communication with the groups at risk and the public at large in the development, implementation and evaluation of the education campaign is emphasised. In this context we plead for more psychosocial research. These recommendations were reached largely by consensus, although there were occasions when individual authors condoned recommendations with which they did not personally agree.

Acquired Immunodeficiency Syndrome↗
PubMed1986

The conventional versus the new radiological contrast media. Cost-benefit analysis and medicolegal implications.

New iodinated radiological contrast media, which are safer but much more expensive than the conventional ones, have been introduced. Since the financial implications are considerable a compromise between cost and safety is inevitable. It is therefore recommended that, at present, the conventional media be used routinely and the new media be reserved for potentially painful examinations and for patients at higher risk. Should a question of wrongfulness or negligence concerning the use of contrast media be considered by our courts, they will undoubtedly be influenced by what is considered 'common practice' and 'accepted practice' within a medical specialty and that may be co-determined by socio-economic considerations.

Contrast Media↗
PubMed1975

[Death and the moment of death: several legal aspects].

None of the important legal issues concerning the moment of death and re-animation procedures can be solved by means of simplistic legal formulae. In adjudicating on a particular problem, a court of law will have to be guided by prevailing religious, societal and medical attitudes. But as jurists we must strongly support the individual's "right to die".

Attitude of Health Personnel↗