Browsing by Author "London, L"

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    Conflict of interest: A tenacious ethical dilemma in public health policy not only in clinical practice/research
    (Health and Medical Publishing Group, 2012) London, L; Matzopoulos, R; Corrigall, J; Myers, J E; Maker, A; Parry, C D H
    In addition to the ethical practice of individual health professionals, bioethical debate about conflict of interest (CoI) must include the institutional ethics of public policy-making, as failure to establish independence from powerful stakeholder influence may pervert public health goals. All involved in public policy processes are accountable for CoI, including experts, scientists, professionals, industry and government officials. The liquor industry in South Africa is presented as a case study. Generic principles of how to identify, manage and address CoI are discussed. We propose that health professionals and policy makers should avoid partnering with industries that are harmful to health. Regarding institutional CoI, we recommend that there should be effective policies, procedures and processes for governing public-private joint ventures with such industries. These include arms-length funding, maintaining the balance between contesting vested interests, and full disclosure of the identity and affiliations of all participants in structures and reports pertaining to public policy-making.
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    Forty-five year apart: Confronting the legacy of racial discrimination at the University of Cape Town
    (2004) Perez, G; London, L
    One of the many consequences of South Africa's history of racial discrimination is the impact it had on the training of black medical students. Blacks, and particularly those classified as African under apartheid’s racial classification, were restricted from entry to medical schools by a permit system introduced in 1959 and only rescinded in 1986.1 In 1967, the ratio of white doctors trained per million of the white population in South Africa was almost 100 times higher than the equivalent ratio for Africans,2 and although whites constituted less than 20% of the population, 83% of all doctors and 94% of all specialists in South Africa in 1985 were white.3 Not only were blacks largely excluded from training opportunities but, for those gaining access to medical schools, the conditions under which they trained were extremely onerous, and lacked the educational, recreational, accommodation and social opportunities afforded their white colleagues.1,2,4,5 A comment by a leading academic in 1988 on the state of medical training could have been applied to almost all of South Africa’s medical schools during apartheid: ‘. . . in spite of our much vaunted Academic Freedom, our policy and practice is heavily influenced, if not determined, by . . . an oppressive apartheid ideology. Why else have we produced so few African doctors; why else does the University . . . not have a satisfactory teaching hospital or residence for its [African] students?’
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    Racial discrimination: experiences of black medical school alumni at the University of Cape Town 1945-1994
    (Health & Medical Publishing Group, 2012) Perez, A M; Ahmed, N; London, L
    Objective. Reflecting on its role during apartheid, the Faculty of Health Sciences of the University of Cape Town (UCT) undertook a study to explore the experiences of black alumni who trained in the period 1945-1994. Design. Seventy-five black alumni were selected through purposive and snowball recruitment, resulting in 52 face-to-face and 23 telephonic or postal interviews. Results. Experiences of racial discrimination were widely reported and respondents believed the quality of their training was adversely affected. Until 1985, black students were required to sign a declaration agreeing to excuse themselves from classes where white patients were present. Black students were denied access to white patients in wards, and the university admitted that it could not guarantee their clinical training. Tutorial groups were racially segregated. Black students were also excluded from university facilities, events and extramural activities. Themes that emerged were: lack of social contact with white staff and students during training, belief that white staff members actively or tacitly upheld discriminatory regulations, and resistance by black students. Efforts of some white staff to resist discrimination were acknowledged. Conclusion. Racism was entrenched explicitly and implicitly. Perceptions of the attitudes of white staff to apartheid legislation on the part of black alumni were diverse, ranging from claims of active support for racial discrimination to recognition of attempts to resist racist rules. These findings provided the basis for Faculty transformation initiatives based on human rights, respect for human dignity and non-discrimination.