Privacy, abortion, resource allocation and other ethical issues: the Thandi case (1).

Abstract

Many developing countries have two-tier healthcare systems: the component provided by the state is often inadequate with primary healthcare clinics seeing most of the patients. These clinics are extremely busy often understaffed and under-resourced; medicines are scarce and laboratory facilities inadequate. Secondary and tertiary hospitals are usually short of adequately trained staff both nursing and medical. Private sector healthcare is of a generally higher standard but is expensive and beyond the reach of the vast majority of the population. A small proportion of the adult population is employed by firms large enough to provide healthcare insurance for their employees. Thandi is a 15 year old teenager. Although Thandis family has no private health cover her mother has by-passed the states clinic and has taken Thandi directly to a doctor in private practice Dr Smith - a radiologist. Given Thandis lower abdominal pain her mothers choice of a radiologist as a primary healthcare provider may be inappropriate but Dr Smith is a good caring doctor and does not strictly confine his practice to radiology. (excerpt)