Medicine and health care in South Africa. A religious/ethical perspective.

Religion and morality are inter-related but nevertheless quite distinct from each other. All the great living religions of the world teach broadly comparable moralities, e.g. the "Golden Rule". In all of them there is general acceptance of the fundamental worth of the human personality. This is true also of the teaching of many moral philosophers, e.g. Kant, who taught that people must be treated as ends and not means. In the Biblical religions such respect derives from the doctrine of the Imago Dei. From this premise stems a number of ethical norms, which, however, are often in conflict and not easily reconciled. Hence, the dilemma of trying to decide on a just and equitable allocation of scarce medical resources and adequate health care in a country where there are not nearly enough medical resources for all who need them. Who lives? Who dies? Who decides? Some ethicists advocate a purely random procedure, recognizing the equal worth of every individual. Others believe there are relevant differences that justify choices being made on valuational or utilitarian grounds. They argue that the distribution of medical care in less than optimal circumstances requires a certain discrimination. Paul Ramsey believes that this problem is so complex as to be almost impervious to human reason. He therefore argues for far greater emphasis on preventive medicine. This raises the question as to whether we should be spending millions on procedures designed mostly for the benefit of the chosen few (who can afford them) when thousands of children are dying annually from diseases for which cures are known but not available to the masses.(ABSTRACT TRUNCATED AT 250 WORDS)