Suchergebnisse

The early history of the occupational health system in South Africa is outlined up to the early 1970s which mark a political and social transition in the society. Relevant demographic and social data are provided, and the roles and mutual relations of capital, labor, state, and academic sectors are discussed. During the past 15 years there has been heightened occupational health activity. Major legislative activity has included several commissions, the promulgation of new laws and regulations governing the workplace, and deregulatory measures in a contradictory mix. Conflictual relations between social forces are illustrated by two examples involving the introduction of safety representatives in the workplace, and compensation for occupational lung disease. The implications of wider political and economic realities are analyzed, and current and probable future trends in the evolution of the occupational health system are identified.

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.