Can private obstetric care be saved in South Africa?

Graham Robert Howarth, Pieter Carstens


This article examines the question of whether private obstetric care in South Africa (SA) can be saved in view of the escalation in medical and legal costs brought about by a dramatic increase in medical negligence litigation. This question is assessed with reference to applicable medical and legal approaches. The crux of the matter is essentially a question of affordability. From a medical perspective, it seems that the English system (as articulated by the Royal College of Obstetricians and Gynaecologists) as well as American perspectives may be well suited to the SA situation. Legal approaches are assessed in the context of the applicable medicolegal framework in SA, the present nature of damages and compensation with reference to obstetric negligence liability, as well as alternative options (no-fault and capping of damages) to the present system based on fault. It is argued, depending on constitutional considerations, that a system of damages caps for noneconomic damages seems to be the most appropriate and legally less invasive system in conjunction with the establishment of a state excess insurance fund.

Authors' affiliations

Graham Robert Howarth, Head of Medical Services: Africa, Medical Protection Society, and part-time lecturer Steve Biko Centre for Bioethics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Pieter Carstens, Associate member of the Pretoria Bar; Head of the Department of Public Law and Professor of Medical Law, University of Pretoria, South Africa

Full Text



Obstetric care; indemnity

Cite this article

South African Journal of Bioethics and Law 2014;7(2):69-73. DOI:10.7196/SAJBL.319

Article History

Date submitted: 2014-03-10
Date published: 2014-11-04

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