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LCR4802 EXAM PACK 2023
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LCR4802EXAM PACK
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,TUT MCQ’S – 2019 SEMESTER 1
Question 1
In Soobramoney v Minister of Health, KwaZulu-Natal 1998 (1) SA 765 (CC), Mr Soobramoney
was not admitted to the kidney dialysis programme at a state hospital because the hospital did
not have the funds to supply dialysis treatment to all patients with chronic kidney failure. As
there were far more patients with chronic kidney failure than dialysis machines to treat these
patients, guidelines were set up to help medical personnel make the soul wrenching decisions
on who will receive treatment. Why could Mr Soobramoney not be admitted to the dialysis
programme in terms of these guidelines?
(1) He did not suffer from acute kidney failure and only patients who suffered from acute kidney
failure were eligible for dialysis. Incorrect: In terms of the hospital‘s policy, patients with acute
kidney failure who could be cured by dialysis were automatically admitted to the dialysis
programme. Patients with irreversible chronic kidney failure (such as Mr. Soobramoney) were
not automatically admitted, although they were not automatically excluded either. They could be
admitted to the programme provided they complied with certain guidelines. According to these
guidelines, the patient with irreversible chronic kidney failure had to be eligible for a kidney
transplant in order to be admitted, and Mr Soobramoney was not eligible for a kidney transplant
because he suffered from ischemic heart disease and cerebra-vascular disease. See 1.6 of the
study guide.
(2) His case was not serious enough. Incorrect: In fact, his case was dire. Dialysis could have
kept him alive for some time, but could not cure him. He was not eligible for a kidney transplant
because he suffered from a number of other serious conditions. There were far more patients
with chronic kidney failure than dialysis machines. It was therefore not possible to treat all
chronically ill patients. The hospital‘s guidelines were intended to help the medical personnel
make the soul-wrenching decisions on who will receive treatment. Application of these
guidelines meant that far more patients benefitted from the programme than would have been
the case had the limited number of dialysis machines been used to keep people with chronic
kidney failure alive. Application of the guidelines ensures a greater probability of more beneficial
treatment, as it is aimed at a cure and not merely at caring for patients in a chronically ill state.
See 1.6 of the study guide.
(3) He suffered from ischemic heart disease and cerebra-vascular disease, which made him
eligible for a kidney transplant, but not for regular kidney dialysis. Incorrect: The hospital‘s
guidelines were intended to ensure that the limited resources (dialysis machines) were allocated
in a way that would lead to the maximum benefit. Hence, patients with acute kidney failure who
could be cured by dialysis were admitted to the programme. Patients with chronic kidney failure
could not be cured by dialysis. A kidney transplant would be required to cure them. Kidneys for
transplant purposes are also in short supply and the hospital‘s policy was to give preference to
patients with a better chance of survival after the kidney transplant. Therefore, patients suffering
from other life-threatening conditions, such as ischemic heart disease and cerebra-vascular
disease, were not eligible for a kidney transplant.
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,(4) He suffered from ischemic heart disease and cerebra-vascular disease, which rendered him
ineligible for a kidney transplant and the hospital would only admit a patient with chronic kidney
failure to their dialysis programme if the patient was eligible for a kidney transplant. Correct: See
1.6 of the study guide.
Question 2
The Health Professions Act 56 of 1974 makes provision for the suspension of a practitioner‘s
registration if—
(1) The practitioner fails to comply with the requirements in respect of continuing professional
development. Correct: See 3.4 and 3.6 of the study guide. This question was aimed at
assessing whether you know the difference between suspension of registration and removal of
a practitioner‘s name from the register. The Act further differentiates between administrative
removal of the name of a practitioner, and removal of his/her name as a form of punishment.
(2) The practitioner fails to pay to the professional board, within three months as from the date
on which it became due for payment, any annual fee prescribed by the professional board.
Incorrect: The Health Professions Act 56 of 1974, section 19A (1)(d) makes provision for the
administrative removal of the name of the practitioner from the register in such a case. See 3.4
of the study guide.
(3) A disciplinary forum finds him/her guilty of unprofessional conduct and imposes the penalty
of removal of his/her name from the register. Incorrect: Note that removal is not the same as
suspension. The Health Professions Act 56 of 1974 (s 19(1)(g)) makes provision for the removal
from the register of the name of a practitioner who was found guilty of unprofessional conduct
and on whom the penalty of removal had been imposed. See 3.4 of the study guide.
(4) The practitioner‘s name was initially entered on the register in error. Incorrect: The Health
Professions Act 56 of 1974 (s 19(1) (f)) makes provision for the administrative removal of the
name of the practitioner is such instances. See 3.4 of the study guide.
Question 3
Mr. Moodley is scheduled to undergo a procedure at the hand of Dr Davidson. Dr Davidson
intends to charge a fee that exceeds that which is usually charged for such procedure. Dr
Davidson must inform Mr. Moodley of the fee—
(1) By furnishing him with a detailed account within a reasonable time after the procedure.
Incorrect: In this case, the fee Dr Davidson intends to charge exceeds that which is usually
charged for such procedure. Where that it is the case, section 53 of the Health Professions Act
56 of 1974 provides that the medical practitioner must inform the patient or any person
responsible for the latter‘s maintenance (e.g. a parent) of the fee which he or she intends to
charge before rendering any professional services. See 4.1.3 of the study guide. Of course, if
the doctor claims payment from the patient in respect of any professional services rendered, he
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, must also furnish the patient with a detailed account within a reasonable period. Compare 3.9 of
the study guide.
(2) Before the procedure is done, and must also inform him of the usual fee. Correct: This is
prescribed in section 53 of the Health Professions Act 56 of 1974. The Act provides that unless
the circumstances render it impossible for him or her to do so, a medical practitioner must
inform the patient or any person responsible for the latter‘s maintenance (e.g. a parent) of the
fee which he or she intends to charge before rendering any professional services. However, this
must be done only where the doctor is so requested by the person concerned, or where the fee
exceeds that usually charged for such service. In the latter instance, the doctor must also inform
the person concerned of the usual fee. See 4.1.3 of the study guide.
(3) By furnishing him with a detailed account within a reasonable time after the procedure,
unless Mr Moodley enquires about the fee to be charged before undergoing the procedure, in
which case Dr Davidson must inform him before the procedure is done. Incorrect: Where Mr
Moodley enquires about the fee before the procedure, Dr Davidson is indeed obliged to inform
him before the procedure. However, as is clear from our comments on statement (2) above, the
duty to inform the patient before the procedure also exists where the fee exceeds that usually
charged for such service. See 4.1.3 of the study guide.
(4) Before the procedure is done, but he need not inform Mr Moodley of the fee usually charged
for such procedure.LCR4802/202 5 Incorrect: In terms of section 53 of the Health Professions
Act 56 of 1974, he is under an obligation to inform Mr Moodley of the fee usually charged for
such procedure. See 4.1.3 of the study guide.
Question 4
A hospital includes an indemnity clause in the fine print of its admission form, purporting to
exclude liability on the part of the hospital or any of its employees for any harm, loss,
consequential loss, damage, and/or injury of whatsoever nature which the patient may suffer in
consequence of any act or omission on the part of the hospital or any of its employees. Assume
that the Consumer Protection Act 68 of 2008 applies in this instance. Which one of the following
best describes the impact that the provisions of the Act would have in the circumstances of the
case?
(1) The patient‘s attention should be drawn to the indemnity clause, and the patient should be
given adequate opportunity to comprehend the provision. Incorrect: It is true that the patient‘s
attention should be drawn to the indemnity clause, and the patient should be given adequate
opportunity to comprehend the provision (s 49 and, in particular, subsection (5)). However, the
statement is not the one that ―best describes‖ the impact of the provisions. The statement omits
to mention the very important possibility that the indemnity clause could be regarded as unfair,
unreasonable or unjust. See section 48 of the Act, as discussed under 4.1.2.3 of the study
guide.
(2) The patient‘s attention should be drawn to the indemnity clause and the patient should be
given adequate opportunity to comprehend the provision. The possibility exists that such
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