Fundamentals of health law in Uganda

Ben Twinomugisha

Description

Fundamentals of Health Law in Uganda is the first book in the country that examines the multidisciplinary field of health law within the broader health related legal and policy frameworks. It employs rights-based approaches to address some of the major health challenges in Uganda. The issues addressed in the book include: the right to health; public health law; mental health law; regulation of health care professionals; malpractice litigation; patients’ rights; and research involving humans as participants. In addition to acting as a reference for students and faculties in universities and other higher institutions of learning, the book will be helpful to researchers, legislators, policy makers, civil society organisations and all those interested in the subject of health and human rights.About the editor:Ben Twinomugisha is Associate Professor of Law and Dean, Faculty of Law, Makerere University, Kampala, Uganda

Sujets

• Economie
• développement
• Politics
• Relations internationales
• Développement
• Géopolitique

Informations

• Publié par: PULP (Pretoria University Law Press)
• Date de parution: 01 janvier 2015
• Nombre de lectures: 2
• EAN13: 9781920538392
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

FUNDAMENTALS OF HEALTH LAW IN UGANDA

Ben Kiromba Twinomugisha School of Law, Makerere University, Uganda

2015

Fundamentals of health law in Uganda

Published by: Pretoria University Law Press (PULP) The Pretoria University Law Press (PULP) is a publisher at the Faculty of Law, University of Pretoria, South Africa. PULP endeavours to publish and make available innovative, high-quality scholarly texts on law in Africa. PULP also publishes a series of collections of legal documents related to public law in Africa, as well as text books from African countries other than South Africa. This book was peer reviewed prior to publication.

For more information on PULP, see www.pulp.up.ac.za

Printed and bound by: BusinessPrint, Pretoria

To order, contact: PULP Faculty of Law University of Pretoria South Africa 0002 Tel: [phone] Fax: [phone] [e-mail] www.pulp.up.ac.za

Cover: Yolanda Booyzen, Centre for Human Rights

ISBN: 978-1-920538-39-2

© 2015

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TABLE OF CONTENTS

Preface Dedication Table of cases Table of principal legislation Table of subsidiary legislation Table of international instruments and documents Abbreviations

Nature, scope and sources of health law 1 Introduction 1.1 Understanding the concepts ‘health’ and ‘law’ 1.2 The scope of health law 1.3 Sources of health law 1.3.1 The 1995 Constitution of the Republic of Uganda 1.3.2 Principal legislation 1.3.3 Subsidiary legislation 1.3.4 International human rights law 1.3.5 Common law and equity 1.3.6 Customary law 1.4 Policy frameworks 1.5 Chapter synopsis

The right to health 1 Introduction 2 The normative content of the right to health 2.1 The right to health at the international level 2.2 The right to health at the regional level 2.3 The right to health at the domestic level 3 Conclusion

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1 1 4 6 6 8 9 11 15 15 17 17

19 20 20 25 27 31

Challenges to realisation of the right to health 1 Introduction 33 2 Mapping out the challenges 34 2.1 Muted recognition of the right to health and a reluctant judiciary 34 2.2 Criminalisation of sexual and reproductive health rights (SRHR) 43 2.2.1 What are SRHR?43 2.2.2 How are SRHR criminalised? The examples of sex work and abortion45 2.3 The intellectual property regime and access to medicines 54 2.4 Commercialisation of health related services 61 2.5 Inequitable gender relations 64 3 Conclusion 65

Strategies for tackling challenges to realisation of the right to health 1 Introduction 67 2 Mapping out the strategies 67 2.1 Lobbying for legislative measures 67 2.1.1 Lifting restrictions on abortion67 2.1.2 Balancing the rights of a fetus and a woman’s rights71 2.1.3 The right to freedom of conscience in the context of abortion73

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2.2 Claiming health rights through the courts 2.3 Using the Uganda Human Rights Commission 2.4 Utilising mechanisms at the regional level 2.5 Utilising TRIPS flexibilities 2.6 Claiming the right to health through participation 2.7 Tackling inequitable gender relations 2.8 Providing free health care to those unable to afford Conclusion

76 79 80 82 84 86 86 86

Public health law and human rights 1 Introduction 89 2 What is public health law? 90 3 Public health and human rights 92 4 Public health legislation and infectious or communicable diseases 98 4.1 General public health 98 4.2 Venereal diseases 104 4.3 HIV and AIDS 106 4.3.1 Giving credit where it is due: Does the Act meet public health and human rights goals?106 4.3.2 HIV and AIDS control strategy: The use of criminal law107 4.3.3 Disclosure and mandatory testing111 5 Conclusion 114

Mental health law 1 Introduction 117 2 Mental health situation 118 3 Understanding mental health disabilities 119 4 The normative framework for realisation of mental health at the international level 122 4.1 The mainstream international human rights instruments 122 4.2 The pre-CRPD situation: Soft law instruments recognising disability as a human rights issue 125 4.3 The CPRD: A transformative paradigm shift 130 5 The normative framework for realisation of mental health at the regional level 133 6 The normative framework for realisation of mental health at the domestic level 135 6.1 General disability rights law 135 6.2 Mental health legislation 136 7 Conclusion 140

Regulation of health care professionals 1 Introduction 143 2 Medical and dental practice 143 2.1 The Medical and Dental Practitioners’ Council 143 2.2 Registration of medical and dental practitioners 145 2.3 Inquiry into professional misconduct 148 2.3.1 Examples of complaints to the council150 2.3.2 Appeal against decisions of the council152 3 Nursing and midwifery 157 3.1 The Nurses and Midwives Council 157 3.2 Registration and enrolment of nurses and midwives 159 3.3 Inquiry into professional misconduct 161 4 Allied health profession 163

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4.1 The Allied Health Professionals Council 4.2 Registration of AHPs 4.3 Inquiry into professional misconduct Pharmacy 5.1 The Pharmaceutical Society of Uganda 5.2 Inquiry into professional misconduct 5.3 The scope of a pharmacist’s responsibility Traditional medical practice 6.1 Understanding traditional medicine 6.2 Regulation of traditional medical practice Conclusion

163 164 165 167 167 168 169 172 172 173 174

Malpractice litigation 1 Introduction 177 2 What the plaintiff must prove in a malpractice action 178 2.1 The duty of care 178 2.2 Breach of the duty of care 179 2.3 Damage suffered 182 3 Vicarious liability 184 4 The burden of proof 186 5 Defences to a malpractice action 188 5.1 Denial 188 5.2 Peer acceptance: Invoking theBolamtest 189 5.3 Contributory negligence 189 5.4 Voluntary assumption of risk 189 5.5 Where the action is time barred 190 6 Remedies 191 6.1 Damages 191 6.2 Alternative dispute resolution (ADR) 192 7 Criminal liability for negligence 193 8 Conclusion 195

Patients’ rights: The question of consent to treatment 1 Introduction 197 2 Patients’ Charter: Patient’s rights and responsibilities 197 3 Why consent to treatment? 199 4 Capacity to consent to treatment 200 5 Form of consent 206 6 Treatment without consent 207 7 The position of children 208 8 Factors that vitiate consent 210 8.1 Coercion and undue influence 210 8.2 Fraud 211 9 Conclusion 212

Research involving humans as participants 1 Introduction 213 2 Understanding research involving humans as participants 214 3 The international framework 214 3.1 International human rights instruments 215 3.2 The Declaration of Helsinki 216 3.3 The UNESCO Declaration 217 3.4 The CIOMS International Ethical Guidelines 219

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3.4.1 General ethical principles219 3.4.2 The Guidelines: An overview220 3.5 UNAIDS/WHO Guidance Document 223 The national framework 224 4.1 The Uganda National Council for Science and Technology Act 224 4.2 The National Drug Policy and Authority Act 225 4.3 The HIV and AIDS Prevention and Control Act 2014 225 4.4 The UNCST National Guidelines 226 4.5 The Uganda Guidelines for AIDS Research 228 Liability in research involving human as participants 228 Conclusion 231

Bibliography

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PREFACE

I am glad to present this publication,Fundamentals of health law in Uganda. I wrote my Doctor of Laws (LLD) thesis on maternal health rights in Uganda. During the period of conducting research, I realised the importance of teaching a health law course at university. Dr Esther Kisakye, then a senior lecturer at the School of Law, Makerere University and now a judge of the Supreme Court of Uganda, and I started aHealth and the lawat the school. As an elective, the course has been course popular: it attracts a big fraction of the fourth year LLB students every year. Indeed a good number of our former students who offered the course have used the knowledge and skills acquired to advocate for health law and policy reform. Some have established Civil Society Organisations (CSOs) engaged in health and human rights advocacy. However, both my former and current students have always complained of a lack of a local text on health law. Thus, this book is my humble response to these complaints.

The goal of this book is to examine health law within the broader legal and policy frameworks with a bearing on human health. Health law is a multi-disciplinary field that covers the relationship between law and health and teases out critical legal and ethical issues concerning public health and health care. It stresses the crucial role played by law in the protection of health, which is critical for an active and productive life. A question that may be asked by a potential reader of the book is: why a book on health law? Although certain courses such as constitutional law, human rights, international law, environmental law, and the law of torts, which are offered in universities and other institutions of higher learning, contain topics with a bearing on health, health law as a distinct subject is relatively young in Uganda.

In spite of the growing recognition of the important role played by law in the promotion of good health, there is no specific book addressing the interface between health and the law in the Ugandan context. The few available books and other relevant materials are foreign in the sense that they cover British, American, Canadian, Australian and other settings outside Uganda. In my view, there is a need for a local book, which may act as a reference for students of health law. It is hoped that the book will be helpful to students and staff of the schools, faculties and institutes of Law, Public Health, and Medicine in Uganda. The book will also be a critical source of information for health professionals, CSOs, practicing lawyers, policy makers, legislators, activists and all people whose interest is in law, health and human rights. The book is meant for both legal and non-legal audiences. It is hoped that the book will serve a broad range of people who are passionate about human health. Given that the book only tacklesfundamentalsof health law in the country, I welcome constructive criticism so that in future I will be able to expand on it.

Ben Kampala, 2015

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DEDICATION

To my beloved wife, Anne, and my children, Faith, Brenda, Rhona and Jenkins and all my former and present students of ‘Health and the law’.

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TABLES

Table of cases Abdalla v Health Professions Council(2009) EWHC 3948 Abdullahi v Pfizer77 Fed App 48 (2d Cir 2003) Abuki v Attorney GeneralConstitutional Petition 2/1992 (CC) Achutrao Haribhau Khodowa v State of MaharshtraAIR 1996 SC 23777 AIDS Law Project v Attorney General & OthersPetition 97/2010 Alcock v Chief Constable of the South Yorkshire Police(1992) 1 AC 310 Alex Wanigina v Attorney General(1985) HCB 102 (HC) Appleton v Garett34 BM 60 Article 19 v Eritrea(2007) AHRLR (ACHPR 2007) Attorney General v Susan Kigula & 417 OthersConstitutional Appeal 3/2006 (CC) Barnett v Chelsea & Kensington Hospital Management Committee(1968) 1 All ER 1068; (1969) 1QB 428 Baker v Carr(369) USB186 (1962) Bedford v Ag, Canada 2010 ONCA 0814 Bitumuka Apolinali v The Trustees of Uganda(1974) HCB 96 (HC) Bikwatirizo v Uganda Railways Corporation(1971) EA 82 Bolam v Friern Hospital Management Committee(1957) 2 All ER 118; (1957) 1 WLR 582 Bolitho v City & Hackney Health Authority(1997) 4 All ER 771; (1997) 3 WLR 115 C v Minister of Correctional Services1996 (4) SA 292 (T) Canterbury v Spence(1972) 464 F 2d 722 Cassidy v Ministry of Health(1954) 2 QB 66; (1951) 2 All ER 132 Centre for Health, Human Rights and Development & 3 Others v the Attorney General Constitutional Petition 16/ 2011 (CC) Centre for Health Rights and Development & Others v Nakaseke District Local AdministrationCivil Suit 111/ 2002 (Unreported) Certification of the Constitution of the Republic of South AfricaCase19961996 (4) SA 744 (CC) Charles Onyango Obbo & Anor v Attorney General(2004) AHRLR 256 Chatterton v Gerson(1981) 1 All ER 257; (1981) QB 432; (1980) WLR 1003 Chester v Afsher(2004) 4 All ER 587 Christian Lawyers’ Association of South Africa & Others v Minister of Health1998 (11) BCLR 1434 (T) Col (Rtd) Dr Kiiza Besigye v Yoweri Museveni KagutaElectoral Petition 1/2001 (SC). Collins v Wilcock(1984) 1 WLR 1172 Consumer Education and Research Centre v Union of India(1995) 3 SCC 117 Cortex & Others v El SalvadorCase 12.249 (20 March 2009) Report 27/ 2009 Cottam v CVS Pharmacy(2002) 764 NE 2d 814 Decision C-355/2006(10 May 2006, Columbia) Decision T-388/09Gaceta de la Corte Constitucional (Columbia) Denloye v Medical and Dental Practitioners Disciplinary Tribunal(1969) 1 All NLR 306 De Souza v Tanga Township(1961) EA 337 Diamond Bank Ltd v Partnership Investment Co Ltd(2010) WRN 42 Donoghue v Stevenson(1932)AC 562 Embu Public Road Services Ltd v Riimi(1968) EA 22 Enhorn v Sweden(2005) ECHR 5652 Environmental Action Network v Attorney General & NEMA Miscellaneous Application 39/2001 (HC)

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F v West Berkshire Health Authority (1989) 2 All ER 545; (1990) 2 AC 1; (1989) 2 WLR 938 Fairland v Glenhaven Funeral Services(2002) UKHL 22 Faulkne v Nursing and Midwifery Council(2009) EWHC 3349 (Admin) Francis Coralie Mullin v the Administrator Union Territory of Delhi & Others2 (1981) SCR 516 Free Legal Assistance Group v Zaire(2000) AHRLR74 (ACHPR 1995) Gelsinger v Trustees of the University of Pennsylvania PhilaCt of CP filed 29 Cnty January 2001 George Ongom & Another v Attorney General & 2 Others(1974) HCB 267 Gillick v West Norfolk & Wisbech AHA(1985) 3 All ER 402 Government of the Republic of South Africa & Others v Grootboom & Others2000 (11) BCLR 1169 (CC) Government of the Republic of Namibia v LM & Others(2014) NASC 19 Haluska v University of Saskatchewan & Others(1965) 53 DLR 2d 436 Happel v Wal-Mart Stores(2002) 766 NE 2d 1118 Health Professional Council of South Africa v Dewald de Bruin(4) All SA 392 2004 (SCA) HL v UK(2005) EHRR 32 Hoffman v South African Airways2001 (1) SA 1 (CC) Hooper v Capoblanco99 A S01792 (Cal Sup Ct 15 November 2000) Horner v Spalitto1 SW 3d 5 (1999) Hutchinson v General Dental Medical Council(2008) EWHC 2896 (Admin) Independent Medico Legal Unit v Attorney General of Kenya29 June 2011, EACJ First Instance Division Ref3/2010 Ireland v United Kingdom(1978) 2 EHRR 162 Ismail Serugo v Kampala City Council & AnotherAppeal 1/1998 Constitutional (Unreported) Jack Busingye & 2 Others v TMK(1992-1993) HCB 171 James Katabazi v Secretary General of the EACNovember 2007, EACJ First 20 Instance Division, Ref1/2007 Jatta v Nursing & Midwifery Council(2010) EWHC 2549 (Admin) Jenkins v Bogalusa Community Medical Centre(1976) 340 So.2d 1065 Jones v Manchester Corporation(1957) 2 All ER 132 Joyce Nakacwa v Attorney General & 3 OthersConstitutional Petition 2/2001 (CC) Kampe v Howard Stark Professional Pharmacy(1992) 841 SW 2d 223 Keshavananda Bharati v State of Kerala(1993) 4 SCC 225 Kiyutin v RussiaECHR Application 2700/10 (10 March 2011) KL v PeruCommunication 1153/2003, adopted 24 October 2005, UN Doc. CCPR/ C/85/D/1153/2003 (22 November 2005) Kylie v Commission for Conciliation, Mediation and Arbitration & 2 Others 2008 (9) BLLR 870 Lanphier v Phipos(1838) 8 C & P 475 Laxim Mandal & Others v Deen Harinagar Hospital & OthersWP (C) 8853/2008 Marbury v Madson5 US 137 (1803) Marko Matovu v Mohamed Sseviri(1979) HCB 174 Maynard v West Midlands Regional Health Authority (1985) 1 All ER 635; (1984) 1 WLR 634 McGhee v National Coal Board(1973) 1 WLR 1 Media Rights Agenda & Others v Nigeria2000 AHRLR 191 (ACHPR 1998) Medical and Dental Practitioners Disciplinary Tribunal v Okonkwo(2002) AHRLR 159 (NgSC 2001) Mehar Singh Bansel v R(1959) EA 813 Minister of Health v Treatment Action Campaign (No 2)2002 (5) SA 721 (CC)

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Miramago v Attorney General(1979) HCB 24 Monteoli v Woolworths(Pty) Ltd2000 (4) SA 735 (W) Morgan v Wal-Mart StoresNo 03-99-00700 (Tex App Dist 3 (8 October 2000) Mukalazi v Davis Kisule(1995) III KALR 42 (HC) Muwonge v Attorney General(1967) EA 17 MX v ZY AIR1997 Bom 406 (High Court of Bombay) National Confederation of Health Workers (CNTS) v Courts of Justice of the StatesADPF 54 (Supreme Court, 12 April 2012) Naude v Transvaal Boot and Shoe Manufacturing Co1983 AD 379 NB v Slovakia Application29518/10 (12 September 2012) Nevil & Another v Cooper & Another(1958) EA 594 Nicola Mc Donald v Dr Graham Wroe2006 (3) All SA 565 Obiga v Electoral Commission & AnotherElection Petition 4/2001 (Unreported) Olaye v Chairman, Medical & Dental Practitioners Disciplinary Tribunal(1977) NMLB 506 P & S v Poland(2012) ECHR 1853 Parxades Okutoyi v Medical Practitioners and Dentists Board(2008) EKR 16 Paschim Banga Khet Sanity v State of West Bengal(1996) 4 SCC 37 Patricia Asero & 2 Others v The Attorney General & AnotherPetition 409/2009 Plaxeda Rugumba v Secretary General of the EAC & Attorney General of Rwanda 1 December 2011, EACJ First Instance Division, Ref8/2010 Pope John’s Hospital & Another v Baby Kasozi(1974) EA 220 President of the Republic of South Africa v Hugo1997 (4) SA 1 (CC) Price v United Kingdom(2001) EHRR 1285 Purohit & Moore v The Gambia(2003) AHRLR (ACHPR 2003) Rail Commuters Action Group v Transnet Ltd t/a Metrorail2005 (2) SA 359 R v Adamako(1994) 3 All ER 79; (1995) 1 AC 624 R v Bateman(1925) 19 CR App R 8 R v DICA92004) EWCA Crim 1103 (CA) R v Jones (Anthony)(2003) 1 AC 1; (2002) UKHL 5 R v Oakes (1986) 1 SCR 103 R (Raheem) v Nursing & Midwifery Council(2010) EWHC 2549 (Admin) R (Thompson) v General Chiropractic Council(2008) EWHC 2499 (Admin) R (Johnson) v Professional Conduct Committee of the Nursing and Midwifery Council (2008) EWHC 885 (Admin) Re Abortion Law Challenge in ColombiaC-355/2006 (10 May 2006) Re (Adult: Refusal of Treatment)(1992) 4 All ER 649; (1992) 3 WLR 782; (1992) 3 Med LR 306 Re C(1994) 1 All ER 819 Regina Nalukwago v Dr Phillip Byaruhanga & 2 Others(1995) III KALR 106 Re MB(1997) 2 FCR 541 Re O (A Minor) (Medical Treatment)(1993) 2 FLR 149 Re Polemis: The Wagon Mound(1961) UKPC 1 Republic of Kenya v Nyamu & OthersCase 81/2004 (Unreported) Republic v Thompson Books Ltd & Others(1996-7) SCGLR 484 Re R (A Minor) (Blood Transfusion)(1993) 2 FLR 757; (1993) FCR 544 Re S (A Minor) (Medical Treatment)(1993) 1 FLR 396 Re T(1992) 4 All ER 649 Re W(1992) 4 All ER 6217 Rex v Bourne(1938) 1 KB 687; (1983) 3 All ER 612 Robertson v Mc GheeNo 01CV00G0H (M) (N.D. Okla, Filed 29 January 2001) Roe v Minister of Health(1954) 2 All ER 132; (1954) QB 66 Roe v Wade419 US 113 (1973) Rosemary Nalwadda v Uganda AIDS CommissionMisc Cause 45/2010 (Unreported)

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