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Doctoral Degrees (Medical Law)

Permanent URI for this collectionhttps://hdl.handle.net/10413/8411

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Browsing Doctoral Degrees (Medical Law) by Author "Thaldar, Donrich Willem."

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    Access to healthcare in the age of CRISPR: an analysis of the right to heritable human genome editing in the context of the tuberculosis epidemic in South Africa.
    (2022) Kamwendo, Tamanda Agatha.; Thaldar, Donrich Willem.
    Tuberculosis (TB) is the leading cause of death from infectious diseases in South Africa and a major risk to global health security. Although notable progress has been made towards TB control, its effectiveness has been limited, partly due to acquired resistance during the first-line TB treatment or poor patient adherence to the treatment. Considering that genetic factors play an important role in one’s susceptibility to TB, it is imperative that all aspects of vertices of the TB triad — a susceptible host gene, pathogen, and environment — be considered in formulating treatment. CRISPR-CasX is a revolutionary new approach to genetic modification that promises effective disease treatment and control in humans. This thesis explores the right to heritable human genome editing in South Africa in the specific context of TB treatment. Against this backdrop is the uncertainty of the ambit of the Constitutional commitment to ensure that all South Africans have access to healthcare services such as gene-editing services. As a result, the application of gene-editing technology for TB treatment is contingent on how this the right of access to healthcare services is interpreted. This thesis endeavours to show how the right of access to healthcare should be interpreted as being inclusive of access to geneediting technology. This study hence serves as an appraisal for South Africans on how to demand access to gene-editing services as a legal right in the search for a suitable treatment for TB. The thesis also provides momentum for South African policymaking by providing recommendations for research and the clinical use of CRISPR therapeutics as a medicinal product as the country has no gene-editing-specific policies or statutes.
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    An Afrocentric approach to CRISPR-Cas9: analysing the use of genetic technologies in human reproduction through the lens of human rights and African values.
    (2021) Shozi, Bonginkosi.; Thaldar, Donrich Willem.
    In the wake of the advent of genome editing technology CRISPR-Cas9, there has been global debate about the potential use of this technology on human gametes or embryos to create individuals with genetically modified genomes. This is a process commonly referred to as germline genome editing (GGE). Given that several countries, including South Africa (SA), have no regulation speaking to GGE, many proposals have been put forward regarding how this technology ought to be regulated in a way that attends to the ethical issues raised by the prospect of modifying the genomes of future generations. Within this global discourse, however, there are several material gaps. Most notably, the proposals have primarily been framed through a Eurocentric paradigm that omits material contextual considerations relevant to SA and the African continent. Furthermore, the proposals tend to be based on value judgements on ethical issues — such as the moral significance of the human genome — rooted in the Western philosophical tradition. This thesis endeavours to respond to these gaps by providing a novel theoretical approach to the regulation of GGE in South Africa, termed an ‘Afrocentric approach’. This approach entails responding to the legal, ethical and human rights issues related to GGE that is rooted in an African philosophical perspective on these issues, and that is sensitive to the realities of the South African context. This thesis concludes that SA ought to be open to the prospect of parents modifying the genomes of future offspring but must also place reasonable and evidence-based constraints on GGE. This thesis finds that there is a tenable argument that prospective parents have a ‘right to CRISPR’, but this right may be limited. Such limitations must be rationally related to the goals of (1) protecting public interests, or (2) promoting the best interests of the prospective child.