Bult - University of the Free State

Navorsing Research
Taking your own medicine may be a bitter pill to swallow
By Cindé Mostert
When faced with surgery, many people
seek a second and sometimes even third
opinion. Medication, however, is often taking
blindly, putting at risk not only the patient,
but also the doctor prescribing and the
pharmacist dispensing. At the core of this
complex problem, health and legal issues
tiptoe around each other. However, one
legal expert was bold enough to let them
meet among the pages of her LL.D.
Prof. Rita-Marié Jansen awaits me at her office door.
She is feminine, graceful and sincerely polite. Her
smile is permanent and her eyes radiate a soft glow.
Out of the window fly my Law & Order ideas of power
dressing, staccato sentences and a quick step.
Rita-Marié’s CV surpasses all superficial superiority
gestures. When she speaks, everyone listens, because
they want to; not because they should.
“If I can give one person a painless death, I have
done enough,” Rita-Marié explains as she starts the
conversation.
Prof. Rita-Marié Jansen started her journey at the UFS
some 40 years ago as a first-year B.Soc.Sc. (Nursing)
student. She completed her honours degree and
started working at the Department of Nursing at Kovsie
Campus. During those years she married Willem, gave
birth to two girls, and completed a B.Iuris degree cum
laude. Intensifying my wordless wonder, Rita-Marié
explains: “My husband wanted to study L.Law, and
I decided to join him. It would make it a lot easier for
both of us, I thought. So I discontinued my master’s
studies in nursing and prepared for law … and my firstborn!
I was such a sight, comfortably ensconced in a
first-year class with my budding belly and my husband
beside me.”
Rita-Marié’s daughter turned out to be a wonderful
baby and she managed to juggle work, studies and
motherhood. At the end of their third year, they were
expecting their second child. “I was eight months
pregnant when I sat through six three-hour papers,”
Rita-Marié only laughs when recalling that time.
“I stayed at home for two years after our second
daughter’s birth. She cried non-stop and I couldn’t
cope with everything on top of her demands.”
After two years of being a stay-at-home-mom, Rita-
Marié returned to Kovsies to complete an LL.B. This
time, however, she was alone. Her husband pursued
another career, but law was already in her blood. In
1989 she was appointed as a lecturer at the Faculty of
Law, and has been there ever since, lecturing in Private
Law.
Rita-Marié is an expert in Medical Law, Law of
Delict and Customary Law. She has delivered a
number of papers at both national and international
conferences, has authored a number of accredited
research publications and chapters in textbooks. She
successfully completed her LL.D dissertation: Legal
liability resulting from medication errors, in 2007.
Rita-Marié explored a field of study that, according
to her, still needs much investigation. Worldwide
the prescription, dispensing and administering of
medication comprise the most common form of
medical treatment. The number of medication errors
made in a medical care institution is regarded as a
good barometer of the general standard of care in that
institution. The number of medication errors that come
to light, however, is only the tip of the iceberg because,
compared to botched surgery, it can easily be swept
under the carpet. Research also indicates that the
prescription of medication as form of treatment is not
regarded as the high-risk activity that it really is.
“The research offers a comprehensive source regarding
medication errors seen from a legal perspective.
The extent and occurrence of medication errors
(prescription, dispensing and administration errors) are
discussed with the aim to also bring it to the attention
of both lawyers and health-care workers. Doctors,
pharmacists and nurses often experience uncertainty
about their legal position and how to deal with
problematic situations.”
In her study, Rita-Marié discusses specific problematic
areas, including the more important legislation with
regard to medication treatment, as well as the offlabel
use of medication, i.e. the use of medication for
conditions (or in dosages) other than that for which it
is registered at the Medicine Control Council (MCC).
Although the off-label use of medication is regarded
as sound medical practice, an adverse outcome may
involve legal complications.
“Doctors find different uses for medication almost on
a daily basis and the registration process at the MCC
simply cannot keep up. It is estimated that as much as
60% of prescriptions in the USA are for off-label uses.”
Rita-Marié also investigates the problems surrounding
the administration of pain medication and especially
the failure to give sufficient pain medication – one of
the most prevalent forms of medication errors. “Owing
to a fear of prosecution and in an attempt to avoid an
arduous inquisition, doctors generally give too low
a dosage of painkillers. Unfortunately there are no
on-line answers to these matters. The only solution is
information. Informed medical and legal practitioners
and – importantly – informed patients. Patients need to
start asking questions.”
Rita-Marié concludes, “I am committed to making
a difference in the lives of both the patients and the
medical practitioners.”
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