The final session of 2026
Medical Ethics
Access Denied: Medicine, Money and Moral Decisions
Ethics at the Frontier of Innovation
Ethics, access, and the cost of care in South African interventional radiology. A case-based examination of justice, financial transparency, and the profession’s obligations beyond the suite.
Ethicist
About This Session
Our final session of the 2026 series steps beyond the procedure room to confront a more uncomfortable question: what does it mean to practise ethically within a healthcare system shaped by unequal funding and access?
In South Africa, healthcare operates across a two-tier landscape — public and private — where the ability to access innovative interventional radiology is often determined not only by clinical need but by where a patient is treated and how care is financed. Importantly, even within the private sector, medical aid cover does not automatically translate into access to every available innovation, leaving gaps between theoretical coverage and real-world availability.
Ethics in interventional radiology is often taught through clinical decision-making: when to intervene, when to escalate, and when to decline. Yet many of the most pressing ethical challenges arise long before a patient reaches the procedure suite. Who can access advanced minimally invasive therapies? Who funds these innovations? And how do clinicians navigate fairness within systems where access is structurally uneven?
This session brings together a multidisciplinary panel of clinicians and thinkers to explore the structural, financial and moral dimensions of interventional radiology in a context where innovation is advancing rapidly, but remains unevenly accessible across the healthcare system.
The most urgent ethical questions in South African IR don’t begin inside the suite. They begin at the door.
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1Apply the principle of justice to the structural realities of South African IR practice, including the access gap between public and private sectors and its implications for practitioner responsibility.
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2Identify the financial consent obligations of the IRologist under HPCSA guidelines, including the ethical requirements around extra billing, pre-authorisation disputes, and transparency of out-of-pocket exposure.
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3Analyse case-based scenarios involving inappropriate procedure requests, medical scheme conflicts, and conflicts of interest — applying ethical reasoning frameworks appropriate to South African clinical practice.
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4Describe the implications of the NHI Act for IR procedure inclusion, private sector restructuring, and the advocacy obligations of the interventional radiology profession.
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5Engage with the HPCSA’s updated ethical guidelines, including Booklet 7 (Withholding and Withdrawing Treatment) and Booklet 20 (Ethical Use of AI), and their relevance to IR governance in 2026.
