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HomeMedico-LegalPenguin withdraws book by Mandela's doctor, former SANDF surgeon-general

Penguin withdraws book by Mandela's doctor, former SANDF surgeon-general

Penguin Random House SA has withdrawn from the shelves Mandela’s Last Years, written by the former Surgeon-General of the SA National Defence Force, who was Madiba’s doctor for nearly a decade, following threats by Graça Machel‚ the former first lady, to sue over a breach of doctor–patient relationship confidentiality.

Business Day reports that Lieutenant-General Vejay Ramlakan‚ who was Madiba’s doctor for nearly a decade and the former surgeon general of the South African National Defence Force (SANDF)‚ published the book, Mandela’s Last Years (Penguin Random House), last week. Among the claims Ramlakan makes are that it was Winnie Madikizela-Mandela‚ and not Machel‚ who was at Mandela’s bedside when he died.

It also details never-before-published information on Madiba’s various health conditions‚ including that doctors were worried the former statesman "might have died" when he stopped breathing on a chilly night in June‚ seven months before his December 2013 death. Internal family politics also negatively affected Mandela’s heath in his final few months‚ Ramlakan claims.

He said he was privileged that the family gave him their blessing in publishing the book, but Machel said she took issue with how the book breached patient-doctor confidentiality.

"I condemn Vejay Ramlakan’s book, Mandela’s Last Years, in the strongest terms. It is an affront to and an assault on the trust and dignity of my late husband‚ president Nelson Mandela. It breaches the doctor–patient relationship of confidentiality and I am taking legal advice on whether to institute legal proceedings against the author and its publisher‚" she wrote.

Machel also said she would be consulting the executors of Mandela’s will "on how best to protect Madiba’s good name and reputation".

The report says that Ramlakan referred queries Penguin Random House‚ who said the book was written "with the support of family members". "Penguin Random House SA accepted Mandela’s Last Years for publication after the author … advised (us) that he had received permission from Mr Mandela’s family to publish the book‚" said spokesperson Surita Joubert. "Their representative was provided with a proof of the book."

Joubert said Mandela’s Last Years "sets the record straight" about the final years of his life‚ adding that it was written by the head of his medical team‚ who saw what Mandela was experiencing – the medical problems‚ interactions between family members and staff, and scrutiny by the press.

"Written with respect and with the support of family members‚ this book completes the story of Nelson Mandela‚" said Joubert. "It reveals a man who showed immense courage‚ not only when he fought for the freedom of millions of people‚ but until the very end of his life."

 

The Department of Defence has distanced itself from the controversial book. The Times quotes DoD spokesperson Siphiwe Dlamini as saying that the department “noted and completely distances itself" from media reports about the book. “The department wishes to explicitly state that all views expressed in the book are those of the author and do not in any way or manner represent the department and the SA Military Health Service.

“The SANDF’s policy on patient-doctor confidentiality is in force‚ as such the views and patient doctor engagements expressed in the book have not been sanctioned by the senior cadre of the department and the SANDF respectively‚” Dlamini added.

Penguin's statement of withdrawal read:

Penguin Random House South Africa (PRHSA) has decided to immediately withdraw the book Mandela’s Last Years from the trade, and no further copies will be issued. The publisher has done so out of respect for the late Mr Mandela's family.

PRHSA accepted Mandela’s Last Years for publication after the author Vejay Ramlakan advised the publisher that he had been requested by Mr Mandela’s family to publish the book. The book was meant to portray Nelson Mandela’s courage and strength until the very end of his life, and was in no way intended to be disrespectful. However, given the statements from family members, we have decided to withdraw the book.

 

But the backlash about the book may not yet be over, as a possible 10-year prison sentence hangs over Ramlakan's head, reports The Citizen.

The report says in writing Mandela’s Last Years, Ramlakan would have been bound, as a member of the SANDF, by laws including the Defence Act, the Protection of Information Act (PIA), which replaced the Official Secrets Act in 1982, and the Minimum Information Security Standards (Miss). He would have signed a declaration of secrecy informed by the PIA.

“I understand that I shall be guilty of an offence if I reveal any information which I have at my disposal by virtue of my office and concerning which I know or should reasonably know that the security or other interests of the republic require that it be kept secret,” the form states.

It goes on to state: “…said provisions and instructions shall apply not only during my term of office, but also after the termination of my services with the department” and lays the signatory open to a fine of R10 000 or up to 10 years’ imprisonment, or both if the breech is serious enough.

While the South African Medical Association (Sama) doesn’t have any teeth to sanction Ramlakan, the report says the SANDF and Health Professions Council of SA (HPCSA) – the statutory body for doctors – certainly do.

SANDF spokesperson Brigadier-General Mafi Mgobozi appeared unable to answers questions sent to him regarding any pending sanction against Ramlakan. The report said the same applied to HPCSA communications manager Priscilla Sekhonyana. Miss was approved by Cabinet in 1998 as the national information security policy and “applies to all departments of state subject to the Public Service Act 103 of 1994 or any other department that handles classified information in the national interest”, according to the State Security Agency.

This makes it unlikely that revealing Mandela’s personal medical records, while being of interest to some of the public, would be in the public interest unless there had been egregious medical malpractice. It’s not an assertion Ramlakan makes and, in death, as in life, doctors have a sacrosanct duty to respect doctor-patient confidentiality.

Sama chair Dr Muzikisi Grootboom is quoted in the report as saying that “In the no longer used Hippocratic Oath, it refers to secrets in the doctor-patient relationship as being ‘holy’”. “Perhaps of greater relevance is the Geneva Declaration, used by most doctors in their oath taking, which contains the line ‘I will respect the secrets that are confided in me, even after the patient has died’.”

[link url="https://www.businesslive.co.za/bd/national/2017-07-21-graa-machel-likely-to-sue-over-book-by-mandelas-doctor/"]Business Day report[/link]
[link url="https://www.timeslive.co.za/news/south-africa/2017-07-22-mandelas-doctor-speaks-for-himself-defence-department/"]The Times report[/link]
[link url="http://citizen.co.za/news/news-national/1585447/10-year-jail-sentence-hangs-over-mandela-doctor/"]The Citizen report[/link]

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