MAPE Theses and Dissertations (2019)

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Moral views on euthanasia amongst medical practitioners in Nairobi, Kenya
(Strathmore University, 2019) Fredrick, Ngatia
Euthanasia has provoked raging debate since antiquity. Natural law adherents consider that death should occur naturally i.e. without acceleration by human acts and/or omissions which are intended to cause or hasten death. Since ancient times, the position taken by natural law adherents has not been accepted universally. Indeed, eminent thinkers, for instance, Epicurus (341 BC- 270 BC) stoically remarked that one was entitled to quit life's theatre "when the play has ceased to please us" (Amicus, 2011). Divergent views on euthanasia exist to date. Hippocrates (460 BC- 3 77 BC) who is reputed as the father of medicine was against euthanasia. The Hippocratic Oath expressly prohibits doctors from administering any drug that would intentionally induce death. A doctor is expressly required to solemnly affirm that he "will neither give a deadly drug to anybody if asked for it nor will I make a suggestion to this effect" (Edelstein, 1943). The two extreme positions, which have origin in antiquity, have persisted to date and no common view is in sight. In the modem world, euthanasia is regarded by a segment of the populace to be empowering and liberating. According to the proponents of euthanasia, one need not experience untold pain and suffering or be subjected to an extended period of treatment. One can liberate oneself from the illness by administration of euthanasia which hastens death instead of medical treatment or procedures which prolong the eventuality of death. Euthanasia is therefore viewed as a mode or vehicle of liberating oneself from pain, suffering, or prolonged treatment. Since no empirical evidence on life after death is available, it is difficult to discern how one weighs the benefit of death instead of the continuance of life, albeit with the discomfort arising from the illness. How death can be liberating instead of a continuation of life is therefore an experimentation with the unknown. This research seeks to ascertain whether euthanasia is administered in Nairobi and if so, the prevalence of the practice. The research also seeks to establish the reasons that patients use to seek euthanasia instead of continuing with life. The research also seeks to ascertain the moral reasons that medical practitioners use to justify the administration of voluntary active euthanasia. The identified reasons are discussed and contrasted with the personalistic philosophy viewpoint. The discussion on moral reasons advanced by medical practitioners is a critical part of this dissertation. A moral reason to justify euthanasia may appear to be a contradiction in that euthanasia is a termination of life. Prima facie, life should continue until death, by a natural process, takes effect. Hence, the question to be considered is whether on account of the grounds advanced by medical practitioners, termination of life can be morally justified. The moral justification is further contrasted with the Personalistic philosophy viewpoint as that is the philosophy that guides this dissertation. Personalist philosophy has deliberately been taken as the regulating philosophical perspective due to the eminence it gives to personhood including the transcendental dimensions.
The Philosophy of hope through photography in Kenya: interpretation of Henri Cartier-Bresson's Gaze under the existentialism of Gabriel Marcel
(Strathmore University, 2019) Sanchez, Ismael Martinez
Today, many Western media impose a simplifying view of photographic reality by narrating African daily life under negative cliches that are perpetuated in time (poverty, famine, corruption, etc.) or recently, it is enough to look at the visual coverage and repercussions of the AI Shabaab dusit02 Hotel attack on the pages of the New York Times (De Freitas, 2015, January 15). That is why, in a globalized culture, Kenyans are asking themselves if there are any positive models or roles of their own that go beyond this one 'aesthetics of despair'. So, the question in this dissertation is: Can Western agency and media photography promote a broader view of reality and bring hope to new generations of Kenyans? To answer this question, we have done an analysis of the characteristics of Cartier-Bresson's photographic work under the philosophy of Gabriel Marcel. Both authors were French and intellectuals at the beginning of the 20th century: Henri Cattier-Bresson is considered the father of modern photojournalism and one of the pioneers of humanist photography; Marcel is a philosopher who considers hope the motor in existential life (because he considers that man is not a being thrown into the world). Thus, this dissertation offers a framework on what photography is, and what hope consists of. We study both fields, specifically, in Henri Cartier-Bresson and in Gabriel Marcel; and conclude with a symbiosis between the four characteristics of photography in Cattier-Bresson with the four notes of the philosophy of hope seen in Gabriel Marcel. Finally, since aesthetics is always a reflection of ethics, we consider the different types of 'photographic gazes' of a photojournalist (gaze of resignation, acceptance or redemption) to propose a gaze of hope that overcomes African stereotypes by proposing new paths to Kenyan society. This look is only possible through virtue in technical excellence and professional ethics.
An Assessment of socially responsible behaviour of motorists in Kenya
(Strathmore University, 2019) Njuguna, Paul Muiyuro
Road accidents are a major challenge globally and a cause of social and economic losses both in developed and developing countries. In Kenya close to 3,000 people die every year in road accidents, and the trend in recent years shows that the number is on the rise. Implementation of road safety initiatives in Kenya is skewed towards authoritative enforcement of rules and the associated punishments intended to motivate adherence and deter ‘deviant’ behaviour by motorists. An approach to road safety where the motorist’s actions are guided purely by the law is however inherently limited by the finite presence of law enforcers on the roads. The purpose of the study was to investigate the relevance of Socially Responsible Behaviour (SRB) and virtue as a complement to the existing road safety efforts in Kenya, and how these could influence motorists’ adherence to road safety requirements. Data was collected from motorists using a mixed methodology, with both quantitative surveys and in-depth qualitative interviews to investigate the perceptions to dimensions such as personal responsibility, intrinsic motivation and the impact of an individual’s actions on the society. The outcomes of the study shed light on the applicability of a virtue-based approach towards road safety, and may be used by policy makers in the transport sector to integrate into the existing road safety framework.
Patient perspectives on access control of Electronic Health Records
(Strathmore University, 2019) Okello, Polly
Recent technological advances pose a challenge to the basic framework of medical ethics and the fundamental nature of the doctor-patient relationship - a relationship based on consent and trust that has stood for almost 2,500 years. Access to health records may be granted, in limited circumstances, for example, to relatives or proxies of incapacitated or deceased patients. Disclosure of patient information for legal or public interest purposes, sharing of health information of people who lack mental capacity, and access to medical information relating to relatives all have ethical implications. The first objective of the study was to identify patient perspectives on access control to their Electronic Health Records (EHRs) by doctors, family, researchers and State. The second objective of the study was to identify the extent to which sensitivity of EHRs is linked to patient-controlled access to their EHRs. The third objective of the study was to investigate the extent to which different situations may affect patients’ perspective on access to their EHRs. This study adopted a mixed study approach in which a multi-site cross-sectional questionnaire was designed and piloted for use in waiting rooms and administered to randomly selected patients (N=394) in private doctor clinics in Nairobi, Kenya (in February 2019) . These clinics were involved in the pilot of a novel EHRs known as MedbookAfrica. Quantitative data was analysed using Statistical Package for Social Sciences (SPSS) while qualitative data was analysed thematically. A vast majority of patients (>70%) agreed that they have the right to grant or deny access to their EHR irrespective of the recipient or sensitivity. A vast majority also agreed that in emergencies, incapacitation or death, their health record should be made accessible. The interviews revealed that the recipients of the health record in case of emergency or incapacitation should be limited to close family members or primary doctor. The interviews also revealed that patients perceive their electronically stored health records to be safe. Patients expressed sharing preferences consistent with a desire to exercise autonomy over which health information is shared and with whom. Close family members and primary iv doctor were people that the patients felt should have access to their health records to assist in treatment and especially in emergency situations. The study recommended that a level of informed consent needs to be factored in during EHR design to protect patient autonomy and conditions when this can be overridden to be agreed upon by all stakeholders. An open dialogue between patients and health care providers is required to balance respect for patient autonomy and the health care provider’s need for patient information to provide good quality care.
Ethical issues in the Basic Education Act No.14 of 2013: an Aristotelian interpretation
(Strathmore University, 2019) Momanyi, Christopher
Aristotle in his educational ideals as presented in his Politics and Nicomachean Ethics, believed that education is a requirement for a fulfilled life. Other philosophers such as Plato and Socrates were greatly concerned about the education of the youth and the role of the polis and the family. The Aristotelian ideas on education as expressed in the Politics and Nicomachean Ethics are not insignificant but very important for the modern day educational disputation. Especially on the debate on connection between law and education, morals and the education of the person. This dispute then arises, who between the polis and the household is to determine the training that students receive in school? Is there plurality of education in Kenya in light of passing of the Basic Education Act no. 14 of 2013? This research discusses the modern times importance of Aristotle’s ideas on plurality of education as presented in his Nicomachean Ethics and Politics. This research discusses whether the Basic Education Act no. 14 of 2013 observes the plurality of education as taught by Aristotle.

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