South Africans place enormous trust in their doctors, especially when life-changing decisions have to be made. That trust comes with responsibility, and in 2025, the Health Professions Council of South Africa has tightened the standards that every medical professional must meet. The changes are wide-ranging and address two deeply sensitive areas. How decisions are handled at the end of a patient’s life, and how artificial intelligence can be used safely in healthcare.

The updates come after years of public concern about dignity, consent, and the speed at which new technologies are entering clinics. Many people across social media have welcomed the changes, describing them as overdue protections for families who often feel overwhelmed during medical crises.

A clearer path for end-of-life decisions

The first group of updates sits in Booklet 7 and focuses on situations where treatment may be withheld or withdrawn. While the core principle remains unchanged (everything must be done in the best interests of the patient), the HPCSA has now given far more detail on how those interests should be determined.

A key new element is the formal introduction of a patient representative. This is someone chosen by the patient to take over medical decision-making if they cannot, or prefer not to, make those decisions themselves. The representative must be able to reflect the patient’s known wishes or, if those wishes were never clearly stated, what the patient would probably have wanted based on past conversations and beliefs.

The HPCSA has also made it clear that patients should still be included in discussions whenever they are able to participate. However, not everyone wants detailed information about end-of-life treatment. The updated rules now allow the doctor to speak directly to the nominated representative in these circumstances.

Consent has been tightened as well. If a patient cannot make decisions and has not granted someone written authority, the rules outline exactly who may give consent. The order starts with a spouse or partner. If unavailable, the decision passes to a parent or grandparent. If they are not able to give consent, an adult child may step in. Only if all of these are not possible may a sibling take on that responsibility. Courts and applicable laws may also assign authority where needed.

Doctors may still choose to stop treatment that has no reasonable chance of helping the patient. What is different now is the emphasis on safeguarding vulnerable people. No decision of this nature can be made unless it clearly serves the patient’s best interests.

How new AI rules will shape the future of healthcare

AI has quickly become one of the most influential tools in global healthcare. In South Africa, it is increasingly used for diagnosis, monitoring, and risk prediction. The HPCSA has now firmed up the ethical rules that guide how medical professionals may use AI.

Booklet 20 sets out three pillars that all AI tools must meet. Ethical, legal, and technical. This means the technology must respect patient autonomy and confidentiality. It must comply with national laws that protect personal information, and it must meet standards for safety, security, and reliability.

The council has also highlighted the dangers. Concerns include privacy risks, discrimination caused by biased data, and the lack of proper oversight for many AI products on the market. The belief that anonymised data is always safe no longer holds true, because modern algorithms can sometimes trace identities from complex patterns.

Only AI tools that have been thoroughly validated and shown to be culturally appropriate may be used. This aligns with recent rules from the South African Health Products Regulatory Authority, which has mapped out how various AI tools should be regulated. These tools can include imaging systems, prediction models, and wearable devices used for patient monitoring.

Importantly, the HPCSA stresses that AI can never replace the judgment of a trained medical professional. A doctor may use technology to support their work, but the final responsibility always remains with the practitioner. AI must benefit the patient rather than simply make the job easier.

Why these changes matter

The updates form part of a broader shift in the country’s healthcare landscape. Patients are becoming more aware of their rights. Families want clearer communication and respect for dignity at the end of life. At the same time, technology is advancing so rapidly that South Africa needs strong guardrails to prevent misuse.

These changes do not solve every challenge, but they create a more transparent framework for the moments that matter most. From the bedside to the digital space, the goal is the same. Protecting patients and supporting doctors as they navigate the complex realities of modern medicine.

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Source: Business Tech

Featured Image: Udok