Ethics for the Dietetic Profession – A South African Perspective

  • Ernie KunnekeEmail author
  • Rina Swart
  • Nico Nortjé
Part of the Advancing Global Bioethics book series (AGBIO, volume 13)


The profession of dietetics has its foundation in science and dieticians are experts in food; diet and nutrition in improving the health of society. A dietician in South Africa, as a healthcare provider, practices in the fields of therapeutic nutrition, community nutrition, food service management and research and are faced with ethical decision making in these domains. As a profession guided by the Professional Board of Dietetics and Nutrition of the Health Professions Council of South Africa (HPCSA), all practicing dieticians in South Africa are guided and regulated by legal statutes which influence ethical and professional conduct. The professional body for dieticians in South Africa, the Association of Dietetics in South Africa (ADSA), also has a code of ethics for their members. Since 2007, eight cases of misconduct by dieticians had served at the HPCSA. Other ethical issues that dieticians in South Africa face are issues regarding conflict of interest, endorsement of products and sponsorship and there are possible ethical reasoning approaches, i.e. the principled or reasoned approaches that can be applied to guide dieticians in the process. In the three different practising fields for dieticians in South Africa, it is important that practitioners can reflect on ethical theories such as egalitarianism (deontology) or utilitarianism to guide ethical decision making. Jonsen’s method of analysing ethical issues can be applied especially in therapeutic cases to assist in analysing the ethical issues at hand. Dietetic practice in South Africa is characterised by diverse ethical issues that makes ethical decision making complicated.


Ethics Dietetics South Africa Therapeutic nutrition Community nutrition Public health nutrition 


  1. ADSA. 2008. ADSA code of ethics for the profession of dietetics in South Africa. Retrieved September 20, 2017 from
  2. Barkley, W.C. 2008. Ethical practice in foodservice management. Journal of the American Dietetics Association 108: 1240–1241.CrossRefGoogle Scholar
  3. Beauchamp, T.L., and J.F. Childress. 2001. Principles of biomedical ethics. New York: Oxford University Press.Google Scholar
  4. Cohen, D. 2009. Conflict of interest and RD practice. Resume: College of Dietitians of Ontario.Google Scholar
  5. Department of Health, Republic of South Africa. 2010. Clinical guidelines: PMTCT (Prevention of mother-to-child transmission). Pretoria: National Department of Health, South Africa, South African National AIDS Council.Google Scholar
  6. Fanzo, J. 2015. Ethical issues for human nutrition in the context of global food security and sustainable development. Global Food Security 7: 15–23.CrossRefGoogle Scholar
  7. Gomes, F.D.S. 2015. Conflicts of interest in food and nutrition. Cadernos De Saude Publica 31 (10): 2039–2046.CrossRefGoogle Scholar
  8. HPCSA. 2007. Guidelines for good practice in the health care professions. Ethical and Professional rules of the Health Professions Council of South Africa as promulgated in Government Gazette R717/2006. Booklet 2. Retrieved from
  9. ———. 2016. Guidelines for good practice in the healthcare professions. Ethical and professional rules of the Health Professions Council of South Africa. Booklet 2. Retrieved from
  10. Hurst, S.A., and A. Mauron. 2008. A question of method. The ethics of managing conflicts of interest. EMBO Reports 9 (2): 119–123.CrossRefGoogle Scholar
  11. Khan, K., and S. Ramachandran. 2012. Conceptual framework for performance assessment: Competency, competence and performance in the context of assessments in healthcare – Deciphering the terminology. Medical Teacher 34: 920–928.CrossRefGoogle Scholar
  12. Kubheka, B. 2017. Ethical and legal perspectives on use of social media by health professionals in South Africa. South African Medical Journal 107 (5): 386–389.CrossRefGoogle Scholar
  13. Lucas, M. 2015. Conflicts of interest in nutritional sciences: The forgotten bias in meta-analysis. World Journal of Methodology 5 (4): 175–178.CrossRefGoogle Scholar
  14. Marais, D., M. Marais, J. Visser, C. Boome, and D. Taylor. 2012. What do dietetics students think professionalism entails? African Journal of Health Professions Education 4 (1): 28–33.CrossRefGoogle Scholar
  15. Nestle, M. 2000. Ethical dilemmas in choosing a healthful diet: Vote with your fork! Proceedings of the Nutrition Society 59 (4): 619–629.CrossRefGoogle Scholar
  16. Newton, A., F. Lloyd-Williams, H. Bromley, and S. Capewell. 2016. Food for thought? Potential conflicts of interest in academic experts advising government and charities on dietary policies. BMC Public Health 16 (1): 735.CrossRefGoogle Scholar
  17. Nortjé, N., and W. Hoffmann. 2015. Ethics misconduct among dietetic practitioners in South Africa (2007–2013). South African Journal of Clinical Nutrition 28 (2): 77–80.CrossRefGoogle Scholar
  18. Palermo, C. 2015. Growing professional competence in nutrition and dietetics. Nutrition & Dietetics 72: 96–100.CrossRefGoogle Scholar
  19. Rowe, S., N. Alexander, F. Clydesdale, R. Applebaum, S. Atkinson, R. Black, J. Dwyer, E. Hentges, N. Higley, M. Lefevre, J. Lupton, S. Miller, D. Tancredi, C. Weaver, C. Woteki, E. Wedral, and International Life Sciences Institute (ILSI) North America Working Group on Guiding Principles. 2009. Funding food science and nutrition research: Financial conflicts and scientific integrity. American Journal of Clinical Nutrition 89: 1285–1291.CrossRefGoogle Scholar
  20. Rucker, R.B., and M.R. Rucker. 2016. Nutrition: Ethical issues and challenges. Nutrition Research 36 (11): 1183–1192.CrossRefGoogle Scholar
  21. Solomons, N., and N. Nortjé. 2013. Treating an intervention level 1 patient: Futile or brave? South African Journal of Clinical Nutrition 26 (4): 176–180.CrossRefGoogle Scholar
  22. Tappenden, K.A. 2015. A unifying vision for scientific decision making: The academy of nutrition and dietetics: Scientific integrity principles. Journal of the Academy of Nutrition and Dietetics 115 (9): 1486–1490.CrossRefGoogle Scholar
  23. Turoldo, F. 2009. Responsibility as an ethical framework for public health interventions. American Journal of Public Health 99 (7): 1197–1202.CrossRefGoogle Scholar

Further Reading

  1. Asknes, B., M. Alvim, and S.G. Diaz. 2017. The normalization of conflicts of interest in the USA and their potential impact on public health nutrition. World Nutrition 8 (1): 123–127.CrossRefGoogle Scholar
  2. HPCSA. n.d.. Guidelines for good practice in the health care professions. Retrieved October 10, 2017 from
  3. OECD (Organisation for Economic Co-operation and Development). 2003. Managing conflict of interest in the public service. Retrieved October 8, 2017 from
  4. World Health Organisation. (2016). Addressing and managing conflicts of interest in the planning and delivery of nutrition programmes at country level. Report of a technical consultation convened in Geneva, Switzerland, on 8–9 October 2015. Geneva: WHO Document Production Services.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of the Western CapeBellvilleSouth Africa
  2. 2.University of Texas, MD Anderson Cancer CenterHoustonUSA
  3. 3.The University of the Free StateBloemfonteinSouth Africa

Personalised recommendations