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Apart from medical emergencies, when is it justified for gynaecologists, and obstetricians to deviate from informed consent without reverting back to their patients?

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2018

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Abstract

Medical care relies on a bond of trust between the patient and caregiver and on the patient’s ability to make free and informed choices, to understand and guide the course of their care. Informed consent is the foundation of this trust, ensuring that the patient is adequately informed so as to best understand their options and decide their treatment path. Informed consent is an express legal mandate granted by a patient to a healthcare practitioner after consultation. The patient relies on the provided information when choosing to accept, reject, or seek to modify a proposed intervention. The patient is protected by Statutes that dictate the manner in which informed consent must be obtained, requiring that relevant information be provided in such a way that the patient understands the nature, intended effect, and risk or consequence associated with the intervention. In many cases, it must be established if the patient has the legal capacity to consent or not. This research topic will consider how proper enforcement of informed consent practices, procedures, and the implementation of current policies and rules in gynaecology and obstetrics may prevent cases of gross negligence, unlawful assault or the compromising of patient rights under the Constitution, the common law and specifically, the criminal law. The study aimed at: 1. Investigating under which circumstances, despite current legislation, policies and procedures, health practitioners choose and still adopt a paternalistic approach towards patients in their care in the field of gynaecology and obstetrics, which leads to deviations from the requirements of informed consent; 2. Obtaining explanations for cases where doctors, particularly in gynaecology and obstetrics, neglect patient autonomy and the need for informed consent, and are seen to deviate from their ethical and legal obligations, and actively make decisions that properly belong to the patients.

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Masters Degree. University of KwaZulu-Natal, Durban.

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