INFORMED CONSENT PRACTICES IN NIGERIA
INFORMED CONSENT PRACTICES IN NIGERIA
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DOI：
10.1111/j.1471-8847.2008.00234.x
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发表时间：
2009-12-01
影响因子：
2.2
通讯作者：
Marshall, Patricia A.
中科院分区：
文献类型：
--
作者：
Ezeome, Emmanuel R.;Marshall, Patricia A.
在非洲，大多数关于知情同意的文章强调了影响知情同意做法的不同文化和社会属性，特别是在研究环境中。这篇综述使用实证研究、法律和法规处方以及临床经验，展示了尼日利亚知情同意的综合图景。它表明，尼日利亚和非洲其他大多数国家一样，是一个社会文化实体的混合体，尽管有许多因素影响它，但知情同意正在沿着纯粹的西方模式发展。经验研究表明，70%-95%的尼日利亚患者报告同意他们的手术治疗。尼日利亚的监管处方和已判决的案件遵循西方的知情同意模式。然而，由于多种原因，对抗式法律程序在尼日利亚执行良好的医疗实践方面没有发挥重大作用。性别偏见是显而易见的，但不是一种常态。即使在家庭内部作出决定时，个人自主权也得到承认。同意做法受到教育水平、大家庭制度、城市化、宗教习俗和可用的医疗保健融资选择的影响。尽管存在种种限制，但同意讨论随着患者教育水平的提高而改善，这表明医生知识的提高以及患者意识和教育的增加可以压倒其他影响。尼日利亚的医学院应该调整他们的医德教学，以提高医生的知识和实践。需要对尼日利亚人民在知情同意方面的偏好进行更多的研究，以便充分培训医生并积极影响医生的行为。
Most writing on informed consent in Africa highlights different cultural and social attributes that influence informed consent practices, especially in research settings. This review presents a composite picture of informed consent in Nigeria using empirical studies and legal and regulatory prescriptions, as well as clinical experience. It shows that Nigeria, like most other nations in Africa, is a mixture of sociocultural entities, and, notwithstanding the multitude of factors affecting it, informed consent is evolving along a purely Western model.Empirical studies show that 70-95% of Nigerian patients report giving consent for their surgical treatments. Regulatory prescriptions and adjudicated cases in Nigeria follow the Western model of informed consent. However, adversarial legal proceedings, for a multiplicity of reasons, do not play significant roles in enforcing good medical practice in Nigeria. Gender prejudices are evident, but not a norm. Individual autonomy is recognized even when decisions are made within the family. Consent practices are influenced by the level of education, extended family system, urbanization, religious practices, and health care financing options available. All limitations notwithstanding, consent discussions improved with increasing level of education of the patients, suggesting that improved physician's knowledge and increasing awareness and education of patients can override other influences.Nigerian medical schools should restructure their teaching of medical ethics to improve the knowledge and practices of physicians. More research is needed on the preferences of the Nigerian people regarding informed consent so as to adequately train physicians and positively influence physicians' behaviors.