Evaluating the quality of informed consent and contemporary clinical practices by medical doctors in South Africa: An empirical study
Evaluating the quality of informed consent and contemporary clinical practices by medical doctors in South Africa: An empirical study
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DOI：
10.1186/1472-6939-14-s1-s3
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发表时间：
2013-12-19
影响因子：
2.7
通讯作者：
Chima, Sylvester C.
中科院分区：
文献类型：
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作者：
Chima, Sylvester C.
背景：知情同意是一个法律的和伦理的原则，来自尊重自主权的原则。一般来说，自治产生的两项权利受到法律的保护。身体完整的宪法权利，其次是身体健康的权利，受到专业过失规则的保护。因此，医疗保健专业人员在未经有效同意的情况下治疗患者可能会侵犯患者的权利。在南非这样复杂的多元文化社会中，医生获得知情同意面临许多挑战。这些因素包括不同的文化精神，多种语言，贫困，教育，对基于自主权的自由主义权利的不熟悉，以及医生和病人之间的权力不对称。所有这些都可能影响医生获得合法有效的知情同意书的能力。方法：本研究的目的是评估在南非执业的医生获得的知情同意书的质量是否符合国际道德标准和当地法规。从946名参与者，包括医生，护士和患者的反应进行了分析，使用半结构化的自填问卷和人三角定位在选定的公立医院在德班，夸祖鲁-纳塔尔，南非。结果：168名医生参与的中位年龄为30岁，51%的女性，28%的实习生，16%的医务人员，26%的登记员，30%的顾问/专家。代表了广泛的临床专业。知情同意实践面临的挑战包括语言困难、缺乏口译员、工作量和时间限制。医生花了5-10分钟的时间获得同意，向病人透露了所需的大部分信息，但对当地基本法律的了解不够。知情同意综合评分（ICAS）显示，实习生/注册员的评分低于顾问/专家。ICAS评分在不同专业之间具有统计学显著性（p
Background: Informed consent is a legal and ethical doctrine derived from the principle of respect for autonomy. Generally two rights derived from autonomy are accorded legal protection. The constitutional right to bodily integrity followed by the right to bodily well-being, protected by professional negligence rules. Therefore healthcare professionals treating patients' without valid consent may be guilty of infringing patients' rights. Many challenges are experienced by doctors obtaining informed consent in complex multicultural societies like South Africa. These include different cultural ethos, multilingualism, poverty, education, unfamiliarity with libertarian rights based autonomy, and power asymmetry between doctors and patients. All of which could impact on the ability of doctors to obtain legally valid informed consent.Methods: The objective of this study was to evaluate whether the quality of informed consent obtained by doctors practicing in South Africa is consistent with international ethical standards and local regulations. Responses from 946 participants including doctors, nurses and patients was analyzed, using a semi-structured selfadministered questionnaire and person triangulation in selected public hospitals in Durban, KwaZulu-Natal, South Africa.Results: The median age of 168 doctors participating was 30 years with 51% females, 28% interns, 16% medical officers, 26% registrars, 30% consultant/specialists. A broad range of clinical specialties were represented. Challenges to informed consent practice include language difficulties, lack of interpreters, workload, and time constraints. Doctors spent 5-10 minutes on consent, disclosed most information required to patients, however knowledge of essential local laws was inadequate. Informed consent aggregate scores (ICAS) showed that interns/registrars scored lower than consultants/specialists. ICAS scores were statistically significant by specialty (p