Patients' Experience on Practice and Applicability of Informed Consent in Traditional Medical Practice in KwaZulu-Natal Province, South Africa

Francis Akpa-Inyang; Elizabeth Ojewole; Sylvester C Chima

doi:10.1155/2022/3674467

Patients' Experience on Practice and Applicability of Informed Consent in Traditional Medical Practice in KwaZulu-Natal Province, South Africa

Evid Based Complement Alternat Med. 2022 Jan 20:2022:3674467. doi: 10.1155/2022/3674467. eCollection 2022.

Authors

Francis Akpa-Inyang¹, Elizabeth Ojewole², Sylvester C Chima^{1

3}

Affiliations

¹ Programme of Bio & Research Ethics and Medical Law, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
² Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal (Westville Campus), P.O. Box X54001, Durban 4000, South Africa.
³ Programme of Bio & Research Ethics and Medical Law, School of Nursing and Public Health, and Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Abstract

Background: Informed consent (IC) is constitutionally protected in South Africa based on individual rights to bodily integrity and well-being. In terms of the law, patients cannot be involved in medical treatment or research without IC. This study explored patients' experience on practice and applicability of IC in African traditional medicine (ATM) in Msunduzi and eThekwini municipalities, KwaZulu-Natal province, South Africa, to evaluate whether important elements of IC such as full information disclosure, capacity, understanding, and volition are considered or being applied during ATM.

Methods: This cross-sectional quantitative study was conducted using semistructured questionnaires administered to patients attending traditional health practitioners' (THPs') treatment centres. Stata V15.1 was used to analyse variables including descriptive and inferential data analysis.

Results: One hundred and twenty-nine (129) participants completed this study, of which 62% were females. Most participants were in the age range of 26-35 (38.8%). All respondents were IsiZulu home-language speakers, single (62.8%), employed (48%), and with some tertiary education (48.8%). Most patients were informed about their diagnosis (58.9%), treatment benefits (79.8%), and recommended treatment (79.8%). Fewer were informed about risks of treatment (36.4%), right of refusal (3.1%), and risks of refusing recommended treatment (0.8%). All participants reported satisfaction with information disclosed by the THPs and did not feel coerced to accept treatment. Consent was obtained verbally in all cases. The majority of participants (76.7%) sought surrogate assistance when consulting THPS, and 81.4% preferred being informed about all treatment risks. Most respondents also preferred involvement in healthcare decision-making during ATM.

Conclusion: This study reveals that most patients consulting THPs in the KwaZulu-Natal province for treatment are aware of their right to information disclosure and the need to reach agreement before involvement in ATM treatment procedures. The study also showed that some key elements of IC are currently being applied during ATM practice in South Africa.