A SOUTH AFRICAN PERSPECTIVE TO MEDICAL LAW AND ETHICS IN NURSING: GETTING BASIC PRINCIPLES RIGHT

Abstract

The legal requirements for informed consent and confidentiality of patient information are clearly specified in chapter two of the National Health Act (NHA). Along with informed consent, the right to privacy is enshrined not only in the Constitution but also obligations to recognize this right are set out in the NHA. The study aims to survey the habits and practices of healthcare providers working in the public and private sectors in Durban, KwaZulu-Natal, when obtaining informed consent in clinical practice. A quantitative descriptive questionnaire was developed to investigate how nurses take informed consent in various clinical scenarios. A total of 207 nurses completed the questionnaire and the data was analyzed using Chi-squared, T-test and Z-tests. While 84.5% took consent to examine a patient, only 56% did so when ordering a special investigation with 19.8% taking written consent. Consent to refer patients to other healthcare providers was obtained by 67.6%, and 15% was obtained in a written format. There were 14% of nurses who did not use a computer at all.Of those who did, few used emails to send patient information, 19.1%, and less than half of those obtained informed consent to do so. The key conclusions of this study are that informed consent practices among nurses fall below legal requirements, and written consent is not routinely obtained, even for those practices that carry some element of risk, such as special investigations or transmitting health information via fax or email.