Practices and attitudes of herbalists regarding informed consent in Uganda: a qualitative study.
Communal consent
Ethical principles
Herbal medicine
Informed consent
Journal
BMC medical ethics
ISSN: 1472-6939
Titre abrégé: BMC Med Ethics
Pays: England
ID NLM: 101088680
Informations de publication
Date de publication:
04 Oct 2024
04 Oct 2024
Historique:
received:
30
01
2024
accepted:
20
09
2024
medline:
5
10
2024
pubmed:
5
10
2024
entrez:
4
10
2024
Statut:
epublish
Résumé
Informed consent (IC) is a fundamental principle in medical ethics that upholds respect for patient autonomy. Although widely applied in healthcare, its feasibility and implementation in herbal medicine have been underexplored. This study therefore aimed to explore the practices and attitudes of herbalists regarding informed consent. To achieve these objectives, a qualitative cross-sectional study was conducted from June to December 2020. Twenty-one in-depth interviews with herbalists and four key informant interviews with leaders of the different traditional medicine organizations were conducted. The data were analyzed thematically using NVivo version 12 software. Sixteen of the twenty-one participants acquired oral herbal medicine knowledge from their relatives. Although a positive inclination toward obtaining IC was evident, the focus was on disclosing basic information. Discussions of alternative treatments and herbal specifics were less frequent. Disease management decisions often involve shared responsibility within families or societies. Documented IC procedures are rare among herbalists, who deem consent forms unnecessary, although they recognize the potential benefits of IC in fostering trust and professionalism. Challenges hindering IC implementation included regulatory gaps, inadequate skills, and the absence of mechanisms to protect the intellectual property rights of herbal medicine. This study illuminates how educational, cultural, familial, and regulatory factors influence herbalists' practices and attitudes toward informed consent.
Sections du résumé
BACKGROUND
BACKGROUND
Informed consent (IC) is a fundamental principle in medical ethics that upholds respect for patient autonomy. Although widely applied in healthcare, its feasibility and implementation in herbal medicine have been underexplored. This study therefore aimed to explore the practices and attitudes of herbalists regarding informed consent.
METHODS
METHODS
To achieve these objectives, a qualitative cross-sectional study was conducted from June to December 2020. Twenty-one in-depth interviews with herbalists and four key informant interviews with leaders of the different traditional medicine organizations were conducted. The data were analyzed thematically using NVivo version 12 software.
RESULTS
RESULTS
Sixteen of the twenty-one participants acquired oral herbal medicine knowledge from their relatives. Although a positive inclination toward obtaining IC was evident, the focus was on disclosing basic information. Discussions of alternative treatments and herbal specifics were less frequent. Disease management decisions often involve shared responsibility within families or societies. Documented IC procedures are rare among herbalists, who deem consent forms unnecessary, although they recognize the potential benefits of IC in fostering trust and professionalism. Challenges hindering IC implementation included regulatory gaps, inadequate skills, and the absence of mechanisms to protect the intellectual property rights of herbal medicine.
CONCLUSION
CONCLUSIONS
This study illuminates how educational, cultural, familial, and regulatory factors influence herbalists' practices and attitudes toward informed consent.
Identifiants
pubmed: 39367374
doi: 10.1186/s12910-024-01104-1
pii: 10.1186/s12910-024-01104-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
106Subventions
Organisme : Forgaty International Centre of the National Institutes of Health
ID : R25TW009730
Organisme : Forgaty International Centre of the National Institutes of Health
ID : R25TW009730
Organisme : Forgaty International Centre of the National Institutes of Health
ID : R25TW009730
Organisme : Forgaty International Centre of the National Institutes of Health
ID : R25TW009730
Organisme : Forgaty International Centre of the National Institutes of Health
ID : R25TW009730
Informations de copyright
© 2024. The Author(s).
Références
Beauchamp T, Childress J. Principles of biomedical ethics: marking its fortieth anniversary. Taylor & Francis; 2019. pp. 9–12.
Akpa-Inyang F, Ojewole E, Chima SC. Patients’ experience on practice and applicability of informed consent in traditional medical practice in KwaZulu-Natal Province, South Africa. Evidence-Based Complementary and Alternative Medicine. 2022;2022.
Grady C. Enduring and emerging challenges of informed consent. N Engl J Med. 2015;372(9):855–62.
doi: 10.1056/NEJMra1411250
Paterick TJ, Carson GV, Allen MC, Paterick TE, editors. Medical informed consent: general considerations for physicians. Mayo Clinic Proceedings; 2008: Elsevier.
Langworthy JM, Cambron J. Consent: its practices and implications in United Kingdom and United States chiropractic practice. J Manip Physiol Ther. 2007;30(6):419–31.
doi: 10.1016/j.jmpt.2007.05.002
Agu KA, Obi EI, Eze BI, Okenwa WO. Attitude towards informed consent practice in a developing country: a community-based assessment of the role of educational status. BMC Med Ethics. 2014;15(1):1–8.
doi: 10.1186/1472-6939-15-77
Nzaumvila D, Ntotolo P, Govender I, Niati JL, Sanduku D, Bongongo T. Knowledge and practices of seeking informed consent for medical examinations and procedures by health workers in the Democratic Republic of Congo. Afr Health Sci. 2021;21(1):478–88.
doi: 10.4314/ahs.v21i1.58
Minei AP, Arafia R, Kaipu SO, Minei JM. Physicians’ perspectives of informed consent for medical procedures: a qualitative interview study. J Health Sci. 2020;8:9–26.
Hooft A, Nabukalu D, Mwanga-Amumpaire J, Gardiner MA, Sundararajan R. Factors motivating traditional healer versus Biomedical Facility Use for Treatment of Pediatric Febrile illness: results from a qualitative study in Southwestern Uganda. Am J Trop Med Hyg. 2020;103(1):501–7.
doi: 10.4269/ajtmh.19-0897
Kamatenesi-Mugisha M, Oryem-Origa H. Traditional herbal remedies used in the management of sexual impotence and erectile dysfunction in western Uganda. Afr Health Sci. 2005;5(1):40–9.
Okaiyeto K, Oguntibeju OO. African herbal medicines: adverse effects and cytotoxic potentials with different therapeutic applications. Int J Environ Res Public Health. 2021;18(11):5988.
doi: 10.3390/ijerph18115988
Demeke CA, Woldeyohanins AE, Kifle ZD. Herbal medicine use for the management of COVID-19: a review article. Metabolism Open. 2021;12:100141.
doi: 10.1016/j.metop.2021.100141
Bassman LE, Uellendahl G. Complementary/alternative medicine: ethical, professional, and practical challenges for psychologists. Prof Psychology: Res Pract. 2003;34(3):264.
doi: 10.1037/0735-7028.34.3.264
Nkeck JR, Tsafack EE, Ndoadoumgue AL, Endomba FT. An alert on the incautious use of herbal medicines by sub-saharan African populations to fight against the COVID-19. Pan Afr Med J. 2020;35(Suppl 2).
Caspi O, Holexa J. Lack of standards in informed consent in complementary and alternative medicine. Complement Ther Med. 2005;13(2):123–30.
doi: 10.1016/j.ctim.2005.03.004
Kakar H, Gambhir RS, Singh S, Kaur A, Nanda T. Informed consent: corner stone in ethical medical and dental practice. J Family Med Prim Care. 2014;3(1):68–71.
doi: 10.4103/2249-4863.130284
Ministryofhealth. Patients rights and responsiblities charter. In: health mo, editor. 2019. pp. 7–8.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.
doi: 10.1093/intqhc/mzm042
Swart M, Carstens P. The application of the Doctrine of Informed Consent in South African Medical Law: reflections on significant developments in the Case Law. South Afr Law J. 2024;141(1):45–83.
doi: 10.47348/SALJ/v141/i1a4
Terry PB. Informed consent in clinical medicine. Chest. 2007;131(2):563–8.
doi: 10.1378/chest.06-1955
Iserson KV. Is informed consent required for the administration of intravenous contrast and similar clinical procedures? Ann Emerg Med. 2007;49(2):231–3.
doi: 10.1016/j.annemergmed.2006.08.018
Winterbottom M, Boon H, Mior S, Facey M. Informed consent for chiropractic care: comparing patients’ perceptions to the legal perspective. Man Therap. 2015;20(3):463–8.
doi: 10.1016/j.math.2014.11.009
Peled R, Rabin Y. The constitutional right to information. Colum Hum Rts L Rev. 2010;42:357.
Nicholson DR, Kawooya D, editors. The impact of copyright on access to public information in African countries: A perspective from Uganda and South Africa. IFLA Conference Proceedings 2009; 2008.
Cocanour CS. Informed consent—It’s more than a signature on a piece of paper. Am J Surg. 2017;214(6):993–7.
doi: 10.1016/j.amjsurg.2017.09.015
Hall DE, Prochazka AV, Fink AS. Informed consent for clinical treatment. CMAJ. 2012;184(5):533–40.
doi: 10.1503/cmaj.112120
Akpa-Inyang F, Chima SC. Traditional Health Care practitioners’ perspectives on applying informed Consent during African Traditional Medical Practice in Akwa Ibom State, Nigeria: a cross-sectional qualitative study. J Integr Complement Med. 2023;29(6–7):361–71.
doi: 10.1089/jicm.2022.0687
Jose J, AlHajri L. Potential negative impact of informing patients about medication side effects: a systematic review. Int J Clin Pharm. 2018;40:806–22.
doi: 10.1007/s11096-018-0716-7
Koong JK, Rajandram R, Sidambram N, Narayanan V. The effectiveness of handout assisted versus verbal consent on post-operative recall and understanding - A randomized control study. Surgeon. 2022;20(3):169–76.
doi: 10.1016/j.surge.2021.04.002
Schenker Y, Meisel A. Informed consent in clinical care: practical considerations in the effort to achieve ethical goals. JAMA. 2011;305(11):1130–1.
doi: 10.1001/jama.2011.333
Whitney SN, McGuire AL, McCullough LB. A typology of shared decision making, informed consent, and simple consent. Ann Intern Med. 2004;140(1):54–9.
doi: 10.7326/0003-4819-140-1-200401060-00012
Murray B. Informed consent: what must a physician disclose to a patient? AMA J Ethics. 2012;14(7):563–6.
doi: 10.1001/virtualmentor.2012.14.7.hlaw1-1207
Sambala EZ, Cooper S, Manderson L. Ubuntu as a framework for ethical decision making in Africa: responding to epidemics. Ethics Behav. 2020;30(1):1–13.
doi: 10.1080/10508422.2019.1583565
Caspi O, Shalom T, Holexa J. Informed consent in complementary and alternative medicine. Evidence-based Complement Altern Medicine: eCAM. 2011;2011:170793.
doi: 10.1093/ecam/nep032
Aveyard H. Implied consent prior to nursing care procedures. J Adv Nurs. 2002;39(2):201–7.
doi: 10.1046/j.1365-2648.2002.02260.x
Chima SC. Informed consent in South Africa: a legal, ethical and cross-cultural perspective. Informed Consent and Health: Edward Elgar Publishing; 2020. pp. 183–214.