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

Authors

  • Caron Lee Jack University of KwaZulu-Natal
  • Yashik Singh University of KwaZulu-Natal
  • Busisiwe Purity Ncama University of KwaZulu-Natal

DOI:

https://doi.org/10.25159/2520-5293/378

Keywords:

confidentiality, ethics, informed consent, medical law, nursing practice

Abstract

The legal requirements for informed consent and confidentiality of patient information are clearly specified in chapter two of the National Health Act.  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 questioner and the data 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% obtained it in a written format. There were 14% of nurses who did not use a computer at all.  Of those that did few used email to send patient information, 19.1% and less than half of those obtained informed consent to do so.  The key conclusion of this study are that informed consent practices amongst 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.

Metrics

Metrics Loading ...

References

Bateman, C., 2009, ‘I’m sick of the media’s witch-hunt Manto’, Continuing Medical Education, 27(7): 333.

Beren, R. 2010, ‘Health law in the 21st century’, Medicine and Law, 29(2):129-139.

C v Minister of Correctional Services (REF: 1996 (4) SA292 (T)).

Caffery, L. & Smith, A.C., 2010, ‘A literature review of email-based telemedicine’, Studies in Health Systems and Technology, 161:20-34.

Castell v De Greef 1994 (4) SA 408 (C) at 425.

Chima, S., 2013,’ Evaluating the quality of informed consent and contemporary clinical practices by medical doctors in South Africa: An empirical study’, BMC Medical Ethics, 14 suppl. ser.1.

Clwyd, A. & Hart, t., 2013, ‘A review of the NHS Hospitals Complaints System Putting Patients Back in the Picture’, viewed 20 may 2015 from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/255615/NHS_complaints_accessible.pdf

Colin, F., 2012, ‘HPCSA’s “Report a Doc†Campaign likely to hike medical costs’, in Medical Chronical, viewed 19 May 2015, from http://www.medicalchronicle.co.za/hpcsa%E2%80%99s-%E2%80%98report-a-doc%E2%80%99-campaign-likely-to-hike-medical-costs/

Fassin, D., 2008, ‘The elementary forms of care An empirical approach to ethics in a South African Hospital’, Social Science and Medicine, 67,262-270.

Health Professional Council of South Africa, 2008, ‘Seeking patients informed consent, the ethical considerations’, Booklet 9, Viewed 20 May 2015, from http://www.hpcsa.co.za/Uploads/editor/UserFiles/downloads/conduct_ethics/rules/generic_ethical_rules/booklet_9_informed_consent.pdf

International Council of Nurses, 2012, ‘The ICN code of ethics for nurses. Revised 2012’, viewed 20 May 2015, from http://www.icn.ch/images/stories/documents/about/icncode_english.pdf

Jack, C. & Mars, M., 2014, ’Informed consent for telemedicine in South Africa: A survey of consent practices among healthcare professionals in Durban, KwaZulu-Natal’, South African Journal of Bioethics and Law, 7(1),14-18.

Lemonidou, C., Merkouris, H., Leino-Kilpi, H., et al. 2003, ‘A comparison of surgical patients’ and nurses’ perceptions of patients’ autonomy, privacy and informed consent in nursing interventions’, Clinical Effectiveness in Nursing, 7,73-83.

McQuiod-Mason, D & Dada M.A., (ed.), 2001, Introduction to Medico-Legal Practice, 1st Edition. Durban: Butterworth Publishers.

Moodley, K. (ed.), 2011, Medical Ethics, Law and Human Rights, 1st Edition. Pretoria: Van Schaik.

Murray, T. l., Calhoun, M., Philipsen, N.C., et al. 2011, ‘Privacy, confidentiality, HIPPA, and HITECH: Implications for the healthcare practitioner’, The Journal for Nurse Practitioners, 7(4): 747-752.

National Department of Health. 2012/13-2016/17 National Strategic Plan for Nurse Education. Pretoria.

Pepper, S. & Slabbert, M.N., 2011, ‘Is South Africa on the verge of a medical malpractice storm?’, South African Journal of Bioethics and Law, 4(1), 29-35.

Police, R. L., Foster, T., Wong, K.S., 2010, ‘Adoption and use of health information technology in physician practice organisations: systematic review’, Informatics in Primary Care, 18(4):245-258.

South African Government. National Health Act 61 of 2003. Pretoria: Government Printer, 2003.

South African Government. Protection of Personal Information Act 4 of 2013. Pretoria: Government Printer, 2013.

Stellenberg, E. L. & Dorse, A. J., 2014, ‘Ethical issues that confront nurses in private hospitals in the Western Cape Metropolitan area’, Curationis, 37(1).

The South African Nursing Council, 2013, ‘Code of Ethics for Nursing Practitioners in South Africa’, viewed 20 May 2015, from http://www.sanc.co.za/pdf/SANC%20Code%20of%20Ethics%20for%20Nursing%20in%20South%20Africa.pdf

The South African Nursing Council. nd. Statistics on Professional Misconduct Cases.

The South African Nursing Council. nd. Guidelines for reporting a case of professional misconduct.

Downloads

Published

2016-02-23

How to Cite

Jack, Caron Lee, Yashik Singh, and Busisiwe Purity Ncama. 2015. “A SOUTH AFRICAN PERSPECTIVE TO MEDICAL LAW AND ETHICS IN NURSING: GETTING BASIC PRINCIPLES RIGHT”. Africa Journal of Nursing and Midwifery 17 (2):118-29. https://doi.org/10.25159/2520-5293/378.

Issue

Section

Articles
Received 2015-08-13
Accepted 2016-01-19
Published 2016-02-23