Southern African traditional values and belief systems and the informed consent process in biomedical research : perceptions of the san’s code of ethics.

Master of Art in Population Studies. University of KwaZulu-Natal. Durban, 2017.Aside from development, further reductions in mortality rates in the population require advances in medical technologies, medications and vaccinations. To achieve these advances, medical research has to be undertaken in populations to determine the safety, efficacy and cost effectiveness of these interventions. In order to provide this evidence base, human participants are required in randomised control trails and studies of other designs. Obtaining proper informed consent is crucial to ensuring that we conduct such studies in an ethical manner. The focus of this work will be on the comprehensibility of the concept and its application on the general population of South Africa, taking into account the fact that informed consent advocates for individuality while most Southern African concepts like Ubuntu emphasizes communal living. Concepts such as “I am because you are and you because I am” highlight the thinking that one’s existence is dependent on the existence of the group at large. With that said, it bring us to the African communitarian ethic, whose interest is on mutual dependence rather than autonomy, therefore influencing collective decision-making process over individual consent. The above evidence suggest that the application of ethical concepts like informed consent in Southern Africa may encounter intractable ethical problems (moral dilemmas) that might be generated by some of the traditional values, practices, rituals and taboos that still govern people’s behaviour and relationships. This study explored the concept of informed consent in the doctor-patient relationship in the context of Southern African traditional values, taking into account that the communitarian system in Africa and other traditional African belief systems undoubtedly deepens ones connectedness with family, the language and belief in ancestral spirits/witchcraft. Thus there a dilemma in the application of the western principle of medical ethics in the general population in Africa. Study Design: The application of the qualitative research method with a case study strategy and the incorporation of the inductive research philosophy with a critical postmodern approach contributed to the effectiveness of the research in achieving its objectives Measures: Individual interviews were conducted. Medical researchers were asked of their experience of implementing informed consent in South African and their perception of the new San code of ethics. Analysis: the data from the interview was analysed in combination with data available through publications. The research adopted a thematic content analysis of the available data in order to make some evaluations and thereafter, draw inferences. As a result, it was discovered in the research that bioethics principles and framework in Africa though may take cognizance of the bioethics principles as postulated by Western philosophy but with different approaches and practices. This is because of the difference in understanding of personhood and social interactions existing within the various communities in Africa compared to what is typically adopted in Western communities. Thus, the need for an alternative approach was necessary and Ross’ Prima Facie duties were adopted in the research as an alternative approach to ethical decision making in the process of implementing informed consent in Africa