The Contribution of African Traditional Medicine For a Model of Relational Autonomy in Informed Consent

The Western liberal approach to informed consent defines autonomy as an independent choice or decision made by an individual as the final authority in medical decision-making. This approach is so dominant that one can fail to see the merits of other traditional and cultural perspectives. In this dissertation, another approach to informed consent is considered -that of communal culture of Africa, a process used in African traditional medicine (ATM) wherein patients make medical decisions and give consent in consultation with the members of their community and the ATM doctor. Often, but not necessarily, the final consent rests on the consensus reached in consultation with the group rather than on that by the individual patient alone. This dissertation argues that the ATM form of consent constitutes legitimate informed consent based on the concept of relational autonomy, commonly called relational autonomy in informed consent (RAIC) in this dissertation. To interpret and enlighten the significance of the ATM approach to RAIC, the analysis in this dissertation examines the ethics of care movement in Western bioethics which also advocates a relational approach to informed consent. This movement presents a concept of persons as relational beings who are socially embedded, thereby interpreting patient autonomy in their relationships with others. This movement provides the hermeneutic to enlighten the significance of the ATM approach as a legitimate model of RAIC. By comparison of the ethics of care approach with that of ATM to RAIC, this dissertation further provides a relational approach to informed consent in order to inform the restrictive emphasis on individual autonomy practiced in Western bioethics, all with a view towards fostering current discourse on global bioethics. The dissertation also provides an applied example of the contribution of ATM\u27s RAIC approach to ethics committees in Africa, focusing in particular, on the decision-making process for patient informed consent. This dissertation is distinct insofar as it focuses on informed consent in ATM, employs ethics of care as a hermeneutic to interpret ATM, advocates integrated model of healthcare ethics committees in ATM. Because ATM forms a large portion of the healthcare systems in Africa, it follows that ATM and its practices should receive more attention in bioethics in the present global era