Informed Consent in Societies with Different Ethos of ‘Selfhood’
Journal Title: Sultan Qaboos University Medical Journal - Year 2019, Vol 19, Issue 1
Abstract
It has been well established that many illnesses, disabilities and distress are influenced by psychosocial factors.1 Tese psychosocial factors are central to the predisposition, onset, course, and outcome of illnesses.2 Tus, biopsychosocial factors are of major importance in designing intervention and management plans. According to Sirri et al., “When patient behaviors differ from those expected or recommended by physicians, the greater this discrepancy, the less likely the course of the disease will be predicted solely by bio medical factors” (P. 74).3 However, social and cultural factors appear to be marginalised when applying informed consent in traditional societies around the world where factors underpinning cultural beliefs or practices and social behaviour might be different to what is often taught in medical schools. In this issue of SQUMJ, Al-Balushi raised interesting points on the hegemony of modern medicine in the midst of a pluralistic world.4 Specifcally, Al-Balushi has observed that in a traditional society, it is the male members of a family rather than the female patients themselves who took the lead on issues pertinent to the doctor-patient relationship. From a bioethical persepective, this conduct undermines the patient’s inalienable right to personal autonomy. Such occurrence has been previously observed in many traditional societies.5–7 Tis contradictory practice of bioethics in traditional societies owes its origin to how medical science has spread in different parts of the world without being culturally sensitive. Modern medicine, sometimes known as ‘cosmopolitan medicine’ or simply biomedicine, often tends to have its true identity hidden. When one examines the underlying bioethical outlook, one cannot escape observing that it is shrouded with a Western philosophical view. Te Western bioethical approach is taken as an article of faith.8 Such a stance appears to have set forth what has been previously observed by Al-Balushi.4 It is well-known that Western medicine with its reliance on experimentation and empiricism has triumphed over many epidemics that have caused the deaths of millions.9 Te global impact of the development of antibiotics and vaccinations, without which the world would have looked very different than what it is today, can also not be ignored. On a superfcial level, it appears that Western medicine has transcended geographical, cultural and linguistic groups. Terefore, it is safe to assume that Western medicine is accepted in all corners of the world. However, such acceptance appears to be limited to its curative ability and there is a concern regarding its applicability in medical policy, practice and professionalism. Te universal applicability of Western bioethical approaches, including issues pertinent to confdentiality, determination of death, doctor-patient relationship and the topic of present scrutiny, informed consent.10 Informed consent refers to the process of obtaining the permission of a patient before proceeding with healthcare intervention.10 In essence, informed consent requires the treatment team to enlighten the patient about the nature of the treatment, risks and benefts and alternative treatments, if any. Once informed, patients have the choice to agree or disagree with the suggested intervention. Informed consent is, therefore, a voluntary agreement. Te principle of informed consent is based on the undeniable right to personal autonomy, self-determination, self-governance or ‘self-mastery’.
Authors and Affiliations
Muna Al-Saadoon, Samir Al-Adawi
Keywords
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- EP ID EP43091
- DOI http://dx.doi.org/10.18295/squmj.2019.19.01.001
- Views 343
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