Informed consent practices in nigeria

Developing World Bioethics

Volumn 9, Issue 3, 2009, Pages 138-148

  Ezeome, Emmanuel R ^a   Marshall, Patricia A ^a  

^a UNIVERSITY OF NIGERIA   (Nigeria)

Author keywords

Clinical practice; Informed consent; Nigeria; Sociocultural context

Indexed keywords

ARTICLE; CULTURAL FACTOR; EDUCATION; ETHICS; HUMAN; INFORMED CONSENT; LEGAL ASPECT; MEDICAL ETHICS; NIGERIA; PATIENT EDUCATION;

CULTURAL CHARACTERISTICS; ETHICS, MEDICAL; HUMANS; INFORMED CONSENT; NIGERIA; PATIENT EDUCATION AS TOPIC;

EID: 70449629542     PISSN: 14718731     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1471-8847.2008.00234.x     Document Type: Article

References (87)

1. J.W. Berg, et al., eds. 2001. Informed Consent: Legal Theory and Clinical Practice. New York, NY: Oxford University Press.
2. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. 1979. The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research. Washington, DC: US Government Printing Office. Available at: http://ohsr.od.nih.gov/guidelines/ belmont.html [Accessed 7 Apr 2007].
3. R.J. Levine. Informed Consent: Some Challenges to the Universal Validity of Western Model. Law Med Health Care 1991 19 : 107 213.
4. C.S. Molyneux, N. Peshu K. Marsh. Understanding of Informed Consent in Low Income Setting: Three Case Studies from the Kenyan Coast. Soc Sci Med 2004 59 : 2547 2559
5. P.A. Marshall. Informed Consent in International Health Research. J Empir Res Hum Res Ethics 2006 1 : 25 42.
6. S. Yin. 2007. In the News: Results Trickle Out from the Nigerian Census. Washington, DC: Population Reference Bureau. Available at: http://www.prb.org/ Articles/2007/ResultsFromNigerianCensus.aspx [Accessed 7 Apr 2007].
7. Wikipedia. 2007. s.v. Nigeria. Wikipedia Online Encyclopedia. Available at: http://en.wikipedia.org/wiki/Nigeria [Accessed 10 Apr 2007].
8. Ibid..
9. E. Amadi, ed. 1982. Ethics in Nigerian Culture. Ibadan: Heinemann Educational Books Ltd.
10. Ibid..
11. Medical and Dental Council of Nigeria. 2004. Codes of Medical Ethics in Nigeria. Surulere: Petruvanni Co. Ltd: 26-31.
12. J.A. Yakubu, ed. 2004. Medical Law in Nigeria. Ibadan: Demyaxs Press.
13. Ibid..
14. C.C. Nweze. Medical Negligence: Comparative Contemporary Legal Perspectives. Consumer Journal 2005 1 : 35 67.
15. Supreme Court of Nigeria. Medical and Dental Disciplinary Tribunal V Okonkwo (2001) 4 SCN 78. Nigerian Weekly Law Report 2001 Part 711 : 205 255.
16. A.J. Dada. 2002. Consent to Medical Treatment. In Legal Aspects of Medical Practice in Nigeria. A.J. Dada, ed. Calabar: University of Calabar Press: 157-171: 158.
17. Yakubu, op. cit. note 11;
18. Nweze, op. cit. note 13
19. Dada, op. cit. note 15.
20. Medical and Dental Council of Nigeria, op. cit. note 10.
21. O.C. Osime, et al. Current Practices and Medico-Legal Aspects of Pre-Operative Consent. East Afr Med J 2004 81 : 331 335.
22. N.J. Jebbin J.M. Adotey. Informed Consent: How Informed are Patients? Niger J Med 2004 13 : 148 151.
23. Osime, et al., op. cit. note 18.
24. O.I. Aisuodionoe-Shadrach, O.S. Ogunlade O.E. Amoran. An Evaluation of the Informed Consent Process for Elective Surgery at a University Hospital. Niger J Med 2006 15 : 281 284.
25. K.A. Agu. Informed Consent Policy and Surgeons in Southeast Nigeria. Niger J Surg 2003 9 : 39 41.
26. Osime, et al., op. cit. note 18.
27. Agu, op. cit. note 22; Medical and Dental Council of Nigeria, op. cit. note 10.
28. Jebbin & Adotey, op. cit. note 19.
29. Agu, op. cit. note 22.
30. Aisuodionoe-Shadrach, op. cit. note 21.
31. P.A. Marshall, et al. Informed Consent to Genetic Research on Breast Cancer in Nigeria. In press.
32. P.A. Marshall, et al. Voluntary Participation and Informed Consent to International Genetic Research. Am J Public Health 2006 96 : 1989 1995.
33. th rev edn. New York, NY: Oxford University Press.
34. Marshal, et al., op. cit. note 28; Marshall, et al., op. cit. note 29.
35. P.A. Marshall. 2001. Relevance of Culture for Informed Consent in U.S.-Funded International Health Research. In Ethical and Policy Issues in International Research: Clinical Trials in Developing Countries. Vol. II. Bethesda, MD: National Bioethics Advisory Commission: C1-C38.
36. Ibid..
37. Ibid.. The following was recorded in a focus group discussion of Nigerian physicians involved in informed consent for genetic studies: 'In the Unites States, we say things like "You may die... this may not benefit you." I had a resident who was keen on informed consent. She would tell patients that they could die. [She would tell them this] pre-op [before they went into surgery]... and they would say, "why are you telling me I could die?" they [the patients] thoroughly abused her. We [Nigerians] don't like to talk about it. It makes it more important... it distorts the importance [of the risk of dying].'
38. Ibid..
39. Osime, et al., op. cit. note 18
40. Aisuodionoe-Shadrach, et al., op. cit. note 21.
41. Marshal, et al., op. cit. note 32.
42. Ibid; Amadi, op. cit. note 8.
43. G.J. Annas F.H. Miller. The Empire of Death: How Culture and Economics Affect Informed Consent in the U.S., the U.K., and Japan. Am J Law Med 1994 20 : 357 394.
44. Amadi, op. cit. note 8
45. Marshall, et al., op. cit. note 28
46. Amadi, ibid.
47. Ibid..
48. Nweze, op. cit. note 13.
49. Y. Cong. Doctor-Family-Patient Relationship: The Chinese Paradigm of Informed Consent. J Med Phil 2004 29 : 149 178.
50. Amadi, op. cit. note 8. Some authors have even alluded to the bride price, which is a high point of the customary rite of marriage as a symbol of the wife being the property of her husband. Most sociologists in Nigeria will however disagree with this.
51. Jebbin & Adotey, op. cit. note 19.
52. Marshall, et al., op. cit. note 29.
53. Ibid..
54. O.O. Ajayi. Taboos and Clinical Research in West Africa. J Med Ethics 1980 6 : 61 63.
55. Amadi, op. cit. note 8.
56. Ibid.. Among the Yorubas, children prostrate to greet their elders and it is disrespectful for a child to address an elder by his name or look into his eyes during a conversation. It is seen as irresponsible for a child to express a dissenting opinion with his or her parents or seniors in public. While a person from the Western world may see this as shiftiness on the part of the young person, for Nigerians it is a sign of obedience and gratitude, which are due to parents, guardians and senior relations who the young person depends on for sustenance, education and protection.
57. Amadi, op. cit. note 8.
58. Marshall, et al., op. cit. note 32.
59. Annas & Miller, op. cit. note 39.
60. Ibid..
61. Osime, et al., op. cit. note 18.
62. Agu, op. cit. note 22.
63. Marshall, et al., op. cit. note 29.
64. Marshall, et al., op. cit. note 29.
65. J. Onah. 2007. UNESCO Laments the Level of Illiteracy in Nigeria. Business Day (Lagos, Nigeria) 11 October. Available at: http:// businessdayonline.com/print/508.html [Accessed 18 Aug 2007].
66. Annas & Miller, op. cit. note 39.
67. Osime, et al., op. cit. note 18
68. Jebbin & Adotey, op. cit. note 19
69. Aisuodionoe-Shadrach, et al., op. cit. note 21.
70. Marshall, et al., op. cit. note 32.
71. Ibid..
72. Ibid..
73. J.A. Carrese L.A. Rhodes. Bridging Cultural Differences in Medical Practice: The Case of Discussing Negative Information with Navajo Patients. J Gen Intern Med 2000 15 : 92 96
74. Levine, op. cit. note 3
75. L.O. Gostin. Informed Consent, Cultural Sensitivity and Respect for Persons. JAMA 1995 274 : 844 845.
76. Levine, op. cit. note 3.
77. Carrese & Rhodes, op. cit. note 65.
78. In many places in southern Nigeria, deaths, especially that of older persons whose relations have the means, are mourned in festive atmosphere with expensive ceremonies, rituals and music.
79. E.H. Hern Jr., et al. The Difference that Culture Can Make in End-of-Life Decision Making. Camb Q Healthc Ethics 1998 7 : 27 40.
80. H.C. Metz, ed 1991. Nigeria: A Country Study. Washington, DC: Government Printing Office for the Library of Congress. Available at: http:// countrystudies.us/nigeria/42.htm [Accessed on 7 Apr 2007].
81. Ibid..
82. Yin, op. cit. note 5.
83. Medical and Dental Council of Nigeria, op. cit. note 10.
84. Osime, et al., op. cit. note 18
85. Jebbin & Adotey, op. cit. note 19
86. Aisuodionoe-Shadrach, et al., op. cit. note 21.
87. A. Howe. Professional Development in Undergraduate Medical Curricula - The Key to the Door of a New Culture? Med Educ 2002 36 : 353 359.