Introduction: Informed Consent in a Communal Culture

Abstract

In traditional African society, it is a duty to help those who are in need or are sick—family, relatives, and clan, all members of the community. Whoever fails to render such help incurs a reprimand. Despite urbanization and movement of people to cities, this obligation to help has survived in various ways. Community members—family, relatives, and clan—continue to regard it as a duty to take care of a sick member. It has remained an enduring feature of the family in particular and of African society in general. Hence, the sick (the patient) rarely goes unaccompanied to consult the African traditional medicine (ATM) doctor. In some cases, the patient does not have to go at all. Instead, relatives go on the patient’s behalf. Generally, when an adult becomes ill, the head of the family and relevant community members consult among themselves to decide on a common course of action. If, however, the ill person is able, the group will discuss practical matters regarding the situation at hand with this person. Such practical matters may include: which ATM doctor to consult, how to finance treatment, whether the patient will be brought to the ATM doctor’s place, or whether the doctor will be invited to attend to the sick person within the family setting. The decision is reached by consensus. If the consensus is to take the sick person to the ATM doctor’s place, the group will proceed further to decide the following: who will accompany the patient, who will take care of the house as well as the children of both the patient and of those accompanying the patient. Some members of the community (relatives or elders) will sit in with the patient as the ATM doctor is consulted.