Culture within Informed Consent: Papua New Guinea Perspective

Abstract

This paper examines informed consent in medical practice. We have explored the notion of consent and determined its underlying theory and important attributes. We argue that consent is a permissive state of mind that waives the right to bodily integrity. Once communicated to the actor the permission takes effect by justifying the intervention and legitimizing the virtuous exercise of the doctor's power. The process is usually formally documented by the reading and signing of a "consent form" by both the patient and the doctor who is proposing the treatment that takes place within a clinical setting. Many people grow up in the traditional communities where the idea of informed consent is undeveloped and tend to be passive in their roles in the informed consent process. We have gathered from this study that people tend to stick to their traditional customs and custom has become a source of their rules, brings people together, shares food, and uses for resolving issues in family, land, water rights, and compensation following disputes. In other words, peoples' ways of life revolve around their traditional customs. Family wellbeing decisions and especially health care are usually a family matter but not an individual. Going to receive health care services at the hospital or modern health care center for medical treatment is enough to make a patient say they do not want to follow through the clinical procedure including the process of informed consent. A medical consent form is a common form used in health care facilities to obtain medical consent for a certain treatment or medical procedure or dental. We found in the interview questionnaires that many patients do not understand the use of consent forms. We examined informed consent in the context of the people's culture and how the healthcare professionals handle the situation with patients that have widespread customs, beliefs and opinions which they strictly adhere to and practice.

Challenges of Obtaining Informed Consent in Poorly Coordinated and Funded Healthcare Services: Papua New Guinea Situation

“…We describe the situation as we assess it based on the past studies on informed consent in PNG [35][36][37][38][39]. There are many patients from many different parts of PNG and all of whom have received or are receiving medical treatment at the healthcare facilities which participated in our assessments.…”

“…Women would speak about their personal health and give personal details and things that they would not routinely disclose or see. It is only when that personal information potentially becomes available to a wider audience that the person becomes worried about privacy and confidentiality [37]. The patient is worried because they have lost control over how and what the information is used for.…”

“…Patients must talk to draw on the doctor's interest to help. In healthcare relationships patients make decisions all the time; about what secrets to tell, what to let the professional see, and how much to trust the healthcare professional to use that information constructively and to respect it as private and confidential [37][38][39]. A good doctor-patient relationship involves establishing trust and ground rules, before tackling the difficult issues that have prompted the patient to seek help from the doctor.…”