Evaluation of MENA refugees’ attitudes towards patient autonomy-based ethics of informed consent

Abstract

Background The objective of this study was to identify refugees’ attitudes concerning the autonomy-based ethics of informed consent and to determine whether these attitudes varied by gender. Methods A quantitative methodology was adopted for this study. Questions were scored using a Likert-type scale and face-to-face interviews were conducted with 610 refugees who had migrated to Turkey from MENA (Middle East and North Africa) countries. Results Refugees from eleven countries participated in the survey, of whom the majority were men (62.5% male versus 37.5% female). Reasons for migration include war/security, poverty, and persecution (67.3%), and wanting to live in developed countries (81.1%). The decision to migrate was mainly decided upon either solely by males (as stated by 46.1% of participants) or by the family as a whole (39.0%). Regarding competence in spoken Turkish, most participants (58.5%) were judged to be at a moderate level. A plurality preferred to follow their doctor’s advice for treatment (42.6%), while nearly one-third deferred to the male authority figure in the family (33.1%). A majority stated that they were unaware of the concept of informed consent (63.3%). There was a significant difference between the responses of men and women with respect to the eight questions concerning informed consent. Conclusion Autonomy is a fundamental principle of human rights and medical ethics. Refugees from MENA countries, where the concept of autonomy is contrary to deeply-help traditional religious views of much of the population, in general, have a poor grasp of informed consent as a patient right. Traditional religious/cultural values steeped in patriarchy constitute an obstacle to women making decisions regarding their own lives in MENA countries. Therefore, the practice of informed consent is of critical importance in helping to reduce gender differentials in health care.