Chingore-Munazvo Nyasha, Furman Katherine, Raw Annabel, Slabbert Mariette
Centre for Reproductive Rights, P.O. Box 48136-00100, Nairobi, Kenya.
Durham University, 50 Old Elvet, Durham, DH1 3HN, UK.
Theor Med Bioeth. 2017 Apr;38(2):145-162. doi: 10.1007/s11017-017-9405-0.
The 2015 judgment of the Namibia Supreme Court in Government of the Republic of Namibia v LM and Others set an important precedent on informed consent in a case involving the coercive sterilisation of HIV-positive women. This article analyses the reasoning and factual narratives of the judgment by applying Neil Manson and Onora O'Neill's approach to informed consent as a communicative process. This is done in an effort to understand the practical import of the judgment in the particular context of resource constrained public healthcare facilities through which many women in southern Africa access reproductive healthcare. While the judgment affirms certain established tenets in informed consent to surgical procedures, aspects of the reasoning in context demand more particularised applications of what it means for a patient to have capacity and to be informed, and to appropriately accommodate the disruptive role of power dynamics in the communicative process.
2015年纳米比亚最高法院在“纳米比亚共和国政府诉LM及其他人”一案中的判决，在涉及对艾滋病毒呈阳性女性进行强制绝育的案件中，就知情同意问题开创了一个重要先例。本文运用尼尔·曼森和奥诺拉·奥尼尔将知情同意视为一个交流过程的方法，分析了该判决的推理过程和事实叙述。这样做是为了通过许多南部非洲女性获得生殖健康护理的资源有限的公共医疗设施这一特定背景，来理解该判决的实际意义。虽然该判决确认了手术程序知情同意方面的某些既定原则，但结合具体情况来看，其推理的某些方面要求对患者具备行为能力、获得信息的含义进行更具体的应用，并适当考虑权力动态在交流过程中的干扰作用。
