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乌干达草药医生在知情同意方面的做法和态度:一项定性研究。

Practices and attitudes of herbalists regarding informed consent in Uganda: a qualitative study.

机构信息

School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

The AIDS Support Organisation, Kampala, Uganda.

出版信息

BMC Med Ethics. 2024 Oct 4;25(1):106. doi: 10.1186/s12910-024-01104-1.

Abstract

BACKGROUND

Informed consent (IC) is a fundamental principle in medical ethics that upholds respect for patient autonomy. Although widely applied in healthcare, its feasibility and implementation in herbal medicine have been underexplored. This study therefore aimed to explore the practices and attitudes of herbalists regarding informed consent.

METHODS

To achieve these objectives, a qualitative cross-sectional study was conducted from June to December 2020. Twenty-one in-depth interviews with herbalists and four key informant interviews with leaders of the different traditional medicine organizations were conducted. The data were analyzed thematically using NVivo version 12 software.

RESULTS

Sixteen of the twenty-one participants acquired oral herbal medicine knowledge from their relatives. Although a positive inclination toward obtaining IC was evident, the focus was on disclosing basic information. Discussions of alternative treatments and herbal specifics were less frequent. Disease management decisions often involve shared responsibility within families or societies. Documented IC procedures are rare among herbalists, who deem consent forms unnecessary, although they recognize the potential benefits of IC in fostering trust and professionalism. Challenges hindering IC implementation included regulatory gaps, inadequate skills, and the absence of mechanisms to protect the intellectual property rights of herbal medicine.

CONCLUSION

This study illuminates how educational, cultural, familial, and regulatory factors influence herbalists' practices and attitudes toward informed consent.

摘要

背景

知情同意(IC)是医学伦理中的一项基本原则,它坚持尊重患者自主权。尽管在医疗保健中广泛应用,但在草药医学中,其可行性和实施情况尚未得到充分探索。因此,本研究旨在探讨草药医生在知情同意方面的实践和态度。

方法

为了实现这些目标,我们于 2020 年 6 月至 12 月进行了一项定性的横断面研究。对 21 名草药医生进行了 21 次深入访谈,并对不同传统医学组织的 4 名主要信息提供者进行了 4 次访谈。使用 NVivo 版本 12 软件对数据进行了主题分析。

结果

21 名参与者中有 16 名从亲戚那里获得了口头草药医学知识。尽管他们对获得知情同意表现出积极的倾向,但重点是披露基本信息。对替代治疗和草药具体情况的讨论较少。疾病管理决策通常涉及家庭或社会内部的共同责任。草药医生很少有记录知情同意的程序,他们认为同意书没有必要,尽管他们认识到知情同意在培养信任和专业精神方面的潜在好处。妨碍知情同意实施的挑战包括监管空白、技能不足以及缺乏保护草药知识产权的机制。

结论

本研究阐明了教育、文化、家庭和监管因素如何影响草药医生在知情同意方面的实践和态度。

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