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

Sumayiya Nalubega, P. Kutyabami, Adeline Twimukye, D. Mafigiri, Nelson K. Sewankambo
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Abstract

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 also 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 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.
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乌干达草药医生对知情同意的做法和态度:定性研究
摘要 背景 知情同意(IC)是医学伦理的一项基本原则,坚持尊重患者的自主权。虽然知情同意被广泛应用于医疗保健领域,但其在中草药领域的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做法和态度。方法 为实现上述目标,我们在 2020 年 6 月至 12 月期间开展了一项横断面定性研究。此外,还对草药师进行了 21 次深入访谈,并对不同传统医药组织的领导人进行了 4 次关键信息提供者访谈。使用 NVivo 第 12 版软件对数据进行了专题分析。结果 在 21 位参与者中,有 16 位是从亲戚那里获得口服草药知识的。虽然获取集成电路的积极倾向是显而易见的,但重点是披露基本信息。关于替代疗法和草药具体情况的讨论较少。疾病管理决策往往涉及家庭或社会的共同责任。草药医生中很少有记录在案的 IC 程序,他们认为没有必要填写同意书,尽管他们认识到 IC 在促进信任和专业性方面的潜在益处。阻碍集成电路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 本研究揭示了教育、文化、家庭和监管因素如何影响草药医生对知情同意的实践和态度。
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