Consent to Medical Treatment in South Africa: An MPS Guide

Correct as of July 2011

Summary

• Consent is not a signature on a form, but a communication process.
• Competent adult patients can refuse to consent to treatment or withdraw their consent once given.
• To be valid, consent must be obtained from a competent informed person free from undue duress.
• All adults are assumed to be competent to consent to treatment unless there is reason to believe their decisional capacity has been impaired.
• Decisional capacity is not an “all or nothing” concept – a person’s capacity to make a decision depends on the nature of the decision.
• Consent can be given by specified surrogates if a patient’s decisional capacity is impaired.
• If they have the maturity to do so, children aged 12 or over may consent to medical treatment on their own behalf and to surgical treatment with the assistance/assent of a parent or guardian.
• For consent to be valid, the person giving consent must be given all relevant information, including the material risks and consequences of each option, including no treatment.
• HIV testing without a patient’s consent is illegal, except in circumscribed situations authorised by law.
• When a patient loses decisional capacity, an advance directive made when he or she was still competent must be honoured unless there are good reasons for believing that the patient changed his or her mind.