Medical information therapy and medical malpractice litigation in South Africa

Abstract

In South Africa, increases in both the size and amount of medical malpractice claims have resulted in a move towards so-called defensive medicine, and have had devastating emotional effects on healthcare professionals. Among several recommendations for addressing these consequences, the first author’s recent doctoral study critically analysed evidence-based patient choice as a partnership model in clinical decision making. This study indicated that none of the key skills of this approach are completely adequate in honouring the principle of respect for autonomy in clinical decision making. Instead, the study proposed the concept of medical information therapy – an expanded conception of the generic concept of information therapy – as an adequate approach to reconciling the opposing perspectives of patients and healthcare professionals in a therapeutic alliance. Recent case law, as well as relevant provisions of the National Health Act, emphasise patient autonomy, as well as the notion of shared decision making in the context of informed consent. The South African healthcare context is characterised by specific challenges affecting the process of obtaining informed consent. The article submits that the concept of medical information therapy will help address the significant increase in litigation against healthcare practitioners based on a lack of informed consent, in both the public and private healthcare sectors.