Compliance with the Informed Consent to Blood Transfusion: Constraints and Physic for the Developing Africa
Asian Journal of Medicine and Health,
The informed consent to blood transfusion is a patient centered care where the health care provider is ethically obliged and legally compelled to disclose the details, alternatives and consequences of a procedure such as blood donation or transfusion and obtain from the patient a prior consent before it is carried out. However, this newly evolving practice is largely constrained in many developing countries of Africa and this study sought to identify constraints and advance remedies. Literature search on PubMed, PubMed Central, Google Scholar, and African Journal on Line (AJOL) as well as print material literatures where applicable was used to retrieve 66 publications whose contents met the criteria for inclusion into the study. Constraints range from nondisclosure or defective disclosure, knowledge gaps of health care providers and non-comprehension of consent-based information by patients, illiteracy, religious and cultural practices, poor funding and administrative bottlenecks like non provision of consent forms or consent-based information materials as well as weak structures of effective oversight for compliance of health institutions by governmental regulating agencies. Physic like deployment of contentious professional development (CPD) activities for different professionals, focused training on consent-related guidelines, public awareness and education on prevailing social, religious and cultural impediments, research and localization of institution specific challenges. Additionally, proactive economic policies like the deployment of insurance indemnity covers for healthcare workers with negligent liabilities in order to dissuade health care providers from practicing defensive medicine which is inimical to quality health care delivery. There is a need for more researches on constraints prevalent in each developing country in Africa for a more appreciable advancement of the practice.
- Informed consent
- blood transfusion
- health care provider
- constraints and physic
- developing Africa
- negligent liabilities.
How to Cite
Committee on Quality of Health Care in America; Institute of Medicine. Shaping the Future; Crossing the quality chasm: a new health system for the 21th century [Internet]. Institute of Medicine. National Academies Press. 2001;1–8.
Johnstone MJ. Nursing Ethics and Informed Consent. Aust Nurs J. 1993;19(5):29.
Queensland Health. Guide to Informed Decision Making in Health Care. 2nd ed. 2017;1–80 .
Lindsay A Alaishuski RDG and RED. The informed consent process in whole blood donation. Arch Path Lab Med. 2008;132(3):309–15.
Caine N and Roux J. Informed Consent and the Mature minor. PathCare Pathol Forum Med Ethics Ed. 2010;3(3):13–8.
Joint United Kingdom Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC). Consent for blood transfusion. 2020;1.
Watson D, Lander A, Court E, Clayton K, Kinnear S, Dalrymple K. Development of an E-learning resource on consent for transfusion [Internet]. Transfusion Medicine. 2012;22:46.
Canadian Society for Transfusion Medicine. Informed Consent – Position Paper [Internet]. 2008;2.
Science Daily. Blood transfusions should not go ahead without informed consent. BMJ-British Med Journal [Internet]. 2010;AugustBMJ-British Medical Journal. Blood transfusions should not go ahead without informed consent, experts say. ScienceDaily; 2010.
Retrieved March 1, 2021
Available:www.sciencedaily.com/releases/2010/08/100824231220.htm%0A%0ABMJ-British Medical Journa
Chitiyo ME. Informed consent for blood transfusion. Cent Afr J Med. 1999;45(7):189–90.
Michael T Krosin, Robert Klitzman, Bruce Levin, Jianfeng Cheng MLR. Problems in comprehension of informed consent in rural and peri-urban Mali, West Africa. Clin Trials. 2006;3(3):306–13.
Chima SC. Evaluating the quality of informed consent and contemporary clinical practices by medical doctors in South Africa: An empirical study. BMC Med Ethics. 2013;14(SUPPL.1):S1–3.
Laws, Louisiana, Statutes R, Safety T 40 — P health and, Applications R 40:1299. 4. — D and general. La. Rev. Stat. 2011;9:129:104–5.
Shivaram Chandrashekar. Blood Banker’ s Ethical Dilemma : To Assure Quality or Contain Costs. Glob J Transfus Med J Transfus Med. 2017;2(1):1–4.
Almutairi AF, Salam M, Abbas OA, Nasim M, Adlan AA. The public ’ s risk perception of blood transfusion in Saudi Arabia. J Blood Med. 2018;9:75–82.
Campbell M. Montgomery v Lanarkshire Health Board. Common Law World Rev. 2015;44(3):222–8.
Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee. Informed Consent [Internet]. Guidelines for the Blood Transfusion Services 2013;1–2.
Shaz BH, Demmons DG, Hillyer CD. Critical evaluation of informed consent forms for adult and minor aged whole blood donation used by United States blood centers. Transfusion. 2009;49(6): 1136–45.
Flanagan BG and peter. Informed consent for whole blood donation. vox Sang. 2020;115(1):3–10.
Shah P, Thornton I, Turrin D. Informed Consent - StatPearls - NCBI Bookshelf [Internet]. StatPearls Publishing. 2020. Shah P, Thornton I, Turrin D, et al. Informed Cons; 2020.
Canada SC of. Reibl V. Hughes. Dominion law reports. 1980;114:1–35.
Court AH. Rogers v. Grimaldi. Aust Law J. 1993;67(1):47–55.
South Africa. Supreme Court CPDSALR. Castell v. De Greef. 1994(4):408-41.
Friedman M, Arja W, Batra R, Daniel S, Hoehn D, Paniz AM, et al. Informed consent for blood transfusion: What do medicine residents tell? What do patients understand? Am J Clin Pathol. 2012; 138(4):559–65.
Osime OC, Okojie O, Osadolor F, Mohammed S. Current practices and medico-legal aspects of pre-operative consent. East Afr Med J. 2004;81(7):331–5.
Jebbin NJ, Adotey JM. Informed consent: how informed are patients? Niger J Med. 2004;13(2):148–51.
Aisuodionoe-Shadrach OI, Ogunlade OS, Amoran OE. An evaluation of the informed consent process for elective surgery at a university hospital. Niger J Med. 2006;15(3):281–4.
Agu KA, Obi EI, Eze BI, Okenwa WO. Attitude towards informed consent practice in a developing country: A community-based assessment of the role of educational status. BMC Med Ethics. 2014;15(77):
Kajja I, Bimenya GS, Smit Sibinga CT. Informed consent in blood transfusion: Knowledge and administrative issues in Uganda hospitals. Transfus Apher Sci. 2011;44(1):33–9.
Ddungu H, Krantz EM, Phipps W, Naluzze S, Orem J, Kiwanuka N, et al. Survey to assess knowledge and reported practices regarding blood transfusion among cancer physicians in Uganda. J Glob Oncol. 2018;(4).
Gbobo PI, Oke-chinda M. An Analysis of the Doctrine of Informed Consent in Nigeria ’ s Health Care Services. J Law, Policy Glob [Internet]. 2018;69:15–25. Available from: www.iiste.org
Carrese JA, Rhodes LA. Western Bioethics on the Navajo Reservation: Benefit or Harm? J Am Med Assoc. 1995;274 (10):826–9.
Steinberg A. Disclosure of information and informed consent: Ethical and practical considerations. J Child Neurol. 2009;24 (12):1568–71.
Aondowase JO, Ogar EE, George N, Ojobi J, Simji GS. Informed Consent in Transfusion Medicine : An Ethical Obligation Or a Legal Compulsion to Avert Liabilities for Negligence to the Health Care Provider. Int Blood Res Rev. 2021;12(3):40–55.
F. Jahan, R. Roshan, K. Nanji, U. Sajwani SW and SJ. Factors affecting the process of obtaining informed consent to surgery among patients and relatives in a developing country: results from Pakistan. East Medeterrinean Heal J. 2014;20 (9):569–77.
Schlemmer A, Mash B. The effects of a language barrier in a South African district hospital. SAMJ. 2006;96(10).
West JM. Ethical issues in the care of Jehovah's Witnesses. Curr Opin Anaesthesiol. 2014;27(2):170–6.
Husseini DI Al. The Implications of Religious Beliefs on Medical and Patient Care. 2011;51.
Savoia H. Management of Blood Refusal Procedure [Internet]. Blood Transfusion Consent and Consumer Information Guideline. 2015;11.
Kumar N. Informed consent: Past and present. Perspect Clin Res. 2013;4(1):21.
Ezeome ER, Marshall PA. Informed Consent Practices in Nigeria. Dev World Bioeth. 2009;9(3):138–48.
Al Balushi AA. Female patients and informed consent. Sultan Qaboos Univ Med J. 2019;19(1):11–4.
Rathor MY, Rathor, Fauzi ARM, Fauzi, AR M How SH and, Rasool A. Awareness, knowledge and attitude toward informed consent among doctors in two different cultures in Asia_ A cross-sectional comparative study in Malaysia and Kashmir, India. •Singapore Med J. 2007;l 48(6):559–65.
Fink BR, Dripps RD. Patient consent. Anesthesiology. 1967;28(6):1109–10.
Sacchini D, Liumbruno GM, Bruno G, Liumbruno C, Minacori R, Refolo P, et al. Ethical and deontological issues in Transfusion Medicine. Blood Transfus. 2013;11:14–25.
Brian Grainger EM and EP. Legal and ethical considerations in blood transfusion. CMAJ. 1997;156(11 suppl):S1.
Okojie E. Professional Medical Negligence in Nigeria. Practice [Internet]. 1994;(3):1–14.
Available:http://www.nigerianlawguru.com/articles/torts/PROFESSIONAL MEDICAL NEGLIGENCE IN NIGERIA.pdf
Joseph O. Fadare, Olufemi O. Desalu, Abiodun C. Jemilohun and OAB. Knowledge of medical ethics among Nigerian medical doctors. Niger Med J . 2012;5(4):226–230.
Taiwo OO, Kass N. Post-consent assessment of dental subjects’ understanding of informed consent in oral health research in Nigeria _ BMC Medical Ethics _ Full Text. BMC Med Ethics. 2009;10(11):
Vossoughi SR, Macauley R, Sazama K, Fung MK. Attitudes , Practices , and Training on Informed Consent for Transfusions and Procedures: A Survey of Medical Students and Physicians. Am J Clin Pathol. 2015;144:315–21.
Eisenstaedt RS, Glanz K, Smith DG, Derstine T. Informed consent for blood transfusion: a regional hospital survey. Transfusion. 1993;33(7):558–61.
Leparc GF. Informed consent for blood transfusion. J Fla Med Asso. 1991; 78(7):423–5.
Orkuma JA, Ayia ON. Ethico-legal aspects of hospital-based blood transfusion practice; implications of professional negligence to medical practitioners: a review. Int J Med Biomed Res [Internet]. 2014;3(3):219–35.
Available from: www.ijmbr.com
Akira Sato, Naofumi Yoshioka SO and AM. Informed Consent for Transfusion Medicine -Questionnair from Physicians-. J Japan Soc Blood Transfus. 1999;42(5): 199–204.
Goodnough, Lawrence T. HA and KM. Informed consent for blood transfusion as a transfusion medicine educational intervention . Transfus Med. 1994;4(1):51–5.
Court EL, Robinson JA, Hocken DB. Informed consent and patient understanding of blood transfusion. Transfusion Medicine. 2011;21:183–9.
Chan T, Eckert K, Venesoen P, Leslie K, Chin-Yee I. Consenting to blood: What do patients remember? Transfus Med. 2005;15(6):461–6.
Cheung D, Lieberman L, Lin Y, Callum J. Consent for blood transfusion: Do patients understand the risks and benefits? Transfus Med. 2014;24(5):269–73.
Goodnough LT, Shuck JM. Risks, options, and informed consent for blood transfusion in elective surgery. Am J Surg. 1990;159(6):602–9.
Garg P, Sarita N, Tayal I, Joshi R, Mishra A. Ethical and legal aspects of transfusion medicine- review literature. IP Int J Forensic Med Toxicol Sci. 2020;2(2):24–6.
Brown RH. The pediatrician and malpractice. Pediatrics. 1976;57(3):392–401.
Babalola Abegunde. Legal Implications of Ethical Breaches in Medical Practice: Nigeria a Case Study. Asian J Humanit Soc Sci. 2013;1(3):2320–9720.
Gorea RK. Medicolegal aspects of blood transfusion. J Punjab Acad Forensic Med Toxicol. 2010;10(1).
District Court of Appeal, First District, Division 1 C. Salgo v. Leland Stanford Jr University Board Of Trustees [Internet]. 1957. p. 17045.
Kirsch M. The myth of informed consent. Am J Gastroenterol. 2000;95(3):588–9.
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