Repairing broken bones and broken promises: informed consent and orthopaedic practice in South Africa

Abstract

The discipline of orthopaedic surgery is a fast growing surgical specialty directed at the diagnosis and management of disorders of the musculoskeletal system e.g. acute trauma, fractured or dislocated joints, elective reconstructive surgery as well as related research. The standard of care in orthopaedic surgery treatment reflects the status of its evolution and what is currently available in terms of the knowledge, surgical expertise, orthopaedic implant materials, and equipment. It is the duty of the orthopaedic surgeon to live up to the promise as best he or she can to heal when it is possible to heal and to provide the level of care expected that transcends simple surgical expertise and bio-technological intervention. The informed consent process is an often neglected but vital component of the standard of care which has to satisfy prescribed ethical and legal requirements. This research is focused on how to heighten the awareness of, and to encourage engagement within the orthopaedic surgery fraternity with the informed consent process. If the informed consent is given more recognition within this group, it will benefit the potentially vulnerable orthopaedic patient, protect the orthopaedic surgeon against litigation, and importantly, contribute to the ethical imperatives bound in a doctor-patient relationship. For this research, a vast search of the available local and international literature has been perused and my finding is that the application of Ethics and recognition of the informed consent concept within the medical community in general is gathering momentum and it must be both supported and internalized by those in orthopaedic surgical practice.