Language as a Barrier to Informed Consent and Patient Communications in South African Hospitals


Background: The ability of HCPs to communicate effectively is critical to patient understanding. Barriers to communication arising from illiteracy and language could prevent understanding of medical procedures, thereby putting patients at risk of providing informed consent (IC) without comprehension. The National Health Act stipulates that healthcare professionals (HCPs) when obtaining IC, “must, where possible, inform the user in a language the user understands and in a manner which takes into account the user’s level of literacy.” Language barriers can negatively impact on healthcare services by causing errors such as misdiagnosis, non-adherence to prescribed medications; affecting patients’ rights to IC and confidentiality, leading ultimately to negligence claims against HCPs. Methods: This was a cross-sectional descriptive study, designed to evaluate the quality of IC obtained by HCPs at randomly selected public hospitals in Durban, South Africa. To determine challenges to IC experienced during clinical practice, HCPs were asked to rank 6 criteria as potential barriers to obtaining IC.Results: There were 927 participants, comprising 168 doctors, 355 nurses and 404 patients. Most HCPs were female with 1-55years professional experience. Most patients spoke IsiZulu language (55%); unemployed (66%), with secondary education (69%). HCPs identified language, poor education, workload, and lack of interpreters, as major barriers to IC.Conclusions: This study’s results are consistent with others from multicultural settings which indicate that major challenges to IC practice include language barriers. Provision of trained interpreters may assist with minimizing language barriers, improved communications and overall quality of healthcare service delivery.

Author Information
Sylvester Chima, University of KwaZulu-Natal, South Africa

Paper Information
Conference: ACERP2018
Stream: Ethics - Medical Ethics

This paper is part of the ACERP2018 Conference Proceedings (View)
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Posted by James Alexander Gordon