n CME : Your SA Journal of CPD - Consent, with particular reference to HIV and AIDS : main article

Volume 24, Issue 2
  • ISSN : 0256-2170



Legally valid consent must be given by a competent person, in possession of adequate information that allows him or her to make an informed decision, without coercion or threat. <BR>A girl of 16 years and older may consent to sexual intercourse. <BR>For medical examination and treatment a legally competent adult and any competent person over the age of 14 may give consent, without parental knowledge or assistance. <BR>The Children's Bill, passed in parliament on 30 November 2005, once promulgated into an Act, will reduce this minimum age to 12 years for medical treatment, including contraceptive medication requested by the child. <BR>In certain emergency and life-threatening circumstances, where no family member or partner is available, the doctor uses discretion and treats an adult professionally and ethically as well as possible. It is advisable that the superintendent or officer specifically appointed for this purpose in a hospital should be informed of the situation and the treatment given and / or actions taken. Where permanent disability may result from non-treatment and parents refuse consent, the Minister of Health or a suitably delegated representative of the minister may give consent or a court order may be obtained. <BR>For invasive and surgical procedures the minimum age of legal consent is 18 years. <BR>It is ethically and morally important to respect and protect the privacy and confidentiality of a child, irrespective of age. <BR>The same legal and ethical principles apply to HIV testing as apply to any other medical examination and / or treatment. <BR>Large wall posters informing patients that HIV testing will be conducted routinely are not acceptable or adequate. <BR>The treating doctor is responsible for obtaining consent and ensuring conformity to the ethical guidelines. <BR>Oral consent, preferably with written documentation, is advisable; implied consent is not sufficient. <BR>Emergency testing must be done in the best interest of and for the optimal treatment of the patient. <BR>Testing in special circumstances, e.g. after needle-stick injuries, in pregnancy, after rape, pre-employment and before organ donation, carries special problems that must be fully considered before an HIV test is carried out. <BR>There are advantages and disadvantages, to both the patient and the health care worker, of HIV testing and knowing the result of the test.

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