n South African Medical Journal - Bioethics in medicine : commentary on the need to obtain consent for vaginal delivery : forum

Volume 101, Issue 5
  • ISSN : 0256-9574
  • E-ISSN: 2078-5135



The arguments in the paper by Dhai may be summarised as follows: Since childbirth may take place by vaginal delivery or caesarean section, a choice must be made and consent to vaginal delivery is as necessary as consent for caesarean section. Dhai affirm the patient's right to choose, together with the observation that the safety of vaginal delivery may be limited in the public sector. Rising caesarean section rates and the differences between public and private sector rates are noted. They argue that sound ethical and legal principles should be used in determining mode of delivery. The right to choose is enshrined in the process of informed consent, which requires full disclosure. This includes the possibility that the labour ward may be inadequately staffed. Dhai state that informed consent and respect for patient autonomy are an 'ethical and legal imperative'; furthermore, they argue that failure to obtain consent may be construed to be assault. They also cite the Consumer Protection Act, which stipulates that consumers have a right to the performance of services in a manner and quality that persons may be entitled to expect.

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