Family planning services in Namibia, voluntary sterilization

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Date

2015-03

Authors

Kochubiei, Oksana
Кочубєй, Оксана Анатоліївна
Ащеулова, Тетяна Вадимівна
Ащеулова, Татьяна Вадимовна
Ashcheulova, Tetyana
Weyulu, Selma
Кочубей, Оксана Анатольевна

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KhNMU

Abstract

According to Namibia’s National Family Planning Policy all persons of reproductive age who are sexually active shall on request be provided with adequate information, education and counseling about reproductive health and family planning. They shall be eligible to use contraceptive methods of their choice irrespective of their age and marital status. Family planning services in Namibia is based on respect of human rights and dignity of clients. Voluntary sterilization is a surgical procedure for permanent contraception and an excellent method for couples who have reached the desired family size. It can be performed for both men and women with written consent. Female sterilization is much more widely used in the world, but fairly common in Namibia accounting for about 4% of family planning cases. In Namibia Sterilization is regulated under the Abortion and Sterilization Act, 1975(Act No 2 of 1975). Voluntary sterilization is not an emergency procedure and individuals/ couples are normally given sufficient time to consider and reconsider all the consequences after proper counseling. The procedure is not to be performed on any person who for any reason is incapable of consenting or incompetent to consent thereto. In case of minors and mentally ill persons, consent for sterilization must be obtained from parents or legal guardians. For the procedure to be conducted client/patient must first give a written consent specific for sterilization. No man or women may be coerced or pressurized into having sterilization in Namibia. The Namibian court in the case against the Government of the Republic of Namibia in which three women brought before court in 2007 alleging that they have been sterilized at a public hospital when giving birth via Caesarean Section under coercion as they had not been told the contents of the consent form they were signing, found that obtaining consent from a woman when she is labour or extreme pain could not constitute informed consent. The court further concluded that for consent to be valid, it must be clear, unequivocal, given freely and voluntarily and not induced by fear, fraud or force. It was further held by court that written consent does not automatically equate to informed consent. Culturally, for many women in Namibia pregnancy and childbearing is central to self esteem and personal satisfaction. In a patriarchal society such as Namibia, women are often valued for their ability to bear children and therefore sterilization may affect how a woman is accepted in her community. The Medical and Dental Council of Namibia has issued ethical rules for medical practice which for purposes of this discussion emphasized amongst other things on the following: That medical practice is based on a relationship of trust with patients/clients; To be a medical doctor requires a life –long commitment to good professional and ethical practice and unreserved dedication to the good of fellow human beings and society; Being a registered medical doctor confers on the doctor the right and privilege to practice medicine, but correspondingly, the doctor has moral or ethical duties to others and society; Good professional practice is grounded in core professional values and standards. At times however these core values and standards may class and to address such clashes ethical reasoning is necessary; Medical Doctors should always respect patients as persons and acknowledge their intrinsic equal worth and dignity; Medical Doctors should at all times work in the best interest or well-being of patients even when they conflict with their own interest; Medical Doctors must recognize and respect patients’ right to self-determination or to make informed choices, living their lives by their own beliefs, values and preferences; Medical Doctors must incorporate core ethical values and standards for good and upright character and responsible practice in their professional relationships with patients; In professional relationship with patients, to regard the truth and truthfulness as the basis of trust; To treat personal/private information as confidential, unless overriding reasons confer a moral right of disclosure; Respect the right of people to have different beliefs as these may arise from deeply held personal, religious or cultural conviction; Treat all individuals or groups in an impartial, fair and just manner; Apply the principle of informed consent at all times; Maintaining professional boundaries is every Doctor’s individual responsibility and one must always guard against approaching things which may violate the tenets of Doctor- patient relationships. Always follow the right procedures step by step;

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Keywords

family planning services, voluntary sterilization, Namibia

Citation

Weyulu Selma Taatsu. Family planning services in Namibia, voluntary sterilization / Selma Taatsu Weyulu, T. Ashcheulova, O. Kochubiei // Implementation of biethics principles in clinical practice : IV International scientific students`conference, dedicated to the 210th anniversary of KhNMU, 31 of March 2015 : abstract book. – Kharkiv : KhNMU, 2015. – P. 59–61.

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