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Open Access Debate

Changes to the law on consent in South Africa: implications for school-based adolescent sexual and reproductive health research

Melanie Zuch1*, Amanda J Mason-Jones2, Catherine Mathews3 and Lesley Henley4

Author affiliations

1 Brown University, Medical Research Council, PO Box 19070, Cape Town, Tygerberg 7505, South Africa

2 Adolescent Health Research Unit, University of Cape Town, Specialist Scientist, Health Systems Research Unit, Medical Research Council, PO Box 19070, Cape Town, Tygerberg 7505, South Africa

3 School of Public Health and Family Medicine, University of Cape Town, Health Systems Research Unit, Medical Research Council, PO Box 19070, Cape Town, Tygerberg 7505, South Africa

4 School of Child and Adolescent Health, University of Cape Town, Cape Town, Rondebosch 7700, South Africa

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Citation and License

BMC International Health and Human Rights 2012, 12:3  doi:10.1186/1472-698X-12-3

Published: 10 April 2012

Abstract

Background

The National Health Act, No 61, 2003 in South Africa is the first effort made by the government to protect health-related research participants under law. Implemented on March 1, 2012, the law mandates active consent from a parent or legal guardian for all research conducted with research participants under the age of 18 years. This paper focuses on the Act's implications for school-based adolescent sexual and reproductive health research.

Discussion

Although well intentioned, the added legal protections in the National Health Act may have the unintended consequence of reducing participation rates in school-based adolescent sexual and reproductive health research, thereby excluding the most at-risk students. The Act may also compromise adolescents' right to dignity and privacy, especially considering the personal nature of research on sex and sexuality. Devolved, discretionary decision-making, which empowers local human research ethics committees to permit a wider range of protective measures, including passive consent, independent adolescent consent or community consultation ought to be considered. The continued and direct involvement of young people in their sexual and reproductive health and well-being is an important principle to uphold.

Summary

This paper calls for a re-examination of section 71's ethical guidelines relating to informed consent in the National Health Act, No 61, 2003 in South Africa in order to better serve the interests of South African adolescents in sexual and reproductive health research.