The high court has overruled parents’ beliefs and desire to use traditional medicine to cure their child’s gangrene to avoid double amputation of her legs.
The Western Cape High Court has granted the Red Cross War Memorial Children’s Hospital permission to perform a bilateral lower limb amputation on a six-year-old child known as “AD” whose parents refused the medical intervention and opted for traditional healing.
The application by the hospital was based on the urgent need for surgical intervention for the child as her parents refused to provide their consent due to their religious and cultural beliefs.
According to the hospital, the child suffered from meningococcal septicaemia, which is a blood infection caused by bacteria that release toxins that damage blood vessels, leading to clots, poor circulation and necrosis.
This condition caused necrosis of the tissue in the child’s feet, which resulted in gangrene in both feet.
According to the manager of medical services and one of two medical superintendents at the hospital, Dr Jessica Brown, the only medical treatment for a child in such circumstances was surgical intervention with amputations of both her legs.
Due to the significant risk of a further infection developing around the necrotic tissue of the feet, the hospital found it critical that the child receive surgical intervention as soon as possible.
However, her parents refused to provide their consent for surgical intervention based on their traditional and religious beliefs.
AD’s parents wanted to explore traditional medicine/healing as an option because, in their view, her condition could be cured without surgical intervention and without amputation of her legs.
The parents conveyed to the hospital that the traditional healing would have to take place in the Eastern Cape, and this would require the hospital to discharge the child to enable her to travel to the province.
The hospital was, however, reluctant to discharge her due to her serious medical condition and because she was on strong pain medication, which included opioids. The hospital concluded that discharging her in such condition could be fatal. This decision was conveyed to her parents.
Despite the parents’ refusal to give consent for surgical intervention, the medical team and hospital continued to engage them.
After further discussion with the father, the hospital proceeded to invite a traditional healer of the parents’ choice to the orthopaedic ward to assess the child. The healer advised that he could cure her condition with oral medication, topical creams and ointment.
However, the hospital made it clear that it could not allow traditional healing on its premises. Considering the hospital’s stance, AD’s father believed the process was incomplete as the hospital had refused to allow the healer to do what he needed to do.
A second traditional healer, who is also a psychologist, was arranged to discuss the matter with the father, particularly the view that the traditional healing did not have to take place in the Eastern Cape. This discussion eventually resulted in the parents inviting another traditional healer to come to the hospital for a meeting. However, this healer cancelled the appointment and failed to arrive.
The medical and nursing teams together with social workers emphasised to the parents that any action taken would have to be in the minor child’s best interests.
Another traditional healer visited the hospital to assess AD. He advised that he would use oral traditional medication and lotion to cure AD’s feet. He said her condition would improve within four days.
The engagement with the parents’ cultural and traditional views on AD’s healing did not end there, as the hospital also requested the details of the parents’ elders. This resulted in further engagement with the father’s uncle, who was advised that AD’s infection could spread further up her legs.
However, he communicated that the family insisted on pursuing traditional medicine before amputation, and if the traditional medicine did not improve AD’s gangrene or achieve the desired result, then the family would return the child to the hospital. It was made clear that the family had no intention of changing their minds.
In granting the application in favour of the hospital and consenting to the surgical intervention for the amputation of AD’s legs, judge Mas-udah Pangarker said that this was not a case where AD, the medical team and the hospital had time at their disposal.
She said while she would not lightly interfere with parents’ rights to consent and care for their child, this was a case where intervention in terms of the Children’s Act was justified. Pangarker was of the view that the parents’ objections based on religious and cultural beliefs placed AD’s health, dignity and life at risk.
Sowetan
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