Manual for Male Circumcision under Local Anaesthesia

Male circumcision under local anaesthesia
Version 3.1 (Dec09)
helps clients see the whole picture and understand the situation
better.
Example:
Counsellor: “We have discussed several ways in which you can
reduce your risk of getting infected with an STI or HIV. For
example, you seem comfortable with starting to use condoms
during sex and drinking less alcohol when you go out with friends.
You have many choices and we will develop a specific plan later.
First, let’s talk about HIV testing because your plan could change
depending on your test result.”
INFORMED CONSENT FOR SURGERY
General
Clients (or parents, in the case of a child) must give informed consent
before a circumcision is performed. Health care providers should give
clients all the information they need to make a fully informed decision.
The following elements should be included.
• Provide information. Clients (or parents) should be given an
explanation, in plain language, of male circumcision and the nature
of the surgery. They should be informed about the risks and
benefits of the procedure and of other ways to reduce the risk of
HIV infection. They should know that they can choose not to be
circumcised.
• Assess whether the client understands the information provided.
• Assess the capacity of the client to make the necessary decisions.
• Assure the client that he is free to choose whether or not to be
circumcised. If there is any suggestion that the client is not ready
to provide consent, advise him to reflect on it for a few days.
• Ask clients who decide to undergo circumcision to sign a consent
document.
The goal of this consent process is to ensure that the clients (or
parents) understand the surgical procedure. At the same time, they
should be given the opportunity to make use of other sexual and
reproductive health services.
Only clients who have appropriate decision-making capacity and legal
status can give their informed consent to medical care. Where a child
(usually defined as a person under the age of majority in national law)
lacks the legal status required to provide independent, informed
consent, or lacks the capacity to appreciate the risks and benefits
associated with the procedure, written consent based on full
information must be obtained from the parent or legal guardian. The
parent or legal guardian should make the decision according to the
best interests of the child.
Children nevertheless have a right to participate in decisions affecting
their health, according to their evolving capacities. Even where the law
Educating and Counselling Clients and Obtaining Informed Consent Chapter 3-10