A NARRATIVE MODEL OF INFORMED CONSENT WITH YOUTH: DECISIONS AROUND ELECTIVE NON-MEDICAL CIRCUMCISION.

Abstract

This paper examines narratives from young men seeking non-medical circumcision. Non-medical circumcision remains controversial, yet there are young men seeking elective circumcision. At our centre, young men 15 to 17 seeking elective circumcision were asked to write short pieces to reflect their understanding and reason(s) for wanting circumcision. Fourteen youth participated; four changed their minds about the procedure. Findings are described and evaluated within the medico-legal description of informed consent, and, from a narrative ethics perspective explicitly concerned with giving voice to patients. Persons are presumed capable of making their own health care decisions, yet, with youth, there may be a concern that an irrevocable decision may be coerced, or impulsive. Narrative reflections provide a means by which (i) misinformation/misunderstanding can be resolved (ii) coercion can be minimized and (iii) impulsivity mitigated. This paper describes our experience with narrative reflection and aims to facilitate informed decision-making for elective procedures among youth, and other potentially vulnerable populations.