[12] Therapeutic privilege referred to serves the purpose of protecting the patient’s health not necessarily ensuring patient autonomy. 8 [13] In Castel at 425 the Court stated the following: “For consent to operate as a defence the following requirements must, inter alia be satisfied: (a) the consenting party must have had knowledge and been aware of the nature and extent of the harm or risk; (b) the consenting party ‘must have appreciated and understood the nature and extent of the harm or risk; (c) the consenting party ‘must have consented to the harm or assumed the risk; (d) the consent ‘must be comprehensive, that is extend to the entire transaction, inclusive of its consequence’.” (See also Louwrens v Oldwage 2006 (2) SA 161 (SCA) at 173). [14] It should be obvious that the required consent must be given freely and voluntarily and should not have been induced by fear, fraud or force. Such consent must also be clear and unequivocal. [15] Carstens and Pearmain in Foundational Principles of South African Medica Law at 687 postulate that the “lack of informed consent amounts to an assault (in the context of wrongfulness/unlawfulness) and not negligence (in context of the element of fault). The concept of assault should not be assessed in its strict literal sense, but as a violation of a patient’s right to bodily or physical integrity”. These authors at 879 are of the view that since the patient is usually a layperson in medical matters, knowledge and appreciation on his or her part can only be effected by providing appropriate information. Adequate information becomes a requisite of knowledge, appreciation and consent and therefore also of lawful consent. [16] In deciding whether or not the plaintiffs given informed consent prior to the surgical procedures this Court must consider whether plaintiffs had been provided with adequate information in order to enable them to make informed decisions. 9 [17] In Castel, with reference to F v R (1983) 33 SASR 189, a decision of the Full Court of the Supreme Court of South Australia, the following appears at 427A: “AJ King CJ considered in F v R at 192 (a passage approved in Rogers v Whitaker at 51): ‘What a careful and responsible doctor would disclose depends upon the circumstances. The relevant circumstances include the nature of the matter to be disclosed, the nature of the treatment, the desire of the patient for information, the temperament and health of the patient?’ ” Expert evidence [18] Matti Kimberg testified that he is a qualified gynaecologist and obstetrician practicing in Windhoek. He holds an MB, B.Ch medical qualification being a fellow of the College of Obstetricians and Gynaecologists in South Africa and a fellow of the Royal College of Obstetricians and Gynaecologists in the United Kingdom. He has been practicing as a gynaecologist and obstetrician for more than 30 years. Prior to this he had