counselling is being done in very clear and simple words for everyone to understand. She further testified that the health officials are experienced in dealing with the group counselling on this basis. Her testimony in respect of the third plaintiff was that she requested a termination of her pregnancy and never mentioned acute pain or other problems as the reason for wishing to terminate the pregnancy. If this had been the case she would have examined the third plaintiff, would have recorded it and would have changed the management immediately and completely. Apart from being HIV positive, being elderly and being a high risk pregnant patient, third plaintiff was found to be otherwise stable and healthy. A caesarean section and a sterilisation was recommended to the patient when she was three months pregnant and had plenty of time to weigh her options. It was put to Dr Krönke that if third plaintiff had understood that what was involved was a sterilisation she would have made a booking for such a procedure. Dr Krönke disagreed. She testified that under these circumstances a booking would normally have to be made for a 33 caesarean section, the sterilisation being additional to that but the fact that a booking was not made does not necessarily indicate that the patient did not want the sterilisation since from her experience there are a number of reasons why patients do not make bookings. Dr Krönke further testified that it is not the common practice, and it is impractical to send out reminders to patients when they do not adhere to their appointments due to the sheer number of patients that are seen. She testified that it often occurs that no booking has been made but a patient would come at a time when it is necessary to do the surgical procedure. The third plaintiff was booked for an elective caesarean section due to her advanced age, the number of her previous deliveries, her HIV status, and because of her prolonged labour. Dr Krönke conceded during cross-examination, that there was no consent given for sterilisation by the third plaintiff in discussion with herself (i.e. Dr Krönke) and that there is no indication in all the hospital records that plaintiff had given consent at any time before she was in hospital and shortly before her surgery. Evaluation of Evidence [66] It is common cause that the plaintiffs underwent sterilisation procedures and it is not disputed that the required consent is more than just written consent, but informed consent. It is furthermore also not disputed what information should be made available to a patient in order to put such a patient in a position to make an informed decision. [67] The defendant’s medical personnel accepted that it is a surgeon’s legal duty to obtain informed consent from a patient although a registered nurse may be requested to procure the patient’s signature on the consent form. This is also in accordance with the ethical standards governing health professionals, as set out in the guidelines for them issued by the professional councils. 34