A note to doctors: We are open to reviewing your consent forms for vasectomies. You definitely want to get these consent forms right – and one way to reduce your risk is to have that consent form vetted by expert counsel. Schedule a consultation with our Founder and CEO, Jeff Segal, MD, JD, by using the calendar tool enclosed below. The article continues below.
I recently came across an informed consent form for a vasectomy. (Not mine. I was doing research.) The consent form included the expected items; risks, options, benefits, and so on.
There was a signature line for the patient.
There was a signature line for a witness.
Just below was a paragraph of additional text and a signature line for the spouse.
I am the wife of ___________________________________. I understand that my husband has asked the physician to perform a bilateral vasectomy procedure on him. I have read the consent which my husband has signed and realize the procedure will not take effect for some time after it is performed, but thereafter it will be very unlikely that my husband will be able to cause me to become pregnant. I have no objection to this procedure and agree that I will not assert any claim against the physician on the basis of the procedure performed and that I release him from any and all liability arising out of or relating to the procedure.
While husbands and wives share many secrets with one another, what happens if the husband does not want to share THIS secret?
In this case, the consequences of the vasectomy may very well impact the spouse’s reasonable expectations.
Still, medical ethics weighs heavily in terms of patient autonomy – to decide what medical procedures the patient wants and does not want performed.
While a husband should discuss major life issues with a spouse, what if he wants to shut his wife out of the decision-making process? Would such an informed consent imply that the spouse has veto power over the procedure?
I can find no state law which mandates spousal approval for a vasectomy.
Further, if a physician forces a spouse to disclose medical details with his wife, this could trigger a HIPAA problem. In this light, the physician would not have disclosed any protected health information. But, the patient might argue he was coerced by the physician against his will to do so; particularly if he was led to believe he had no option.
My personal opinion is that successful relationships are based on honesty. And, if a spouse is affirmatively choosing to become infertile, he should inform. But, it should be patient’s choice.
Perhaps the better middle ground is to suggest to the patient that he should discuss the consequences of the procedure with his spouse. Then document he was encouraged to do so.
By the way, this discussion is not sex-specific. It’s easy to imagine an analogous consent form being presented to a woman and her husband for tubal ligation. Or to a woman and her same sex spouse, again for tubal ligation.
What do you think? Let us know in the comments below.
And a note to doctors: We are open to reviewing your consent forms for vasectomies. You definitely want to get these consent forms right – and one way to reduce your risk is to have that consent form vetted by expert counsel. Schedule a consultation with our Founder and CEO, Jeff Segal, MD, JD, by using the calendar tool enclosed below.
While this discussion concerns itself primarily with physician and therefore HIPAA liability, there are other greater societal changes raging around this issue. (For disclosure this does not affect me, as I am still married for 50 years to the same spouse) I don’t know if physicians are familiar with the “MGTOW” movement, (Men Going Their Own Way) spreading rapidly around men in all social and financial classes. An addendum in a consent from a wife would run severely counter to husbands or male partners, thinking or planning to go MGTOW. There is not enough time or space to explain this here, but physicians may very well encounter men either in this category or seriously considering it. We all know that men are falling severely behind, and marriage rates are dropping precipitously. The purpose of this note is to give you all a “heads-up.” (No puns intended.) Michael M Rosenblatt, DPM
“Suggest to the patient that he should discuss the consequences of the procedure with his spouse. Then document he was encouraged to do so.” = best practice. I suspect the urologist with dual consent may have seen a case of spousal litigation from unexpected pregnancy. The verbiage in this consent is unnecessarily strong, but frankly, I don’t fault the doctor. It may be an unenforceable document, but it can serve as a deterrent to frivolous litigation. Does a physician have a right to refuse to perform an elective procedure if he or she is uncomfortable that the spouse is unaware? If both spouses are on board, there may be less potential for postop aggravation. Thank you.
Henry A UngerI am a retired board certified urologists. With every vasectomy I preformed, I required the spouse to be present at the consultation. I inform7 the patient that the law does not require her consent and she would not be giving it. I wanted her present in the discussion so that she was aware. . If this was not acceptable to the patient, I politely asked him to find another individual to do the deed. I did not want to get involved in drama. This is a family decision and all partipants need to be aware, not necessarily giving their consent.