Jeff Segal, MD, JD, FACS

I was thumbing through General Surgery News recently and read an article espousing a great idea; an idea worth spreading. Philip Schaurer, MD, and Jim Saxton, Esq. wrote about adding a spouse’s name to the informed consent document. Informed consent, of course, is a process, and not a document. But, by engaging the family, you address several issues.

Sometimes the person filing a lawsuit is not the patient, but a family member. The patient might be incapacitated, unresponsive, or even dead. Sometimes the spouse, left out of the loop, might have objected to the procedure being performed – perhaps because of risk; perhaps because of cost; or perhaps a million other reasons. Securing the spouse’s buy in can go a long way to preventing a lawsuit or ending a lawsuit once filed.

Words that occasionally pass a spouse’s lips: “I must have told my husband fifteen times that the surgery was a mistake. It was too risky. And the problem being solved was not that bad.” Or “I had no idea that this surgery was anything other than routine.” You get the picture.

When a spouse’s signature is embedded in the informed consent document, such statements lack any credibility. More important, the process engages a family member to understand the risks, benefits, and options, ask pointed questions, and manage expectations.

If a spouse refuses to sign, then you will be alerted, up front, that there may be challenges down the road. Better to learn that today — than down the road.

Obtaining a spouse or family member’s consent may not always be appropriate. Sometimes a patient might not want their spouse to know they are having a procedure done. Also, many procedures are low risk and the extra time required to bring all parties on board might be an inefficient use of time and resources. But, the riskier the procedure and the more options available to treat a condition, the more it makes sense to expand the signature line.