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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.

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