[...] WANTS A VASECTOMY? Only with the wife’s permission! Where are our “reproductive rights” advocates on [...]

[...] there’s the whole needing a wife’s consent for a vasectomy thing. What are these “reproductive rights” I keep hearing [...]

[...] week, prominent mommy blogger Katie Allison Granju wrote a truly startling article titled “Husband Want a Vasectomy? He’ll Have to Ask Your Permission.” Granju, a [...]

[...] Read Katie’s post about some doctor’s requiring the man’s wife’s permission … (Thankfully my husband’s doctor did not require my permission!) [...]

I’m not a doctor or a lawyer, nor do I play either on TV, but I’m betting that the reason is that somewhere a doctor who performs such surgeries has been sued by a wife who discovered at some point that her supposedly willing to have another child husband had a vasectomy and the doctor lost.

I guess I’m really “old-fashioned,” but I see this as a marriage-rights issue, not a male or female autonomy issue. If a man or woman is married, I firmly believe that person’s spouse has a right to be included in the decision-making process on so-called “reproductive health” issues that affect the common life of the family and not just the individual alone. The idea that a man can prevent his wife from ever having children without her consent, not to mention that a woman can abort her husband’s child without his consent, strikes me as the REAL violation of personal rights.

I am with Michelle. If you are married, it is not an invasion of your rights. No doctor wants to be caught in the middle of the marital version of WW3 and that is exactly what this is seeking to avoid.
I don’t blame them a bit.
And due to the permanent nature of sterilization, that puts it on a bit of a different plane than birth control pills.

I have never, ever, heard of such a thing. I know several men that have gotten vasectomies AGAINST their wife’s wishes. And even more that did it with their wife’s blessing, but never, ever heard of ‘permission’ being required.

My husband got a vasectomy some years ago here in California without my consent– and it was the end of the marriage. I’m happily remarried now and have had my first son, so all’s well that ends well, but still…
I don’t think doctors should legally be able to intrude in this way– and I always knew that in the end my ex-husband had the right to make a decision about his own body, no matter how bitterly I resented it– but I can say from personal experience what a minefield this area is.

This is more of a moral issue than legal. If my husband had a vasectomy without my verbal consent it would be grounds for divorce.

Should men be able to have a vasectomy legally without consent from their wives. Sure, but morally it goes against everything that marriage stands for…becoming one union and making decisions together.

It’s funny…when my husband wanted to take money out of his 401K I had to sign the papers too. Legally, I have the right to know if he is taking money from his 401K so I guess it’s not hard to believe that legally, I would have the right to know if he is altering his reproductive status.

I find this shocking. As Sara’s experience attests, if a married man has a vasectomy without discussing it with his wife, there’s a real issue with the marriage. But such discussion is hardly something a doctor should be enforcing.

That said, because of the mechanics of how a baby comes into the world it’s not quite fair to compare men to women on this – obviously pregnancy is a much, MUCH bigger deal for the woman, so if there’s a requirement for one party to inform the other I’m glad it’s men having to inform their wives rather than the other way around, KWIM? It’s ridiculous either way, of course.

It sounds very weird. Maybe because it’s permanent? Would the same be true for a married woman getting her tubes tied? I would imagine that in both scenarios, in a healthy marriage anyway, husband and wife would obviously have both knowledge and agreement.

My husband had to sign a consent form for his ex-wife (they were married at the time) so she could get her tubes tied. This was a local Knoxville hospital.

Totally agree with Michelle – this is not about individual rights. Or, if you will, once you agree to marry someone, some of your individual rights are not so individual, after all. I also think it is criminal that a woman would be allowed to abort her husband’s baby against his will. And the breast reduction surgery is not a good analogy. We are talking about the creation of life here!

While I find the legal requirement a violation of personal rights, I agree that in a healthy marriage partners *should* communicate honestly with each other about something as important as permanent sterilization. I just don’t think it is is the legislature’s job to make sure people have healthy marriages.

DH got one last year. I had to sign. We had this exact discuss–but it didn’t stop us from having it done!

I think it’s a good practice. Makes everyone involved sit up and take another look. People within the marriage have the right to know what’s going on.

Also, since there is so much prostrate cancer caused by vasectomies, it seems wise to let the wife know what’s going on.

And sadly enough, there are always the cases of the much younger men who have many years of child-creating life ahead of them, but they get manipulated into doing something that they will regret the rest of their lives.

My husband just had a vasectomy in January. I went with him to the consultation at the urologist’s office, but the doctor never mentioned anything about my consent. He gave us the information, and basically said, if you want to do this, stop by the desk and make an appointment on the way out! I did not have to sign any consent form.

OMG? “This is not about individual rights”? Are you effing kidding me? You have the right to do with your body whatever you chose, whether your husband/wife agrees or not. This is not a “marriage issue”. This is a personal one. If I don’t want any more children and my husband does, well, that’s unfortunate for him. But I sure as hell don’t his conscent to do anything to my body. And he doesn’t need mine. If that causes the destruction of a marriage, then it’s the fault of the married parties, not the doctor. It’s not a doctors job to facilitate a conversation that should have occurred between two married adults. If I were male, I’d definitely be fighting this fight if I lived in a state that required conscent.

My husband had a vasectomy last year (happily) and did not need my authorization (I probably would have lost it if they asked for it). We live in Iowa. Honestly, I was on board with the snipping, but if I wasn’t, I would have respected him enough to know that more children were not in our future. Isn’t that what marriage is all about? Compromise? Trusting your spouse?

I think the problem here is that the policy is often presented as “law.” I am pretty sure that spousal consent and/or notification for abortion was held unconstitutional, so I doubt it is TN that has the law. The doctor, however, may have his own practice.

My husband had a vasectomy last year and I was pretty shocked when the doctor made me come in and sign a consent form for the surgery, just like my husband is my child or my pet! I signed it but I did complain to the nurse. She told me that they have to get the wife’s permission because of some state law. We live in Rhode Island.

One other point – even if a patient can choose to go elsewhere – to another doctor – if the first doctor he approaches declines to perform a vasectomy without his wife’s written consent, it seems to me that the first doctor’s actions in even asking this of a patient are probably illegal. Lawyers, what do you think? – Katie

Man this is a tough one. Although I think that the wife should know about the vasectomy I don’t believe that she should have the final say about it. If a women had to have her husbands approval to get a tubal, then a lot of women wouldn’t be allowed to get them. There are a lot of men out there that expect their wives to live the life HE wants her to live, the way he wants her to. If we won’t stand for that, then we can’t stand for it to happen the other way around. Yes, in a healthy marriage, both the husband and wife will know what is going on and will have already agreed to who gets sterilized, but it isn’t up to the legal system to have a say in this. It one spouse wants to get sterilized without the consent of the other spouse, then they are the ones who have to live with the repercussions of said decision. The fact that the legal system even allows that a doctor can be sued by the spouse that didn’t know what was happening is a problem in and of itself. No one outside of the marriage should be ever be held responsible for a decision made by one spouse without the other knowing about it.

I am sure that this has to do with the fear of malpractice lawsuits. Are you sure that the same does not happen with tubal ligations?

Standard of care is one thing. Legality/illegality is something else.

Katie, why do you think it might be illegal? Under what law? As far as I know, doctors have no obligation to perform elective surgical procedures. Did the doctor’s office call you up *without Jon’s knowledge and consent* and tell you he was about to have a vasectomy, and ask if you agreed? If so, I’m almost sure that’s illegal under HIPAA. You didn’t say that’s what happened, so I’m not assuming it. However, I’m really curious what law might prevent a doctor from saying he will not perform this procedure on a married person without the spouse’s consent. That seems to me to be completely within his rights as a doctor. Whether I, personally, think a doctor should have a policy like this (I don’t) has nothing to do with whether it’s legal or not.

I agree that “family rights”, whatever the heck that is, doesn’t trump individual rights. That has nothing to do with whether a doctor has the right to decide under what circumstances he/she will perform certain procedures.

This is no different than the fact that most doctors will not perform a tubal ligation on a female who 1) has not already had at least 1-2 children or 2) is under 30 years of age.

I have a friend who had 3 kids before she was 30 and no one would give her a tubal until she turned 30.

My husband had a vasectomy last month and I certainly didn’t sign anything (in Canada). The forms asked about his marital status and children but that’s it. I don’t know if the doc asked if I was on board with it, but certainly no proof was requested.

Now, I have a friend who had one at the age of 18 and I think it’s kind of criminal that the doctor didn’t refuse! I mean, what 18 year old male wants kids? And what 18 year old is mature enough to make that decision? Of course, now married and in his thirties, he’s looking into having it reversed.

Honestly I can’t think of anything that an adult should need permission from someone else to be able to do. I was shocked to read this!

Marriage isn’t about “my, myself, and I” but about making mutual decisions for what is best for your marriage.

I find it interesting that while Katie had the freedom to have more children with her second husband (who brought none to the marriage) that somehow it was decided that Jon should get sterilized instead of Katie. What if you two divorce and Jon, who is several years younger than you, remarries to someone who does not have children. Why didn’t you get your tubes tied during your planned c-section with Georgia? Doesn’t Jon deserve the freedom that you had?

This coming right on the heels of how it was decided that it would be best for Jon to stay home after you posted multiple times that you would never advise anyone to do something that would leave you so financially vulnerable as stay home.

The same person seems to be making all of the sacrifices in this marriage . . .

Gee, Lolly, a lot of couples I know decide that the man should undergo a vasectomy rather than the woman getting a tubal, just because women have done WAY more their share in terms of the biological part of family-building, for obvious reasons. That seems eminently fair to me. Katie’s just come through two surgeries in the past year (C-section, D&C), so this may play a role in their decision.

But more to the point, they’ve made this decision together, and who are you to second-guess or question that decision? Sounds to me as though you’re talking from your own sense of hurt in terms of who’s making sacrifices in your own relationship, and I’m sorry that it is this way for you. But don’t take it out on Katie, OK? It’s not fair.

Personally, I don’t think it should be legal for a doctor to require a spouse’s approval. If a man or a woman doesn’t want offspring, even though the spouse does, it’s still the right of the individual to decide whether or not to create children.

I forget…. did Katie give us the particulars of her personal situation? I thought not. What she and Jon decide to do is up to them – not us. Her question was about the legality of the consent form, not about our opinion of who should be sterilized.

Just sayin.

I didn’t have to sign and I’m in PA. The thing is, I was all prepared to after hearing about the hoops other people I know had to jump through to get a vasectomy. Wife present at the appointment AND signing off. My husband’s urologist required neither.

To Lolly…. sheesh, reread your post and ask yourself why you felt the need to be so harsh and critical of Katie? Do you feel she hasn’t suffered enough over the last 9 1/2 months?

I’m with you, Katie, I think this is appalling. Were I Jon I’d be running, not walking, to another physician and never looking back, but I remain appalled that any physician would imagine this is appropriate.

(I’m married to a man who’d had a vasectomy years before his prior marriage ended and would strongly encourage virtually any man considering a vasectomy to get, oh, 25 vials of semen frozen before having the procedure done; this might well have saved us a lot of heartache and cost as we tried — eventually successfully, but only once — to add to our family. But that’s a separate issue and also a personal choice. And for the record, unless it’s no longer wanted (and at times even then), vasectomy rocks. Rocks.).

I know that it was requires of my dad over 20 yrs ago in a liberal state (he just forged my mom’s signature)and my Father in law in California about 18yrs ago; in that case, he felt like the spouse being bullied into the procedure and was then unable to have children with his second wife….if that helps with the understanding of how widespread the practice is/was.

What people think/feel and the law are two very different things. If state law (wherever you are) doesn’t require spousal permission for sterilization then the doctor’s “spousals consent form” is all about the doctor’s morals — not yours. So make a consumer choice by finding another urologist who doesn’t ask nosy questions or try to Chis/herA with spousal consent forms. Just make sure you let the doctor know WHY you won’t be using his or her services again before you slam the door behind you.

What chutzpah.

Does not happen in New York City.
Both sex’s have the right to make independent decisions about their own body.
That includes the right to an abortion with out anyone’s permission and a man’s right to a vasectomy without permission.

Consent from your spouse to do something to your body….you have got to be kidding me. That is KRAZEE. I honestly can’t think of a scenario where required spousal permission would be okay.

I had a vas 6 last July in Knoxville (big urology group). No mention of a consent form at all, but the doctor give me the “talk.”

My friend (in Cookeville, TN) was unable to get her tubes tied after her third child was born because her ob/gyn insisted that they had to wait for that child to be at least a year old before they would do it.
She got pregnant again during that year, and was not happy about it.

My husband had a vasectomy nearly 11 years ago in Texas. At his initial appointment he was given a consent form to bring home to me to sign. I read the form and would have happily signed it (I was very aware that my husband was having the procedure – it was a mutual decision) but my husband said “under no circumstances are you going to sign that form. It’s my body and I don’t need your permission to do this!” I understood what he meant. He went back to the doctor on the day of the procedure and told him that his wife was in the waiting room and no, the consent form was not signed. The doctor shrugged and continued on.

I find it interesting that men are not allowed to make autonomous decisions about their bodies but women are. I think that if a man has a vasectomy without input from his wife, then there is definitely something more wrong with the marriage – but having said that, I don’t think it’s right that she needs to give permission.

In this case, it’s probably up to the individual doctor, though it is a violation of HIPAA laws. However, several states are currently litigating whether pharmacists can refuse to fill birth control prescriptions on religious or moral grounds. Also, many OB/GYNs will refuse to perform a tubal ligation on any woman under the age of 25 regardless of marital status, because obviously we can’t know our own minds, and I’m sure most of those would want some similar consent from a husband. In either instance, I don’t think I’d be going back to that doctor. Violation of medical privacy is just that. The doctor has no right to disclose any information to a patient’s spouse without prior authorization, and getting permission from a spouse to perform any procedure is just archaic, and most likely illegal.

Not to throw fuel on the fire, but isn’t the obvious analogy to abortion? The Supreme Court has decided that women have a privacy right that extends to that particlar procedure, why would the same privacy right not apply to men seeking any kind of medical care, not just a vasectomy?

I suspect that whether or not this is legally required varies by state.
That said, when I had one some 20-ish years ago, I was asked about whether I had a wife or a girlfriend. The doctor informed me that under the state law at that time that ones wife/girlfriend had a right to my sperm, and she had to voluntarily give up that right in order for me to have the vasectomy. (Note: I have a wife and have not had a girlfriend since she became my wife – in case there is some question.)
It would seem that if one’s wife/girlfriend has a legal right to the man’s sperm, that reciprocally the husband/boyfriend would have a legal right to the woman’s eggs.
But mens’ rights have seldom been equally enforced or recognized.

Any physician can refuse to perform an elective (non-emergency) procedure on anyone for nearly any reason. This is not against the law. It is therefore within his/her rights to require spousal consent (or any other kind of consent) for the procedure. In my opinion, I find this physician’s policies offensive and I would take my business elsewhere.

I know a urologist who requires permission because he was once threatened with a lawsuit by the unknowing wife post- vasectomy.

I know a urologist who does not require permission and who was surprised to hear of one who did.

“Honey, I’m pregnant.”
“Hmmm. That’s really interesting. I had a vasectomy three years ago.”

Big ol’ can of worms there, that the Doc is trying to avoid becoming enmeshed in. Because women carry the babies and not men, you can’t really “flip” the scenario and connect it to tubal ligation.

Still, it’s appalling and none of the Doc’s business…but until we have legal precedent that the wife can’t sue the husband’s doc for this undisclosed (to her) procedure…

If they insist this is the law, you should insist they provide a written copy of the law. Just a thought.

I am a Urologist in AZ that performs vasectomies and who does not require spousal consent. If it is state law then our office (several urologists) break the law a half dozen times a week.

I cannot let pass some of the posts made here without comment.

“Also, since there is so much prostrate cancer caused by vasectomies, it seems wise to let the wife know what’s going on.”

No proof as someone else has already pointed out.

“Yes, in a healthy marriage, both the husband and wife will know what is going on and will have already agreed to who gets sterilized, but it isn’t up to the legal system to have a say in this.”

Hello? The legal system has a lot to do with how medicine is practiced and generally it has a detrimental influence.

“I agree that “family rights”, whatever the heck that is, doesn’t trump individual rights. That has nothing to do with whether a doctor has the right to decide under what circumstances he/she will perform certain procedures.”

This is an elective procedure, not a life threatening situation. Under those circumstances doctors aren’t required to do whatever the patient wants. Doctors haven’t completely lost their autonomy. Yet

“Katie, keep in mind that in some aspects, a vasectomy can be considered a permanent mutilation to an important bodily function.”

Thanks for that. I think I’ll go mutilate a few more patients this afternoon. That is, after all, what I do. Come on. This is a minor 15 minute office procedure under local anesthetic. And it is in many cases reversible, not permanent although success rates are far from 100%.

Mutilation. Cancer causing. Permanent. It is a wonder any men would want this procedure if all that was true.

Whatever happened to “my body, my choice”? Do women need men’s permission for an abortion? Yeah, didin’t think so.

I am a physician in Ohio. My wife had to sign an informed consent agreement before I could have a vasectomy. If she were to have a tubal ligation, there would be no chance that I would have been required to sign a similar form. This was what I found maddening. Clearly reproductive rights are not enforced the same for women as they are for men.

I had a vasectomy performed last year in Texas. My wife was aware of and included in the decision, but my doctor did NOT require her permission.

I don’t see a problem with requiring spouses be informed of sterilization procedures for men or women. It’s a major decision and has a material impact on marriage. I believe this overreach of privacy is an outgrowth of the abortion debate.

If this is just office policy presented as law, it may well be a HIPAA violation. If not, it’s certainly malpractice.

“Surely this falls foul of equal protection statutes?”

If there actually is a law on the books that requires a wife’s consent to a vasectomy, but not a husband’s consent to a tubal – perhaps. Nobody here has cited any such law, so it’s speculative.

Toby,

For a physician to falsely state that their personal practice is backed by the force of law is unethical, but I don’t see how its a privacy (or HIPAA) violation.

As to “malpractice”, again, physicians aren’t obligated to vasectomize ANYONE. Its not “malpractice” to make a patient go somewhere else for a completely elective procedure the physician isn’t comfortable doing.

In fact, its exactly the OPPOSITE of “malpractice” for physicians to perform an irreversible sterilization on someone if they believe that the patient in question isn’t a good candidate for the procedure.

For example, some urologists won’t vasectomize any male who is under the age of 30 or who has less than two or three children. Its not because any law prevents them from doing the procedure, but its because in their professional experience a significant percentage of these men regret the decision later.

Someone who is trying to hide their sterilization from their spouse may fall into a similar category.

There is no law (that I know of) saying a physician

Lastly, this pamphlet from the State of Oregon describes a 30 day mandatory waiting period for any elective sterilization paid for by Federal or State funds:

http://www.oregon.gov/DHS/ph/fp/docs/updates/VasectomyPamphlet-Eng.pdf?ga=t

Its not malpractice for them to refuse to perform a completely elective procedure!

How it is malpractice?

Golly,
Let’s take a look at what Roe V. Wade determined.
No, look it up, don’t ASSUME you think you know what it actually said.
When you get to the part about (para)”secure in their persons and papers, including medical history…” you’re there. Read the opinions for bonus points. Equality and all that.
That being said, it seems to me that an undisclosed permanent alteration
of reasonable expectation of the potential to procreate (by either party) is certainly valid grounds
for immediate annulment of any marriage “contract” by law.
Any “unmentioned” alleviation of grave consequences for infidelity(by either party) might be considered for immediate annulment of a religious union as well.
I too suspect that lawsuits in “civil” or “family” court have arisen from this issue against a spouse and/or the MD. I’d hazard a guess it was in California, and ended up before the Ninth Circuit, finding for the “injured” woman, and increasingly expensive malpractice insurance “covers” it.
I could be wrong.

>>Except that in general, practicing physicians aren’t complete idiots, and they can probably smell that sort of lie a mile away.

Actually, I doubt they much care. They ask these kind of questions to “fill in the boxes” like all good bureaucrats do. Bureaucrats do not have a personal interest in how the questions are answered, only that they are answered (I’m very good at dealing with bureaucrats when I must deal with them).

>>The truly simple way around this “barrier” is just to find a different urologist willing to do the procedure on you irrespective of spousal consent.

That’s certainly true. I’m sure that there are plenty who do not care about your marital status.

BTW, I thought I would let you know that there already is a male pill, even though it is not used as such. Finasteride and dutasteride, which are used to prevent male pattern balding, also shut down the production of prostate enzyme when taken orally. Since prostate enzyme is needed for sperm production, Finasteride and Dutasteride are tantamount to an effective male pill.

Welcome to defensive medicine, folks. No, there’s no such law that requires the wife’s signature (at least not in my state of licensure). What the doctors are protecting themselves against is an after-the-fact claim by either the wife that (i) “You never told my husband the procedure was irreversible”; and (ii) therefore the doctor has without knowlege or effective consent deprived . . . not the husband, but . . . the *wife* of some portion of her right of consortium. Remember a spouse’s consortium rights are in some measure independent of the rights of the spouse from whom the consortium would otherwise be expected. My guess is that somewhere out there, some half-wit jury or equally challenged judge has ruled that the doctor was directly liable to the wife for having destroyed her procreative interest in her husband, and was backed up on appeal by some appellate court that had confused itself with Robin Hood. Wouldn’t surprise me either to find that malpractice carriers are requiring those forms as a precondition to coverage for claims of non-medical (so to speak) injury resulting from the procedure. And this is what happens when you let lawyers and judges practice medicine.

It makes sense for a harmonious marriage that a husband and wife should jointly agree on whether either partner seeks permanent sterilization. This would be the case in an ideal world. However, we do not live in an ideal world and marriage partners often make this decision based on emotional rather than sensible financial and life planning considerations, thus making rational discussion impossible.

The decision to have or not have kids should not be made lightly. Having kids represents a minimum of 20 years of wage/debt slavery for most people. This reality is not often a considered factor in the decision to have kids. Worse, there are people who have kids by happenstance where there is no thinking and planning at all, let alone rational discussion about life goals, financial planning, etc.

It is for these reason why partners in a marriage need to be able to access sterilization and other birth control unilaterally, despite the cost it may have on marital harmony.

Step into any family law or divorce court and you will realize that, in the USA today, women OWN men. Womens wishes and desires are foremost, mens are meaningless. This includes decisions on money and children. After all, women are just exercising their rights of ownership amd property.

Had a vasectomy almost 17 years ago. The doctor who performed the surgery didn’t need anything from my wife. My wife had just gone through a difficult pregnancy for our 3rd child, and the OB/GYN told her straight out: “get your husband fixed permanently or I’m dropping you as a patient.” I wanted more children and we were both fairly young, but I couldn’t risk my wife’s health again.

its totally a CYA thing. My husband just got his big V done last month and is a lawyer. His dr didn’t do the whole consent thing and my husband asked him about it. He said that he usually does the “are you sure, are you really really sure? is your wife/partner sure?” but he didn’t with my husband because the drs wife is my obgyn and my pregnancy was so awful that he’d heard about us in his wife’s after work stories.
A lawsuit like the one mentioned above could be the end of their practice and cost them not only money but patients, recommendations, and quite a bit of mental anguish (they don’t want to break up anybodies families I’m fairly certain). so is it dumb, totally. but i understand. when we were talking about getting my tubes tied i needed to bring my husband in on the discussion for the same reasons.

My stepdad and mom got married. He was probably around 50. My mom was like 45. She was his third wife. He was her second husband. She had a 14 year old daughter and he had two grown children. They of course did not want kids together. He went to go get a vasectomy. The doctor required my mother to come in and talk to the doctor about it and let him know she was okay with it. Seriously.

So no, I don’t think your doctor is the only one doing it. I think it is wrong for doctors to try to decide what is morally right for their patients. Like how doctors won’t tie a woman’s tubes unless she has had at least 2 kids. My friend had 2 accidental pregnancies that became babies and when she asked her doctor to tie her tubes, he wouldn’t until she had 3 kids! I think she found another doctor who would do it. I have heard of a woman who had a child and almost died. The doctor told her to never have another kid or it could kill her again. So when the woman asked for her tubes to be tied, the doctor refused because she had not had 2 kids! The whole thing is stupid as hell. As long as the patient signs a release saying they won’t sue then they cannot sue and the doctors should just do what the patient asks. It is not their job to tell others what they want,

My ex-husband had a vasectomy in the mid-80s and I had to sign consent forms so I guess we were a litigious society even then.

In some states a woman has to get her husband’s permission to get a credit card (I can’t remember which ones, but I remember reading that in the small print of an application at a nationwide store–I want to say Wisconsin and Eddie Bauer)–because that debt is incurred for both of them. A surgery that affects the expansion of a family should also be taken that seriously.

While it is a rare man who would get snipped behind his wife’s back,it does happen. As a future lawyer I would advise my physician clients to have their patients sign similar forms. If the wife is there for the appointment prior to the surgery you could argue that her consent was implied (and I would have the physicians note that in the chart for potential litigation).
As a wife, it would definitely be grounds for divorce if my husband had this surgery behind my back.