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Consent for Reproductive Care

A mentally competent adult woman has the sole authority to consent to her medical care in all but very limited circumstances. A woman's husband has the right to veto care that will result in the conception of a child without his explicit or implied consent. This is limited to vetoing artificial insemination or embryo transplants. A husband has no veto or right to be be informed of his wife's decisions on contraception, sterilization, or abortion. The state may also determine what care can be obtained or refused under its power to protect either the public health and safety or the best interests of an individual. Unless the state or federal government has passed a law governing consent or access to the care in question, the decision rests with the woman and her physician.

Physicians should encourage women to discuss reproductive choices with their husbands or significant others, but it is improper to require the husband's consent. No court has allowed a husband to recover from a physician on the theory that the husband had a right to be consulted about his wife's medical care. Physicians who obtain a husband's consent rather than the wife's (unless the husband is the legal guardian or has been delegated the right to consent in a durable power of attorney) can be liable for battery to the wife. A more subtle risk arises when the husband and wife are estranged or legally separated. In these cases, the wife's expectation of privacy is great, and a physician who consults her husband without her permission can be sued for breaching the confidential relationship. This becomes a serious medical risk if necessary care is denied or delayed because of a husband's wishes or because of a delay in finding the husband.

Physicians should be very careful about interfering in marital relationships and about giving out patient information to spouses. If a patient does not want a spouse or family member to be informed about medical care, this wish must be honored. In one case, a woman who did not want more children was taking oral contraceptives without her husband's knowledge. When the husband asked the family doctor why the couple had not conceived, the doctor told the husband about the pills. The husband went home and severely beat his wife. In this case, the physician could be held liable for the beating because it was a foreseeable consequence of the physician's improper disclosure of private medical information.

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