Difference between revisions of "Circumcision consent form"

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<BIG><b>Parents are advised that there are NO medical indications for circumcision of newborn boys. No disease is present. Circumcision of the newborn does not treat or prevent disease and subjects him to [[pain]] and [[trauma]].</b></BIG>
  
Neonatal circumcision consent form is a paper parents must sign when opting to have their male baby circumcised.  
+
Neonatal '''circumcision consent form''' is a paper parents must sign when opting to have their male baby [[circumcised]].  
  
According to Temple Health: "Informed consent is an ethical concept—that all patients should understand and agree to the potential consequences of their care—that has become codified in the law and in daily practice at every medical institution. One of the earliest legal precedents in this area was established in 1914 when a physician removed a tumor from the abdomen of a patient who had consented to only a diagnostic procedure (Schloendorff vs. Society of New York Hospital). The judge in this case ruled that the physician was liable for battery because he violated an “individual’s fundamental right to decide what is being done with his or her body.” [Edwards 1998, Wescott 2005] The first case actually defining the elements of informed consent occurred in the late 1950s and involved a question of potential negligence and whether a patient was given sufficient information to make a decision. "
+
According to Temple Health: "[[Informed consent]] is an ethical concept—that all patients should understand and agree to the potential consequences of their care—that has become codified in the law and in daily practice at every medical institution. One of the earliest legal precedents in this area was established in 1914 when a physician removed a tumor from the abdomen of a patient who had consented to only a diagnostic procedure ([https://scholar.google.com/scholar?cluster=17182600591789871337&hl=en&as_sdt=8000005&sciodt=8000006 Schloendorff vs. Society of New York Hospitals]). The judge in this case ruled that the physician was liable for battery because he violated an “individual’s fundamental right to decide what is being done with his or her body.” [Edwards 1998, Wescott 2005] The first case actually defining the elements of [[informed consent]] occurred in the late 1950s and involved a question of potential negligence and whether a patient was given sufficient information to make a decision."
  
"Although the details of these laws vary from state to state, the bottom line is that failure to obtain informed consent renders any U.S. physician liable for negligence or battery and constitutes medical malpractice. [Pizzi 2001] Exceptions are made for emergencies or legally adjudicated mental incompetency or physical incapacity. "
+
"Although the details of these laws vary from state to state, the bottom line is that failure to obtain [[informed consent]] renders any U.S. physician liable for negligence or battery and constitutes medical malpractice. [Pizzi 2001] Exceptions are made for emergencies or legally adjudicated mental incompetency or physical incapacity."
  
" [AMA 1998] For example, federal regulations spell out the minimum requirements for a properly executed informed consent form (Table 2) and state that this form must be in the patient’s chart before surgery. [CFR Title 42] These regulations also stipulate that the information must be given in a language or means of communication that the patient understands. "
+
"[AMA 1998] For example, federal regulations spell out the minimum requirements for a properly executed [[informed consent]] form (Table 2) and state that this form must be in the patient’s chart before surgery. [CFR Title 42] These regulations also stipulate that the information must be given in a language or means of communication that the patient understands. "
  
[Table 1] The Basic Features of Everyday Informed Consent
+
----
 +
 
 +
[Table 1] The Basic Features of Everyday [[Informed consent|Informed Consent]]
 
 
 
The physician (not a delegated representative) should disclose and discuss:
 
The physician (not a delegated representative) should disclose and discuss:
 
 
*   The diagnosis, if known
+
* The diagnosis, if known
*   The nature and purpose of a proposed treatment or procedure
+
* The nature and purpose of a proposed treatment or procedure
*   The risks and benefits of proposed treatment or procedures
+
* The risks and benefits of proposed treatment or procedures
*   Alternatives (regardless of costs or extent covered by insurance)
+
* Alternatives (regardless of costs or extent covered by insurance)
*   The risks and benefits of alternatives
+
* The risks and benefits of alternatives
*   The risks and benefits of not receiving treatments or undergoing procedures
+
* The risks and benefits of not receiving treatments or undergoing procedures
  
 
Source: AMA 1998
 
Source: AMA 1998
  
[Table 2] What’s Needed on the Informed Consent Form
+
----
 +
 
 +
[Table 2] What’s Needed on the [[informed consent|Informed Consent]] Form
 
 
 +
* Name and signature of the patient, or if appropriate, legal representative
 +
* Name of the hospital
 +
* Name of procedure(s)
 +
* Name of all practitioners performing the procedure and individual significant tasks if more than one practitioner
 +
* Risks
 +
* Benefits
 +
* Alternative procedures and treatments and their risks
 +
* Date and time consent is obtained
 +
* Statement that procedure was explained to patient or guardian
 +
* Signature of person witnessing the consent
 +
* Name and signature of person who explained the procedure to the patient or guardian
  
*  Name and signature of the patient, or if appropriate, legal representative
+
Source: Federal Code (Title 42 C.F.R. § 482.51 (b) (2)) Interpretive Guideline A-0392<ref>{{REFweb
*  Name of the hospital
+
|last=
*  Name of procedure(s)
+
|first=
*  Name of all practitioners performing the procedure and individual significant tasks if more than one practitioner
+
|date=
*  Risks
+
|title=A Practical Guide to Informed Consent
*  Benefits
+
  |url=http://www.templehealth.org/ICTOOLKIT/html/ictoolkitpage5.html
*  Alternative procedures and treatments and their risks
+
  |publisher=
*  Date and time consent is obtained
+
  |accessdate=2015-06-30  
*  Statement that procedure was explained to patient or guardian
 
*  Signature of person witnessing the consent
 
*  Name and signature of person who explained the procedure to the patient or guardian
 
 
 
Source: Federal Code (Title 42 C.F.R. § 482.51 (b) (2)) Interpretive Guideline A-0392<ref>{{cite web
 
  | url = http://www.templehealth.org/ICTOOLKIT/html/ictoolkitpage5.html
 
  | title = A Practical Guide to Informed Consent
 
  | accessdate = 2015-06-30
 
 
}}</ref>
 
}}</ref>
  
NOCIRC has written an exhaustive list of complications as an example of what is missing for the consent forms that parents sign in the United States.<ref>{{cite web
+
NOCIRC has written an exhaustive list of complications as an example of what is missing for the consent forms that parents sign in the United States.<ref>{{REFweb
  | url = http://www.nocirc.org/consent/form.php
+
|last=
  | title = Model Circumcision Informed Consent Form
+
|first=
  | accessdate = 2015-06-30
+
|date=
| publisher = NOCIRC
+
|title=Model Circumcision Informed Consent Form
 +
  |url=http://www.nocirc.org/consent/form.php
 +
  |publisher=NOCIRC
 +
  |accessdate=2015-06-30
 
}}</ref>
 
}}</ref>
 
  
 
http://childrightsnurses.org/wp-content/uploads/2012/07/Informed_consent_ARIAL-8-10-R11.pdf
 
http://childrightsnurses.org/wp-content/uploads/2012/07/Informed_consent_ARIAL-8-10-R11.pdf
 
 
  
 
What's missing from the consent forms:
 
What's missing from the consent forms:
Line 60: Line 67:
 
* Removal of the foreskin alters the mechanics of the penis
 
* Removal of the foreskin alters the mechanics of the penis
 
* ...
 
* ...
 
  
 
http://www.cirp.org/library/legal/conundrum/05.html
 
http://www.cirp.org/library/legal/conundrum/05.html
Line 66: Line 72:
 
http://www.legalmatch.com/law-library/article/circumcision-legalityconsent.html
 
http://www.legalmatch.com/law-library/article/circumcision-legalityconsent.html
  
 +
== Sample consent forms ==
  
 
+
=== {{UNI|University of Virginia|UVA}} Health System ===
==Sample consent forms==
 
 
 
===University of Virginia Health System===
 
  
 
http://www.virginia.edu/uvaprint/HSC/pdf/040162.pdf
 
http://www.virginia.edu/uvaprint/HSC/pdf/040162.pdf
  
*Diagnosis: Uncircumcised Newborn Male
+
* Diagnosis: [[Uncircumcised]] Newborn Male
*Nature and purpose of the procedure: Not stated, relies on oral information
+
* Nature and purpose of the procedure: Not stated, relies on oral information
*Additional procedures: If needed, additional procedures may be performed (i.e. if complications occur)
+
* Additional procedures: If needed, additional procedures may be performed (i.e. if complications occur)
*Practitioners: Residents may perform the procedure
+
* Practitioners: Residents may perform the procedure
*Consultants, photographs, video: Consultants may be present, photographs and video may be taken for educational purposes
+
* Consultants, photographs, video: Consultants may be present, photographs and video may be taken for educational purposes
*Tissues removed: may be used for "any lawful purpose including education and research"
+
* Tissues removed: may be used for "any lawful purpose including education and research"
*Risks: risks of surgery (bleeding, infection, damage to tissue, blood vessels, nerves, organs, which may result in paralysis, cardiac arrest, brain damage, death) and specific to circumcision (bleeding, infection, deformity or need for additional surgery)
+
* Risks: risks of surgery ([[bleeding]], infection, damage to tissue, blood vessels, nerves, organs, which may result in paralysis, cardiac arrest, brain damage, death) and specific to circumcision ([[bleeding]], infection, deformity or need for additional surgery)
*Benefits: not listed
+
* Benefits: not listed
*Alternatives: not circumcise
+
* Alternatives: not circumcise
*Risks and benefits of alternatives: not listed, states parent "understands the risks of the alternative"  
+
* Risks and benefits of alternatives: not listed, states parent "understands the risks of the alternative"  
*Risks and benefits of not undergoing the procedure
+
* Risks and benefits of not undergoing the procedure
  
This consent form at list is somewhat honest in the list of risks. The consent form authorizes the hospital to keep and (indirectly) to sell the tissue for profit. The consent form suggests "risk of" not circumcising. The diagnosis suggests that there is something wrong with being born an "uncircumcised newborn male".<ref>{{cite web
+
This consent form at list is somewhat honest in the list of risks. The consent form authorizes the hospital to keep and (indirectly) to sell the tissue for profit. The consent form suggests "risk of" not circumcising. The diagnosis suggests that there is something wrong with being born an "[[uncircumcised]] newborn male".<ref>{{REFweb
  | url = http://www.virginia.edu/uvaprint/HSC/pdf/040162.pdf
+
|last=
  | title = University of Virginia Health System - CONSENT FOR CIRCUMCISION OF PENIS AND ADMINISTRATION OF ANESTHESIA OR SEDATION
+
|first=
  | accessdate = 2015-06-30  
+
|date=
 +
|title=University of Virginia Health System - CONSENT FOR CIRCUMCISION OF PENIS AND ADMINISTRATION OF ANESTHESIA OR SEDATION
 +
  |url=http://www.virginia.edu/uvaprint/HSC/pdf/040162.pdf
 +
  |publisher=
 +
  |accessdate=2015-06-30
 
}}</ref>
 
}}</ref>
  
===MaternOhio===
+
=== MaternOhio ===
  
 
https://maternohio.securespsites.com/PEL/PEL/Shared%20Documents/26%20Newborn%20Circumcision%20Consent%20Form.pdf
 
https://maternohio.securespsites.com/PEL/PEL/Shared%20Documents/26%20Newborn%20Circumcision%20Consent%20Form.pdf
  
*Diagnosis
+
* Diagnosis
*Nature and purpose of the procedure
+
* Nature and purpose of the procedure
*Additional procedures
+
* Additional procedures
*Practitioners
+
* Practitioners
*Consultants, photographs, video
+
* Consultants, photographs, video
*Tissues removed
+
* Tissues removed
*Risks and benefits
+
* Risks and benefits
*Alternatives==
+
* Alternatives
*Risks and benefits of alternatives
+
* Risks and benefits of alternatives
*Risks and benefits of not undergoing the procedure
+
* Risks and benefits of not undergoing the procedure
  
  
Line 112: Line 120:
 
https://www.helgemopediatrics.com/index.php?option=com_chronocontact&Itemid=46
 
https://www.helgemopediatrics.com/index.php?option=com_chronocontact&Itemid=46
  
*Diagnosis
+
* Diagnosis
*Nature and purpose of the procedure
+
* Nature and purpose of the procedure
*Additional procedures
+
* Additional procedures
*Practitioners
+
* Practitioners
*Consultants, photographs, video
+
* Consultants, photographs, video
*Tissues removed
+
* Tissues removed
*Risks and benefits
+
* Risks and benefits
*Alternatives==
+
* Alternatives
*Risks and benefits of alternatives
+
* Risks and benefits of alternatives
*Risks and benefits of not undergoing the procedure
+
* Risks and benefits of not undergoing the procedure
 
 
  
 
http://gentlecirc.ca/consent.pdf
 
http://gentlecirc.ca/consent.pdf
Line 132: Line 139:
 
http://www.enatal.com/gaconsentforms/circ.pdf
 
http://www.enatal.com/gaconsentforms/circ.pdf
  
==Circumcision without consent==
+
== Circumcision without consent ==
  
 
cases
 
cases
 +
== Warning to parents ==
 +
Maternity hospitals commonly include a circumcision consent form in the papers that must be signed on admission to hospital in preparation for birth. At this time the mother is usually in early labor. Parents who DO NOT DESIRE a [[circumcision]] must be careful to NOT sign the circumcision consent form. If the form is signed, then any male infant born will be [[circumcised]].
 +
{{SEEALSO}}
 +
* [[Informed consent]]
 +
* [[Pain]]
 +
* [[Trauma]]
 +
{{REF}}
  
 +
[[Category:Parental information]]
 +
[[Category:Product]]
 +
[[Category:Financial gain]]
 +
[[Category:Law]]
  
==<small>References</small>==
 
<div class='references-small'>
 
<references/>
 
</div>
 
 
[[Category:Products]]
 
[[Category:Financial Gain]]
 
[[Category:Under construction]]
 
 
[[Category:Construction Site]]
 
 
[[Category:From IntactWiki]]
 
[[Category:From IntactWiki]]

Latest revision as of 21:56, 14 September 2023

Parents are advised that there are NO medical indications for circumcision of newborn boys. No disease is present. Circumcision of the newborn does not treat or prevent disease and subjects him to pain and trauma.

Neonatal circumcision consent form is a paper parents must sign when opting to have their male baby circumcised.

According to Temple Health: "Informed consent is an ethical concept—that all patients should understand and agree to the potential consequences of their care—that has become codified in the law and in daily practice at every medical institution. One of the earliest legal precedents in this area was established in 1914 when a physician removed a tumor from the abdomen of a patient who had consented to only a diagnostic procedure (Schloendorff vs. Society of New York Hospitals). The judge in this case ruled that the physician was liable for battery because he violated an “individual’s fundamental right to decide what is being done with his or her body.” [Edwards 1998, Wescott 2005] The first case actually defining the elements of informed consent occurred in the late 1950s and involved a question of potential negligence and whether a patient was given sufficient information to make a decision."

"Although the details of these laws vary from state to state, the bottom line is that failure to obtain informed consent renders any U.S. physician liable for negligence or battery and constitutes medical malpractice. [Pizzi 2001] Exceptions are made for emergencies or legally adjudicated mental incompetency or physical incapacity."

"[AMA 1998] For example, federal regulations spell out the minimum requirements for a properly executed informed consent form (Table 2) and state that this form must be in the patient’s chart before surgery. [CFR Title 42] These regulations also stipulate that the information must be given in a language or means of communication that the patient understands. "


[Table 1] The Basic Features of Everyday Informed Consent

The physician (not a delegated representative) should disclose and discuss:

  • The diagnosis, if known
  • The nature and purpose of a proposed treatment or procedure
  • The risks and benefits of proposed treatment or procedures
  • Alternatives (regardless of costs or extent covered by insurance)
  • The risks and benefits of alternatives
  • The risks and benefits of not receiving treatments or undergoing procedures

Source: AMA 1998


[Table 2] What’s Needed on the Informed Consent Form

  • Name and signature of the patient, or if appropriate, legal representative
  • Name of the hospital
  • Name of procedure(s)
  • Name of all practitioners performing the procedure and individual significant tasks if more than one practitioner
  • Risks
  • Benefits
  • Alternative procedures and treatments and their risks
  • Date and time consent is obtained
  • Statement that procedure was explained to patient or guardian
  • Signature of person witnessing the consent
  • Name and signature of person who explained the procedure to the patient or guardian

Source: Federal Code (Title 42 C.F.R. § 482.51 (b) (2)) Interpretive Guideline A-0392[1]

NOCIRC has written an exhaustive list of complications as an example of what is missing for the consent forms that parents sign in the United States.[2]

http://childrightsnurses.org/wp-content/uploads/2012/07/Informed_consent_ARIAL-8-10-R11.pdf

What's missing from the consent forms:

  • The foreskin is normal healthy genital tissue with sexual functions
  • Removal of the foreskin alters the mechanics of the penis
  • ...

http://www.cirp.org/library/legal/conundrum/05.html

http://www.legalmatch.com/law-library/article/circumcision-legalityconsent.html

Sample consent forms

University of Virginia Health System

http://www.virginia.edu/uvaprint/HSC/pdf/040162.pdf

  • Diagnosis: Uncircumcised Newborn Male
  • Nature and purpose of the procedure: Not stated, relies on oral information
  • Additional procedures: If needed, additional procedures may be performed (i.e. if complications occur)
  • Practitioners: Residents may perform the procedure
  • Consultants, photographs, video: Consultants may be present, photographs and video may be taken for educational purposes
  • Tissues removed: may be used for "any lawful purpose including education and research"
  • Risks: risks of surgery (bleeding, infection, damage to tissue, blood vessels, nerves, organs, which may result in paralysis, cardiac arrest, brain damage, death) and specific to circumcision (bleeding, infection, deformity or need for additional surgery)
  • Benefits: not listed
  • Alternatives: not circumcise
  • Risks and benefits of alternatives: not listed, states parent "understands the risks of the alternative"
  • Risks and benefits of not undergoing the procedure

This consent form at list is somewhat honest in the list of risks. The consent form authorizes the hospital to keep and (indirectly) to sell the tissue for profit. The consent form suggests "risk of" not circumcising. The diagnosis suggests that there is something wrong with being born an "uncircumcised newborn male".[3]

MaternOhio

https://maternohio.securespsites.com/PEL/PEL/Shared%20Documents/26%20Newborn%20Circumcision%20Consent%20Form.pdf

  • Diagnosis
  • Nature and purpose of the procedure
  • Additional procedures
  • Practitioners
  • Consultants, photographs, video
  • Tissues removed
  • Risks and benefits
  • Alternatives
  • Risks and benefits of alternatives
  • Risks and benefits of not undergoing the procedure


Helgemo & Liou Pediatrics

Helgemo & Liou Pediatrics https://www.helgemopediatrics.com/index.php?option=com_chronocontact&Itemid=46

  • Diagnosis
  • Nature and purpose of the procedure
  • Additional procedures
  • Practitioners
  • Consultants, photographs, video
  • Tissues removed
  • Risks and benefits
  • Alternatives
  • Risks and benefits of alternatives
  • Risks and benefits of not undergoing the procedure

http://gentlecirc.ca/consent.pdf

www.blueridgepeds.com/wp-content/uploads/Circumcision-consent.docx

www.palmbeachobgyn.com/Circumcision%20consent%20form.doc

http://www.enatal.com/gaconsentforms/circ.pdf

Circumcision without consent

cases

Warning to parents

Maternity hospitals commonly include a circumcision consent form in the papers that must be signed on admission to hospital in preparation for birth. At this time the mother is usually in early labor. Parents who DO NOT DESIRE a circumcision must be careful to NOT sign the circumcision consent form. If the form is signed, then any male infant born will be circumcised.

See also

References