Cal. Code Regs. Tit. 22, § 51305.4 - Certification of Informed Consent for Sterilization
(a) The Consent Form, provided by the
Department in English and Spanish, shall be the only approved form and shall be
signed and dated by the:
(1) Individual to be
sterilized.
(2) Interpreter, if one
is provided.
(3) Person who
obtained the consent.
(4) Physician
who performed the sterilization procedure.
(b) The person securing consent shall
certify, by signing the Consent Form, to have personally:
(1) Advised the individual to be sterilized,
before the individual to be sterilized signed the Consent Form, that no federal
benefits may be withdrawn because of the decision not to be
sterilized.
(2) Explained orally
the requirements for informed consent to the individual to be sterilized as set
forth on the Consent Form and in Section
51305.3.
(3) Determined, to the best of his or her
knowledge and belief, that the individual to be sterilized appeared mentally
competent and knowingly and voluntarily consented to be
sterilized.
(c) The
physician performing the sterilization shall certify, by signing the Consent
Form, that:
(1) The physician, shortly before
the performance of the sterilization, advised the individual to be sterilized
that federal benefits shall not be withheld or withdrawn because of a decision
not to be sterilized.
(2) The
physician explained orally the requirements for informed consent as set forth
on the Consent Form.
(3) To the
best of the physician's knowledge and belief, the individual to be sterilized
appeared mentally competent and knowingly and voluntarily consented to be
sterilized.
(4) At least 30 days
have passed between the date of the individual's signature on the Consent Form
and the date upon which the sterilization was performed, except in the
following instances:
(A) Sterilization may be
performed at the time of emergency abdominal surgery if the physician:
1. Certifies that the written informed
consent to be sterilized was given at least 30 days before the individual
intended to be sterilized.
2.
Certifies that at least 72 hours have passed after written informed consent to
be sterilized was given.
3.
Describes the emergency on the Consent Form.
(B) Sterilization may be performed at the
time of premature delivery if the physician certifies that:
1. The written informed consent was given at
least 30 days before the expected date of the delivery. The physician shall
state the expected date of delivery on the Consent Form.
2. At least 72 hours have passed after
written informed consent to be sterilized was
given.
(d) The interpreter, if one is provided,
shall certify that the interpreter:
(1)
Transmitted the information and advice presented orally to the individual to be
sterilized.
(2) Read the Consent
Form and explained its contents to the individual to be sterilized.
(3) Determined, to the best of the
interpreter's knowledge and belief, that the individual to be sterilized
understood what the interpreter told the individual.
(e) The person who obtains consent shall
provide the individual to be sterilized with a copy of the booklet on
sterilization, provided by the Department in English and Spanish, before
obtaining consent.
(f) For the
purposes of this section, shortly before means a period within 72 hours prior
to the time the patient receives any preoperative medication.
Notes
2. Repealer and new section filed 6-24-80 designated effective 10-15-80 (Register 80, No. 26).
3. Change without regulatory effect of NOTE (Register 86, No. 49).
Note: Authority cited: Chapter 220, Statutes of 1975, Sections 14105, 14124.5 and 14191, Welfare and Institutions Code. Reference: Sections 14053, 14053.6, 14059, 14105, 14124.5, 14131, 14132, 14184 and 14191, Welfare and Institutions Code.
2. Repealer and new section filed 6-24-80 designated effective 10-15-80 (Register 80, No. 26).
3. Change without regulatory effect of NOTE (Register 86, No. 49).
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