Cal. Code Regs. Tit. 22, § 70707.4 - 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, or an alternate
physician.
(b) The person
securing consent shall certify, by signing the Consent Form, that he or she:
(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benefits may be withdrawn because of the decision not to be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
70707.3.
(3) Determined to the best of his/her
knowledge and belief that the individual to be sterilized appeared to
understand the content and nature of the informed consent process as specified
in 70707.3 and knowingly and voluntarily consented to be
sterilized.
(c) The
physician performing the sterilization, or an alternate physician shall
certify, by signing the Consent Form, that:
(1) The physician or an alternate 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be sterilized that federal benefits shall not be withheld or withdrawn because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 or an alternate physician
explained orally the requirements for informed consent as set forth on the
Consent Form.
(3) To the best of
the physician's or an alternate physician's knowledge and belief, the
individual to be sterilized appeared to knowingly and voluntarily consent 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 the delivery on the Consent Form.
2. At least 72 hours have passed after
written informed consent to be sterilized was given.
(C) The patient voluntarily requests in
writing that the procedure be performed in less than 30 days. However, in no
case shall a sterilization be performed in less than 72 hours following the
signing of the Consent Form.
(d) The interpreter, if one is provided,
shall certify that he or she:
(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 his/her
knowledge and belief that the individual to be sterilized understood that 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 4-17-81; effective thirtieth day thereafter (Register 81, No. 16).
3. Amendment of subsections (a)(4) and (c) filed 7-1-83; effective thirtieth day thereafter (Register 83, No. 27).
Note: Authority cited: Sections 208(a), 1275 and 1276, Health and Safety Code. Reference: Section 1250, Health and Safety Code.
2. Repealer and new section filed 4-17-81; effective thirtieth day thereafter (Register 81, No. 16).
3. Amendment of subsections (a)(4) and (c) filed 7-1-83; effective thirtieth day thereafter (Register 83, No. 27).
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