Hastings Cent Rep. 2022 Jul;52(4):17-25. doi: 10.1002/hast.1405.
Due to a history of coerced sterilization, a federal Medicaid sterilization policy mandates that a specific consent form be signed by a patient at least thirty days prior to when the patient undergoes sterilization. However, in contemporary obstetrical practice, the Medicaid sterilization policy serves as a policy-level barrier to autonomously desired care. We review the clinical and ethical implications of the current Medicaid sterilization policy. After discussing the utility and impact of waiting periods for other surgical procedures, we explore the psychology of time required for decision-making and consider scientific understanding of regret. We argue that the current Medicaid sterilization waiting period is clinically and ethically unjustifiable and that the policy ought to be revised in light of the goals, preferences, and concerns of the people most affected by it. While the need for continued protection against coercion remains, the current mandated waiting period does little to enforce the high-quality shared decision-making that is desired for sterilization counseling.
由于有强制绝育的历史，联邦医疗补助（Medicaid）绝育政策规定，患者在接受绝育手术前至少三十天签署特定的同意书。然而，在当代产科实践中，医疗补助绝育政策成为自主期望护理的政策障碍。我们审查了当前医疗补助绝育政策的临床和伦理影响。在讨论了其他手术程序的等待期的效用和影响之后，我们探讨了决策所需的时间的心理学，并考虑了对遗憾的科学理解。我们认为，当前的医疗补助绝育等待期在临床和伦理上是不合理的，该政策应根据受其影响最大的人的目标、偏好和关注点进行修订。虽然仍然需要继续防止受到强制，但当前规定的等待期对执行绝育咨询所需的高质量共享决策几乎没有帮助。
