Vasectomy provider decision-making balancing autonomy and non-maleficence: qualitative interviews with providers

Area of Science:

• Urology
• Men's Health
• Contraception

Background:

• Vasectomy is a highly effective, low-risk male sterilization method.
• Despite benefits, vasectomy is underutilized globally.
• Healthcare providers influence vasectomy adoption.

Purpose of the Study:

• To explore vasectomy providers' decision-making rationales.
• To understand how providers evaluate patient candidacy in complex cases.

Main Methods:

• Semi-structured interviews with 15 vasectomy providers from 7 countries.
• Thematic analysis of interview data and case vignettes.
• Exploration of provider training, motivations, and challenges.

Main Results:

• Provider decisions balance patient information, consent, and certainty.
• Factors influencing decisions include training, laws, norms, experience, and peer influence.
• Providers weigh patient autonomy against non-maleficence, sometimes prioritizing non-maleficence to avoid regret.

Conclusions:

• Some providers prioritize non-maleficence over patient autonomy in vasectomy candidacy.
• This prioritization is more common in cases with higher perceived risk of regret.
• Enhanced training in shared decision-making and patient-centered care is recommended for vasectomy providers.