Can my Dr test me for pregnancy without my consent?

September 4, 2024 1:59 PM

My new psych provider's office does yearly drug tests. Today when I looked at the lab's website I saw that they had tested me for pregnancy as well. Can they do this?

I am in Massachusetts.

Last year I was having a mental health crisis and I desperately needed a new provider for med management. I finally found someone who took my insurance and even though I thought it was unusual that I had to sign an agreement to be tested for drug I did sign, because I was afraid a psychiatric hospital was the next step if I didn't.

So, this month I had to do a urine test at a commercial lab. I checked in on the website to see if my results were back yet and realized that one of the tests they were doing was for pregnancy.

I don't recall them asking if I menstruate (I am 52) or if I am sexually active. I do not remember signing anything regarding a pregnancy test and I don't see anything to that effect in my account on the portal.

I just can't believe that this is ok. Is it???

posted by Biblio to Health & Fitness (18 answers total)

The same hormone that indicates pregnancy (hCG) also is an indicator of a number of forms of cancer. So a pregnancy test is basically a side effect of a general urine test.
posted by Tell Me No Lies at 2:13 PM on September 4

If you have a copy of the release (or ask for it) I suspect it would be covered there. Some medications are incompatible with, or affect, pregnancies.
posted by zippy at 2:14 PM on September 4

I imagine it's something they do by default for all uterus-having patients, since testing for pregnancy with urine is so cheap and easy.

However, they may be willing to exclude the pregnancy test at your request -- it's worth asking next time.
posted by mekily at 2:16 PM on September 4

I don’t think anyone is going to be able to answer this without seeing the exact wording of what you did sign regarding what they can test for. It wouldn’t be surprising if it were worded broadly enough to cover this, but you’ll need to ask for a copy to know.
posted by Stacey at 2:17 PM on September 4

They do this generally if they may need to place you on medication that can cause birth defects for pregnancies. This is less the case with most psychiatric medications but I believe there are still one or two that are teratogenic, particularly antiepileptic drugs. They don't generally take your word regarding sexual activity on this because it's one of the things people frequently are inaccurate on self-reporting through embarassment.
posted by corb at 2:23 PM on September 4

Yeah, I think this happened to me when they insisted on drug testing me last year as well, and as one medical professional told me, "People come in for birth control and they're already pregnant." They don't trust my jokes about the only way I'd be pregnant is if Jesus is having a baby sister. I also think if it's a meds issue, it'd be crucial for them to know if you're pregnant.

That said, I'm baffled they're checking this on someone who's 52.
posted by jenfullmoon at 2:32 PM on September 4

Anecdotally I have seen people on the childfree subreddit report that they call their doctor's office and request that the coding for the non consensual pregnancy test be removed from their billing, and it generally is without issue.

That unfortunately doesn't do a single thing to help the lesser healthcare or less good drugs you may receive just because you might theoretically one day at some point harbor a baby, but at least you won't be paying for the insult.
posted by phunniemee at 3:04 PM on September 4

Did you give some kind of written consent for this? Possibly. Should they have asked you for explicit consent? In my opinion, yes. You would really like to be able to trust your psychiatrist but them doing this without telling you indicates a lack of trust in you. Drug testing does too, honestly. I am sorry that this happened to you.
posted by mai at 4:15 PM on September 4

That said, I'm baffled they're checking this on someone who's 52.

52-year-olds can still get pregnant. Yes, it's rare. But the chances are not zero especially if the office isn't asking the menstruation question.

TMI but I'm about to turn 53 and I'm still ovulating and having regular periods. WHERE ARE YOU PERI-MENOPAUSE??
posted by cooker girl at 5:10 PM on September 4

Did they ask you to give specific consent to each of the other 30 or 40 tests they presumably performed? Do you feel they should have?

I would guess that you gave blanket consent to "whatever it is you guys routinely test for".
posted by foursentences at 5:55 PM on September 4

I would be livid about this, it seems to me it is absolutely an invasion of privacy unless they asked your express permission. Right wing organizations and governments are trying to use any method they can to block women's right to choose and if this were to happen to me, I'd be seeing it this way at least some. Was it a Catholic-affiliated medical group you were going to? I know MA is a blue state but...yeah I'd call someone in the medical administration to see what's up, or even someone at the local Planned Parenthood. If they needed to do this for a drug safety standpoint they still should have asked in my opinion.
posted by Rufous-headed Towhee heehee at 8:53 PM on September 4

Doctors do not need to obtain written consent to perform a pregnancy test, nor basically any blood or urine tests except for genetic tests and, in some states, HIV testing. corb is correct that this is standard practice if they are prescribing or anticipate they might be prescribing a medication that is unsafe in pregnancy, which unfortunately many psychiatric medications are.

You can certainly request that the doctor not pregnancy test you in the future, but they may find this an insurmountable obstacle to remaining your provider, which is their right.
posted by telegraph at 3:34 AM on September 5

I work in laboratories. I think there are plenty of good responses already, but I'll add that it's often not up to a specific doctor which tests are performed on a sample. Tests are increasingly automated and batched for the sake of improving cost and accuracy metrics while requiring less sample material to test. These tests are sometimes inseparable from one another when they're part of a batch assay. The smartphone analogy (it's cheaper to manufacture a phone that is a camera that is a flashlight rather than manufacture three separate devices) and the bathroom scale (ditto but with weight, body fat, and heart rate) come to mind as equivalents.

I imagine it's likely that you signed a waiver acknowledging that a contract laboratory is involved and so the practice you visit is not liable for disagreements that arise as a result of the lab's practices. You can, though, get a copy of the report and contact the lab to ask about this. They probably could offer some information that could help you avoid or at least be prepared for this in the future.
posted by late afternoon dreaming hotel at 4:38 AM on September 5

For future reference, a warning that proactively opting out of pregnancy tests often involves significant arguing with people who expect you to automatically assent and insist that you might be pregnant without knowing it. I find that the most effective way to stop them from insisting that I may in fact be pregnant is to cross the boundaries of polite euphemism and say something unequivocal like "it has been at least five years since I've had sex with a man." I'm sure there are similarly effective remarks one could make with regard to one's menopausal status.
posted by dizziest at 7:04 AM on September 5

I can tell you from my experience last week that telling people there was no way I might be pregnant and therefore I should not have to take a pee pregnancy test was completely denied and "yes, you have to take one," because people lie.
posted by jenfullmoon at 9:05 AM on September 5

both times I had major surgery, the cost of declining a pregnancy test beforehand was signing a piece of paper saying I declined a pregnancy test. this is normal and ethical policy. the only reason to do it without your knowledge and consent is if you come in unconscious or are judged unable to (withhold) consent for whatever other reason. however, it does not shock me to hear that many places either have unethical policies still in place or don’t bother following the updated ones they have.

there are prescriptions doctors won’t or can’t write for pregnant women, but if they require a test for that reason, they can ask for it and tell you why. they do not have the right to do it without asking, but clearly many still do. it’s worth objecting to.

you have the right to read all paperwork before you sign it, even though they never expect you to or allow time for it. though there’s no guarantee it was actually mentioned there.

my personal policy as a patient regarding both pregnancy tests and naughty-drug screens is that you can investigate my precious bodily fluids to your heart’s content but when it is done to satisfy your curiosity and not mine, you will have to pay for it, not me. I already know what kind of fun I have or haven’t been having, there is no new information the lab can give me.

but I never get to give this stirring oration in person because all my doctors in recent memory have been relatively normal about this and gave me no opportunity to take a stand.
posted by queenofbithynia at 6:10 PM on September 5

I hope you can talk to your doctor's practice about this. When I was going through infertility, having to read past that on test results at a point I wasn't expecting to wouldn't have been great for my mental health that day.

I would hope a psych provider would be willing to at least consider a model of greater informed consent and information about what tests are going to be run (even if it is a set panel from a lab.)
posted by warriorqueen at 6:54 PM on September 5

Yeah, pregnancy tests for uterus-having people is kind of an opt-out procedure precisely because

a) so many other things can be impacted by pregnancy, so it makes sense to check if that's what's gong on,
b) so many things can impact a pregnancy, so if you didn't know you were and you wanted to be (or didn't want to be) you could factor that in, and
c) it's an easy thing to run the test real quick as long as you've got a vial of pee handy.

It's also possible that there's a drug interaction thing and the pharmaceutical company is making them test everyone who takes that drug annually to cover their own ass, so that they can't be sued if another patient gets pregnant and there are complications from the drug.

I feel you on the whole "but I didn't consent to this" thing, and I know that our particular national vibe is feeling pretty damn patriarchal now, but odds are far greater that they were coming from a far more benevolent place; think more "let's just check if this is a thing since this test is so easy" rather than "this is a woman and therefore we must see if she is breeding, amen".

(To give you a chuckle - I was also unexpectedly tested for pregnancy during a very eventful ER visit; I was on my second date with a dude when I had some major abdominal pain and the dude brought me to the ER. One of the things they needed to rule out was an ectopic pregnancy, but they didn't say that was why they tested me for pregnancy; they just came back to us both and said that I wasn't pregnant. The dude just blinked and then quipped, "Frankly, I'm flattered you thought that was a possibility.")
posted by EmpressCallipygos at 11:17 AM on September 6