Complications of not changing last name to spouse's after marriage?
October 3, 2011 6:27 AM   Subscribe

Would having a different last name from your spouse make it difficult to gain access to them or their medical records if they were in an accident?

My friend is getting married in four weeks and is changing her last name to her husband's. A large part of her reason for doing this is because she thinks it will make things like their mortgage and bank accounts less complicated and, more importantly - she is worried that if her husband were in an accident and rushed to the hospital she wouldn't be able to see him if she had a different last name and couldn't be readily identified as his wife.

I don't intend to change my last name when I get married. Is this something I should be concerned about? Can hospital staff really keep you from seeing your husband if you have a different last name? Just how complicated would that be?

I feel like there are so many people out there with different last names from their spouses or children, that this wouldn't be that big of an issue. Maybe I'm wrong.
posted by little_c to Human Relations (23 answers total)
 
I've got a different last name than my husband. While there are some databases that screw things up - it's always interesting to see how they combine two last names - but it's NEVER been an issue with health care or the like. I think most modern databases are set up to manage it.
posted by leslies at 6:33 AM on October 3, 2011


I've been repeatedly able to have spouse privileges at hospitals (both emergency and non-emergency situations) with someone of the same gender and a different last name, no less, even without producing a domestic partnership or wedding certificate. She'll be fine, this is a wacky worry. (One's mileage may vary throughout the country a bit, however!)
posted by RJ Reynolds at 6:35 AM on October 3, 2011


She can (and should for other reason) make sure they each have power of attorney paperwork. She is wildly unlikely to need it, ever and especially in a medical emergency, but it should give her peace of mind
posted by Lesser Shrew at 6:39 AM on October 3, 2011


If this ever happened to straight people, it would have been a Lifetime movie by now.

Carrying a photocopy of your marriage certificate in your bag and glove compartment is practically free and takes 5 minutes. Getting PoA paperwork is something everyone should do. A last name is not proof of legal relationship. If she wants to do it because she wants to, she doesn't have to make up an excuse, because doing so makes life just a little bit harder for those of us who choose not to and have to hear this weird made-up stuff by way of concern trolling from people who don't like our decision.
posted by Lyn Never at 6:44 AM on October 3, 2011 [11 favorites]


Yeah, most medical forms include places to name your spouse and/or people you want to give access to your information. My last name is different in different places, and has never been officially changed with the government, and I have never had an issue.

Agree with Lesser Shrew that the real way to deal with this it through a POA.
posted by dpx.mfx at 6:46 AM on October 3, 2011


"she thinks it will make things like their mortgage and bank accounts less complicated"

Nope. It's no big deal. Either way it has to be a joint account -- it's not like just because you have the same last name, the bank will give you access to someone else's account. One time I had to show our marriage license -- to get my husband the married dude discount on his car insurance when he was still under 30. Also our diocese's computers were not set up to handle married couples with different last names, but they actually updated that because we pointed it out and now it's fine.

"she is worried that if her husband were in an accident and rushed to the hospital she wouldn't be able to see him if she had a different last name and couldn't be readily identified as his wife. ... Is this something I should be concerned about? Can hospital staff really keep you from seeing your husband if you have a different last name? Just how complicated would that be?"

This doesn't happen. Again, it's not like if they suspect you of not being married to the comatose patient, they let you in just because your last names match. Typically they take your word for it, though, unless there's some dispute already underway. My husband actually used to do situations like this for a local hospital, where there was some dispute about who had the right to be the medical decision-maker for a patient (typically spouse vs. parents). If the information about the spouse is not already in the patient's medical records (which will be more and more common with e-records available) and there is a dispute, they call the hospital attorneys and my husband has raced over to court with 20 minutes' notice to get a judge's order settling the matter. In the rare instance where it's a problem because there is a) a dispute between parties over who has medical decision-making rights and b) no evidence of who the spouse is, the problem can be settled by the courts in an hour.

Incidentally, again, having matching last names doesn't avoid this problem -- if his parents say, "No, she's not his wife, they're divorced," neither having the same last name NOR having the marriage certificate handy will "prove" they are married. Since it's not like they go back and cancel marriage certificates when you get divorced.
posted by Eyebrows McGee at 6:56 AM on October 3, 2011 [8 favorites]


The process for having access to the health care record is clearly outlined in any provincial or state legislation. Typically the issue after an accident is not access to the health care record but rather consent for treatment if the patient is unable to express his or her own issue. All patients are encouraged to develop Advanced Care Directives sometimes known by lay people as "Living Wills". Anyone can be named as a Substitute Decision Maker in these documents. If the patient does not have a "living will" they follow an established policy for seeking in put on decisions around health care. Usually it goes something like this: spouse, mother, father, daughter, son, sister, brother...(if the patient is older than the daughter or son would be contacted before their mother or father). In some cases if physicians feel that the substitute decision maker is not acting in the interest of the patient they may apply for the public trustee/guardian to take on this role. In some emergency situations the physician may consult another physician and decide to act in the best interest of the patient (this tends to occur when no substitute decision maker is available).

When seeking disclosure of the health record there is an administrative process that hospitals follow. Wherever possible, the patient provides written consent for release of the health record or provides written consent that the notes can be released to a third party. If the patient is unable to provide written consent then the hospital may provide the record to (and this sometimes varies slightly by jurisdiction) the legal substitute decision maker - this may be the executor of the estate or the person named in an advanced care directive. As I mentioned, I have seen slight differences between jurisdictions so you need to look into the standard for your area.

The bottom line is that the process used for hospitals anyway is not based on what your surname is - it is a carefully legislated and governed process.
posted by YukonQuirm at 6:58 AM on October 3, 2011


If it is the "pain in the ass" factor, I'd suggest that changing her name and dealing with essentially having 2 names for the coming years as well as getting a new SS card, driver's license, credit cards, passport, etc. is way more of a pain in the ass than a bank dealing with 2 last names (which they do every single day.)
posted by k8t at 7:12 AM on October 3, 2011 [4 favorites]


I've been married in California for three years with a different last name and this has never been a problem. We haven't had any accidents or emergencies, but we regularly pick up each others prescriptions and I went to urgent care for my husband because they weren't filling his prescription fast enough and again no problem.
posted by bananafish at 7:14 AM on October 3, 2011


To add another perspective to this "problem," consider that doctors and lawyers almost never change their last names when they get married (for a myriad of other reasons, mostly relating to their public reputation).

They're sympathetic to this predicament, and are set up to handle it.
posted by schmod at 7:30 AM on October 3, 2011 [1 favorite]


First, I have some friends who have hyphenated last names. This is a pain in the ass because apparently schools don't teach alphebetization of names. So Hoofersmith-Grandfleegle ends up in the G section, quite often. One friend has reported that a very young preschool aide insisted she could not be her son's mother because they don't have the same last name. That was more a case of ignorance/youth than institutional red tape. And this is the biggest thing your friend is going to have to worry about if she doesn't change her name. People who don't know what the policies are, or who haven't yet experienced the range of realities. Or who just can't connect the dots.

Second, as an anthropology/sociology major I'm a big believer in Mary Douglas' Cultural Theory of Risk, and I think it applies here. She's part of a group that agrees this is dangerous. You are not (at the moment) part of a group that sees this as dangerous. As such, you're both behaving/planning to behave, in accordance with your assessments of the situation.

That said, I'm all about fighting for gender equality and whatnot, and I recognize that your question is more about the logistical stuff for you in your future. So what follows is more in the interest of giving you some ammunition, or perhaps just insight, for when people start asking you nosy questions about your decision to not change your name in the future. You don't seem to be looking for an angle to go at trying to get your friend to change her mind and keep her name.

There may be another explanation for her wanting to change her name.

She might want to.

That desire is becoming more and more fertile ground for "I'm more liberated" or "more independent" or whatever kinds of feelings between women who change their names and those who don't. Those moments of internal or external snippiness are often a follow on to some other discomfort. But they're there.

So rather than say, "I appreciate the __history/unity/symbolism_ behind/in/of taking my husbands name," many women take the more easily defensible "logistics" route. Because it's not emotional, and it's a little less handwavy.

If there is any chance that

"A large part of her reason for doing this is because she thinks it will make things like their mortgage and bank accounts less complicated and, more importantly - she is worried that if her husband were in an accident and rushed to the hospital she wouldn't be able to see him if she had a different last name and couldn't be readily identified as his wife."

is part of that political/social discomfort, please let it drop between you. Names are such highly charged things (just think back to the last time you or anyone else made fun of parents for choosing a particular name, or combination of names for a baby!) and for women especially, our names are a huge part of our identities.

And when some jerk person starts grilling you about "won't it be harder for the children?" Or whatever logistical thing they choose, feel free to proudly, boldly say, "We've considered that, but thank you" Or "Husband to be and I agree that the risk of that is minimal" or whatever you want to say. Because they probably aren't going to drop it if you say, "I dislike the _____ of changing my name."

Best of luck to you both!
posted by bilabial at 7:42 AM on October 3, 2011 [1 favorite]


Don't buy joint airline tickets, or, if you do, the wife should grit her teeth and use the husband's name. My wife didn't change her name, and the airline refused to let her on until we showed them a joint credit card.

Even though there SHOULDN'T be trouble, there WILL be trouble, particularly in these paranoid times.

Consider a name change for both of you. John Jones and Mary Smith become John Jones-Smith and Mary Jones-Smith.
posted by KRS at 8:00 AM on October 3, 2011


I don't know whether you plan on having children. I did not change my name at first when I got married. Thought about hyphenation but our names were really unhyphenatable, so I kept my name and he kept his. However, during my pregnancy and immediately after my son was born, I got really, really, REALLY tired of health care professionals asking "Are you married to the father?" Which basically happened every time I entered a doctor's office, even when my husband was there with me sporting a matching wedding ring. This did cause me to begin to genuinely fear that I might not be granted immediate access to my husband or son in an emergency.

But I live in Missouri. In more enlightened states this would perhaps not be so much of an issue.

As it happens I was not particularly attached to my own last name for sentimental reasons, and the feminist argument didn't make much sense in my individual case since it was my father's last name and I don't even speak to my father. So I finally just decided it wasn't worth the hassle and switched.

However, I really wish my husband had been willing to switch to an entirely new name for all of us. (I don't so much care for his last name in a paperwork context, either -- my adopted family name is like a first name and therefore confusing.)
posted by BlueJae at 8:24 AM on October 3, 2011


Don't buy joint airline tickets, or, if you do, the wife should grit her teeth and use the husband's name. My wife didn't change her name, and the airline refused to let her on until we showed them a joint credit card.

In what country and on what airline? My husband and I have been traveling together on joint reservations on airlines, trains, etc. since before we were married, with different last names the whole time, and we have never had this problem.

As everyone else has said, there are no issues with banking, health care, or otherwise; my husband and I have different last names and regularly make bank deposits or pick up prescriptions for each other. Access to my husband's non-joint accounts or health-care decision-making have not been things we've had to deal with yet, but we have powers of attorney and health care proxies set up just in case, which we decided to do not because of our different last names but because we've seen other family members deal with weirdness around those topics and wanted to make it really really clear what we want.

In short: if you want to keep your last name, keep it. Do what feels right for you.
posted by bedhead at 8:44 AM on October 3, 2011


We've been married 17 years now with different surnames. Traveling on airplanes, picking up prescriptions, dealing with healthcare providers-- never been a problem. I noticed at the pediatrician's they often call a female parent "Mom" rather than "Mrs. So-and-so", probably because there are lots of us who have different last names than our children.

I had a few ignorant people tell me that not changing my name meant a lack of commitment on my part. I now know of several couples who got married around the same time we did, where the wife changed her surname, who are now divorced. Changing your name is not a guarantee of anything.

I think women should do what they want on this one, since they are probably going to get some pushback for either choice. The amount will depend on where you live and how conservative or progressive your (and your partner's) families are.
posted by tuesdayschild at 8:55 AM on October 3, 2011 [1 favorite]


Don't buy joint airline tickets, or, if you do, the wife should grit her teeth and use the husband's name. My wife didn't change her name, and the airline refused to let her on until we showed them a joint credit card.

I'm not even sure what this means. Are there places that will sell airline tickets to "John Doe and wife"? Whenever I've bought tickets for multiple passengers at once, I've been required to specify the full name of each passenger. The details of our relationship (or lack thereof) have never been relevant.
posted by endless_forms at 8:59 AM on October 3, 2011 [5 favorites]


Yeah, KRS's advice makes no sense; if the wife gets an airline ticket with her husband's last name on it, and doesn't have any ID with that name, that would cause a problem.
posted by rabbitrabbit at 9:20 AM on October 3, 2011


Married 15 years, different last names, kid has a hyphenated last name (so nobody in the house has the same last name), none of us has ever had any problems.
posted by rabbitrabbit at 9:22 AM on October 3, 2011


Best answer: Different last names of parents are common enough at the hospital where I delivered our kid that their policy is that all new babies are registered under the mother's last name regardless of what the kid's legal name will be, and they state this up front. My husband and I have different last names and it has never, not one time, presented a problem more complicated than having his coworkers call me Mrs. Hisname and mine call him Mr. Myname.

For you--I work in health care, and our patients' health care decisionmakers come in a wide variety, including spouses, unmarried partners, siblings, children, grandchildren, neighbors and friends. If it worries you, fill out whatever simple paperwork is needed to name your spouse as the person you want to make health care decisions for you if you are incapacitated (in my state this is a health care proxy form, and can be done anywhere you can scare up 2 witnesses, without a lawyer or doctor present).

I agree that this concern is probably your friend making a plausible-sounding excuse for just wanting to change her name. There is no way that changing credit cards, bank accounts, taxes, payroll, DMV registrations, passports, insurance policies, etc. is somehow easier than carrying a small copy of her marriage license or a wallet-sized health care proxy form. "Just wanting to" is, of course, her right.
posted by The Elusive Architeuthis at 10:53 AM on October 3, 2011 [1 favorite]


Don't buy joint airline tickets, or, if you do, the wife should grit her teeth and use the husband's name. My wife didn't change her name, and the airline refused to let her on until we showed them a joint credit card.

I don't mean to harp on this, but, on further consideration, I'm even more perplexed. The name on ones ticket should match the name on ones identity documents (e.g., passport, driver's license, state ID). I've known women who've had issues because they had plane tickets in their married name before their identity documents caught up with the name change, but that's just more evidence that it's critical to match ones primary identity documents.
posted by endless_forms at 12:28 PM on October 3, 2011


My parents have different last names and have been married for 34 years. They have joint bank accounts, credit cards, and a mortgage and have never had a problem.

Last time my father was in the hospital I walked right up to the desk and asked the nurse for the details of what was going on with him, I said I was his daughter. No one questioned me at all, no one wanted to see any proof of anything. It is probably different if I needed to get an actual copy of his medical records or something but I can't imagine needing that in an emergency or in any situation where I wouldn't have time to prove who I was to get them.
posted by magnetsphere at 2:24 PM on October 3, 2011


I don't intend to change my last name when I get married. Is this something I should be concerned about? Can hospital staff really keep you from seeing your husband if you have a different last name? Just how complicated would that be?

Nope. Heck, my husband and I not only kept our own last names, we're not even legally married, and no-one bats an eyelash. Occasionally we have to say "actually, my last name is ____," but it's a non-issue on the order of "actually, my name is pronounced _____." We had an airport customs dude make some snarky comments once, but we're pretty sure this was just some weird misguided attempt to flirt with me.

(As a queer girl partnered with a man, this does make me acutely aware of heterosexual privilege though.)
posted by desuetude at 11:24 PM on October 3, 2011 [1 favorite]


Mr Corpse and I have been married 13 years, have different last names, our kids have different last names from each other, and we've had no problems. We have a mortgage, we have a car loan, we have joint bank accounts, we have wills -- all that exciting stuff -- and it's never come up at all.
posted by The corpse in the library at 9:00 PM on October 8, 2011


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