Nope, it’s Missouri’s doing.
As others have said, some hospitals require or strongly encourage it. I’m having major surgery tomorrow, and received a packet that includes an Advanced Directive form, a Medical Power of Attorney, a Living Will (separate from the DNR), and a couple of other forms for that worst-case scenario.
And I have had to have many strongly-worded conversations with the surgeon about how I want to keep my left ovary if at all possible, even if that means a later surgery, rather than remove the left ovary “just in case.” I said “unless that ovary is wearing a name tag that says ‘Hello My Name is CANCER’, I want that ovary left in there.”
Surgeons do tend to want to remove unhealthy tissue when you’re already under, to save the pain and stress of future surgeries.
Ascenray, my friend, I’d like you to meet Post #58. 
Those whacky Kentuckians!
More recent new coverage on this case reveals that this was essentially emergency surgery. The patient had urinary obstruction, and the operation was not a complete removal of his penis, just enough to get past the obstruction.
http://www.forbes.com/feeds/ap/2011/08/22/general-us-penis-amputation-trial_8635887.html
Regrettably, obstructive renal failure is a process which can move with devastating speed (a matter of hours).
From the story presented by the urologist, there essentially was no option to wake the patient up and have a full, rational discussion of treatment options. It was either to proceed with the urological surgery to get a Foley catheter passed and hopefully avoid renal failure, or awaking the patient to tell them that you permitted them to progress to end-stage renal failure and a shortened life dependent upon dialysis.
What’s wrong with dialysis as a short-term response, allowing the patient to get second opinions and time to consider how to proceed?
Dialysis only serves as an interim measure before dying of renal failure. It does not reverse the damage done to the kidneys. So, you can’t wake up from surgery, talk it over, then decide; the damage from the obstruction would have already fried his kidneys.
That does put the whole matter in another light, particularly if the doc only amputated enough penis to prevent renal failure and no more. I understand the patient wasn’t happy about losing part of Mr. Happy, but that information makes the situation more understandable.
It sounds like the dialysis would be permanent due to kidney failure caused by the lack of immediate corrective action, rather than a temporary treatment option.
Surgery doesn’t reverse kidney damage either. I’m not clear on why dialysis couldn’t hold him steady for a bit.
I find it a remarkable coincidence that, despite the cancer being unknown to the surgeon, the guy happened to go into the OR at the precise moment when surgery right now would save him–and he’d not need long-term dialysis–but another couple days would spell doom.
Urinary obstruction often presents through the ED and it is an emergency. Often it is symptomatic if it has come on suddenly. If some process blocks off the urinary system suddenly, people fortunately often seek emergency medical attention, although chronic partial obstruction can far more commonly sneak by unnoticed until it’s too late. The Forbes article doesn’t describe how this person presented; if he had rapidly progressed to anuria, then it would have been a true emergency. Again, the Forbes article doesn’t say how he presented, and that’s as far as I’ll go with speculating on the particular circumstances for this person.
No matter how much or how little was lopped off, I’m just curious how long he had to wait before taking a piss, how much that’s gonna’ hurt when he does, and wether or not he’ll ever be able to completely use the damn thing (or what’s left anyway). 
This is completely incorrect. There are many causes of acute kidney injury/failure, one of which is post-renal obstruction. Prompt treatment of the obstruction should result in recovery of renal function. “Holding him steady on dialysis for a bit” will result in permanent kidney failure, necessitating life-long dialysis or kidney transplant.
Dang, I just about put my RN license through the shredder for a minute there.
Wherever I’ve worked, CNAs make minimum wage or a little more. They also work like dogs, and the nature of their work would make any other underpaid, overworked employee run screaming from the building.
However, I’m pretty sure that CNAs are not legally able to obtain informed consent for surgery or other procedures. This may vary a bit by state, but getting consent is serious business. Or at least it should be.
AFAIK, only an MD or an RN (possibly a PA- physician’s assistant- I’m not sure) can get consent.
Regarding the penile amputation, I cannot imagine a circumstance where the doc wouldn’t wake up the patient and get additional consent before performing the deed. It seems like the liability of waiting just one day to perform a needed operation would outweigh the benefits of just whacking it off. (ha! a pun!)
OTOH, women undergoing a breast biopsy sometimes wake up with the whole boob gone. Still, the consent procedure should cover that possibility and the patient should have the right to refuse a mastectomy.
Also, waking up without a penis is probably more traumatic than waking up without a boob.
Was the surgeon a man? It’s a little easier to imagine this scenario if the surgeon was a woman who didn’t understand the psychological implications. I still find it hard to believe a woman would be that clueless.
It’s easier to believe the patient didn’t fully understand what he was signing, even if it was explained thoroughly. Denial is a powerful thing, and if his peepee was hurting, he might not have paid sufficient attention.
If the penile cancer was causing post-renal obstruction, and a normal urinary catheter couldn’t be passed, wouldn’t it make more sense to simply insert a suprapubic catheter? (The catheter goes into the belly, just above the pubic bone, into the bladder.)
That’s a relatively minor and fairly common surgery. Much more common than a penile amputation.
It’s not like chopping off the penis is the only option in that scenario. I imagine if I were a man, I’d rather wake up with a suprapubic catheter and an intact penis.
As the facts roll in, the story changes quite a bit.
http://news.yahoo.com/doctor-says-surprised-penile-cancer-211620233.html
A Kentucky doctor said Monday that he saved a truck driver’s life when he amputated part of the man’s penis after discovering a rare and deadly cancer
Patterson said he removed less than an inch of Seaton’s penis. The rest of the penis was amputated by another doctor later
Patterson testified the cancer prevented him from inserting a catheter into Seaton’s urethra, and he was concerned about the possibility of kidney damage from urinary retention. Although Deborah Seaton was in the hospital waiting room, the doctor said he did not consult her because she had not accompanied her husband to office visits or into the pre-operation area, which he thought was unusual.
If the doctor removed less than an inch (and yes, I realize that even a millimeter of penis is quite precious to the owner) that actually jibes with “I just took enough to get a catheter in him to prevent kidney failure”. Basically, did just enough to keep the man healthy enough for future treatment options.
Of course, this will have an enormous impact on the patient.
Also interesting in that article is that the consent form was read to the patient because the patient couldn’t read. That calls into question just how well the person reading it conveyed the information… but it also means there might be another witness as to how well the patient understood what he was signing. Having it read out might mean a much more thorough “look” at the document than the often cursory glance the literate give such documents.
I always thought that professional drivers HAD to be able to read, not just recognize various road signs. The thought of an illiterate truck driver gives me the willies (that was unintentional, but now I’m gonna leave it).
My husband bought me a handgun on Sunday, and as the intended owner, I had to fill out the paperwork. I had a couple of questions about some of the questions on that paperwork, and the salesclerk said that most people just made a show of reading the stuff and then checking boxes…or asking him what the correct answers were. Too many people will just casually sign waivers without really KNOWING what they’re agreeing to.
However, if the penis looked that bad, I would have hoped that the doctor had told the patient that he might have to remove more than the foreskin, and let him get used to the idea, even if it really is emergency surgery. I’m also glad that Jack Dean Tyler no longer posts on the SDMB.
The gentleman in question might have started working as a driver before a lot of the more recent requirements were written, he might have be purely local as local drivers as subject to less stringent regulations than interstate ones, and he might not have been properly licensed. He also might be functionally illiterate - able to write his own name and read just enough to get by, but not nearly enough to work his way through a medical consent form.
The news also mentioned that he had lesions on his penis for 18 to 24 months before he sought medical attention.