This patient is bilingual but speaks Japanese as his native language. It is therefore most appropriate to wait for an interpreter to obtain the consent in the patient’s native language. However, if a translator is not available or other serious complications arise, since the patient does speak English proficiently, informed consent can be obtained in English and is not required to be in the patient’s native language. The patient’s wife cannot sign his consent form unless she is his durable medical power of attorney or has been appointed by the court. It is unnecessary to obtain a Japanese consent form.