Hospitals must obtain written patient consent for pelvic exams, HHS says

The Department of Health and Human Services said Monday that hospitals must obtain written informed consent from patients before undergoing sensitive tests — such as pelvic and prostate exams — especially if the patients will be under anesthesia.

A New York Times investigation in 2020 found that hospitals, doctors and doctors-in-training sometimes conducted pelvic exams on women under anesthesia, even when such exams were not medically necessary and when the patient had not authorized them. Sometimes these exams were performed only for the educational benefit of medical trainees.

On Monday, the secretary of Health and Human Services, along with senior officials from the Centers for Medicare and Medicaid Services and the department's Office for Civil Rights, sent a letter to teaching hospitals and medical schools around the country denouncing the practice of doctors and students conducting the tests without explicit consent.

“The Department is aware of media reports and medical and scientific literature that highlight cases in which, as part of the study and training courses of medical students, patients have been subjected to delicate and intimate examinations,” it reads in the letter. “It is critically important that hospitals establish clear guidelines to ensure that providers and trainees performing these tests obtain and document informed consent first.”

The department released a set of guidelines clarifying a long-standing requirement that hospitals obtain written informed consent as a condition of participating in the Medicare and Medicaid programs.

“Patients who participate in the training of future doctors should be aware, they should have the opportunity to consent, they should have the same opportunity to participate in that training that they would be given if they were awake and fully clothed,” said Ashley Weitz, who was subjected to an unauthorized pelvic exam while under sedation in the emergency room. “We can expect to have greater trust in medicine only when both patients and providers can expect a standard of care that prioritizes patient consent.”

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