MS2 Advocacy Comic Strip
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- I feel so fortunate that we had specialized standardized patients to teach us how to perform intimate exams during our first year of medical school
- Me too. Did you know that there are some programs that perform intimate exams on patients under anesthesia without their consent?
- That seems unethical. I wonder if there is any legislation pertaining to this topic?
- In a survey conducted on 101 medical students from seven US medical schools, 92% reported performing a pelvic exam on an anesthetized patient, 61% without explicit consent. There are 20 other states that have passed legislation requiring explicit consent to performing intimate exams on patients. I wonder if Colorado has any proposed legislation coming up this session?
- HB23-1077: Informed Consent To Intimate Patient Examinations
- PRIMARY SPONSORS:Jenny Willford (Representative)Lorena Garcia (Representative)Faith Winter (Senator)Sonya Jaquez Lewis (Senator)BILL DESCRIPTION:This bill prohibits healthcare providers and trainees from performing intimate examinations on sedated or unconscious patients without specific informed consent. Additionally, trainees may only perform intimate examinations for educational or training purposes if (1) the examination is related to the planned procedure being performed (2) the patient recognizes the trainee as part of the care team (3) the trainee is under the direct supervision of the supervising licensee.
- It looks like proponents of the bill argue that it protects patients and provides transparency, particularly for survivors of sexual assault. Supporters include Elizabeth Newman, public policy director at the Colorado Coalition Against Sexual Assault.
- On the other hand, some healthcare providers argue the bill is redundant and that consent to intimate exams is already standard of practice. Additionally, limiting those who can perform intimate exams to specific, named learners may hinder learning opportunities for others in the ever fluctuating and dynamic hospital environments.
- A 2020 article by the New York Times describes several women's experiences with alleged unauthorized pelvic examinations. The article included the story of Ashley Weitz, a survivor of child abuse who would later testify to the Utah Senate in favor of a bill requiring expressed consent for the procedure.
- 1-19-2023 Bill is introduced to the house3-13-2023 Bill passes third reading in the house 64-03-16-2023 Bill is introduced to the senate4-20-2023 Bill passes third reading in the senate4-26-2023 House considered senate amendments and passed bill 64-05-22-2023 Bill is signed by the speaker of the house and president of the senate
- It looks like the bill has overwhelming bipartisan support and has been able to efficiently move through the house and the senate with few major amendments. One aspect that sets this bill apart from similar bills passed in other states is that it requires trainees be named ahead of time and meet the patient.
- Lt. Gov. Dianne Primavera
- Today, on May 25th 2023, I am signing HB23-1077 into law!
- Reflecting on my experience following this bill through the Colorado state legislature, I feel like the main theme is patient autonomy and the nuances of informed consent.
- TOP 3 POINTS OF REFLECTION:(1) This bill underscores the nuances of informed consent, specifically transparency as it pertains to trauma informed care and performing intimate exams.(2) This bill is an indirect reminder of the darker side of medical history and the ethical questions surrounding learning at the expense of patient autonomy. (3) In my experience, every team I have been a part of that performed intimate exams on patients sedated or not sedated, has required that all members introduce themselves and their role to the patient before the procedure. While this bill may have little logistical effect on these existing practices, it may help to spread awareness and make patients feel better informed in their care.
- SOURCES:(1) https://leg.colorado.gov/bills/hb23-1077(2) https://www.elle.com/life-love/a28125604/nonconsensual-pelvic-exams-teaching-hospitals/(3) https://www.cpr.org/2023/05/25/colorado-medical-students-pelvic-exams-consent-law/(4) https://www.nytimes.com/2020/02/17/health/pelvic-medical-exam-unconscious.html
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