Hospitals have to get permission from patients before letting doctors do sensitive and invasive tests, like pelvic and prostate exams, especially if the patients are under anesthesia, according to the Department of Health and Human Services (HHS) on Monday.
In new advice and in a message sent to teaching hospitals, HHS Secretary Xavier Becerra and other officials said they were acting based on “increasing concerns” about the absence of informed patient consent in educational settings.
“The Department is aware of media reports as well as medical and scientific literature highlighting instances where, as part of medical students’ courses of study and training, patients have been subjected to sensitive and intimate examinations,” HHS said in the letter.
“It is critically important that hospitals set clear guidelines to ensure providers and trainees performing these examinations first obtain and document informed consent from patients before performing sensitive examinations in all circumstances,” the agency said.
A New York Times investigation in 2020 found that hospitals and doctors, including medical students in training, aren’t required to get explicit consent from patients before doing pelvic exams. In some cases, the investigation found the exams were only done for teaching purposes and weren’t medically necessary.
HHS in the advice said that informed consent includes the right to refuse consent for sensitive exams done for teaching purposes and the right to refuse to consent to any previously unagreed exams during treatment while under anesthesia.
Privacy laws give individuals the right to control who can see their protected health information, even in situations where they may be unconscious during a medical procedure, HHS said.
“While we recognize that medical training on patients is an important part of medical education, this advice lines up with the standard of care of many major medical organizations, as well as state laws that have put in place specific protections as well,” the department said. “Informed consent is the law and essential to maintaining trust in the patient-provider relationship and respecting patients’ autonomy.”
