Pa. House committee advances bill requiring informed consent for certain medical exams

A legislative committee sent a proposal requiring patient permission before performing some medical exams for educational purposes to the full Pennsylvania House of Representatives for consideration.

The House Health Committee on Wednesday voted 20-1 to advance a bill requiring explicit verbal and written consent from a patient to receive a pelvic, rectal, or prostate exam performed by medical students while they’re under anesthesia or while they’re unconscious, still allowing exceptions for emergencies and exams deemed “within the scope of care.”

State Reps. Elizabeth Fiedler, D-Philadelphia, and Liz Hanbidge, D-Montgomery, first introduced the bill in 2020 after a constituent told Fiedler that a pelvic exam was performed on her for “training purposes” while unconscious — something currently allowed under Pennsylvania law and initially meant to be a learning opportunity in medical schools and teaching hospitals.

The constituent didn’t consent to the exam before being put under anesthesia, Fiedler explained.

“I have to say, I was shocked,” Fiedler said. “And the more I researched the situation, the more and more horrified I was as a lawmaker and as someone who has been a patient.”

The proposal, Fiedler said, allows for medical training while still protecting patients and trust between someone receiving care and their medical provider. She also noted that medical programs at Temple University and the University of Pennsylvania already implemented informed consent measures before a patient receives care at their facilities.

A series of medical groups have declared that explicit consent from a patient is needed whenever possible before they receive a pelvic, rectal, or prostate exam. The Women’s Law Center also supports the measure, saying that required consent protects patient rights, empowers students, and mitigates racist and sexist medical practices.

“Making sure we have highly trained medical professionals is incredibly important, but at the same time, patients should be asked for their consent ahead of time,” Fiedler said. “We’ve taken great care to ensure that this legislation doesn’t limit how doctors treat patients’ medical concerns. It simply requires explicit consent where medical students are performing intrusive examinations for training purposes.”

Lawmakers in Colorado introduced a ban on the method earlier this year, but nonconsensual exams are still legal in roughly half of the United States.

“The idea that there is still a situation in Pennsylvania where it’s legal for a provider to perform an exam — a pelvic exam or a rectal exam — without the express consent of the patient or their representative is horrifying,” state Rep. Tarik Khan, D-Philadelphia, said.

Khan, who still practices medicine, described the legislation as “a long time coming.”

The legislation holds the health care provider overseeing a medical student for violating the measure, mandating a $500 penalty for a first violation and $1,000 for a second or subsequent one.