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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 exams, such as pelvic and prostate exams, especially if patients will be under anesthesia.

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

On Monday, the Secretary of Health and Human Services, along with top officials from the Centers for Medicare and Medicaid Services and the department’s Office for Civil Rights, sent a letter to the nation’s teaching hospitals and medical schools denouncing the practice of doctors and students performing exams without explicit consent.

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

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

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