Doctors and medical students in Connecticut would require a patient’s consent before conducting intimate examinations on unconscious or sedated patients under a bill advanced Friday by the Public Health Committee.
The legislation, approved by the committee with broad bipartisan support during an afternoon meeting, addresses a little-known detail: in more than half of American states, health care providers do not require authorization to conduct an examination of an unconscious patient’s rectal or pelvic region.
If passed by the full legislature, the bill would require consent for those exams and task the Public Health Department with investigating situations where exams were conducted without approval. Providers found in violation risk losing their licenses.
“The goal is to make sure that anybody who is put in that circumstance has actively consented for that kind of examination,” said Rep. Jonathan Steinberg, a Westport Democrat who is co-chair of the committee. “We’re hoping that, with passage of this bill, this will cease to happen in the state of Connecticut.”
The bill aligns Connecticut with a growing number of states passing legislation on the issue in recent years. Twenty states have prohibited conducting the exams without consent, according to the Epstein Health Law and Policy Program at the University of Illinois. Many have passed the legislation within the last three years.
The proposal advanced by the public health panel Friday seems to have broad support. Two dozen lawmakers from both parties have signed on as co-sponsors of the bill. And during a public hearing held earlier this month, witnesses submitted testimony detailing trauma they felt at such unwanted examinations.
“I know I never consented to the exam because I woke up in stirrups screaming,” Ashley S. Weitz, a victim advocate from Utah, wrote. “As a survivor of sexual abuse and assault, the experience was as confusing as it was traumatizing.”
However, others brought concerns about the bill. The Connecticut State Medical Society opposed the legislation during the hearing, saying the group supported the need for medical providers to have explicit conversations with patients regarding the importance of “intimate exam under anesthesia,” but generally did not support efforts by the government to dictate medical best practices.
“This is the underlying tenet of informed consent and the foundation of trust upon which the doctor-patient relationship is built,” the medical society wrote. “However, it is our view that government attempts to mandate specifics of medical practices, especially regarding informed consent processes, can set ill-advised precedents.”
Some providers have also expressed concern that the bill may limit the ability of medical students to be present for exams as part of their training. Steinberg said the bill was a work in progress and there was still time to adjust its language before it is raised for a vote in either chamber of the legislature.
“There are ongoing conversations taking place currently,” Steinberg said. “I believe the hospital association and a couple of the bigger hospitals are involved. They’re the ones who … most likely want to make sure we get the language right.”
During the hearing, the state Division of Criminal Justice also asked lawmakers to modify the bill in order to preserve the ability of medical providers to collect evidence in “rare, but grave, circumstances” where a sexual assault victim is rendered unconscious by an attacker.
“As you know, the collection of evidence is time sensitive, so the time it would take to go through the court process of having a legal representative appointed simply is not feasible,” the division wrote. “The unintended consequence of this bill would allow a violent, sexual offender to benefit from the physical injuries they inflicted.”