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Government issues new guidelines for pelvic exam patient consent

The Department of Health and Human Services credits reporting like that of Scripps News Kansas City for the new recommendations.
Posted at 2:26 PM, Apr 02, 2024

On Monday, the federal government issued new recommendations that require hospitals to get consent before conducting intimate exams on patients, especially those under anesthesia.

The Scripps News Kansas City investigative team has extensively reported on this practice for a year and a half, and our coverage led to Missouri passing a law banning pelvic exams without consent.

The Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services (CMS), said if hospitals want medical students to practice a pelvic exam on someone, they must have processes in place to get informed consent from the patient first.

Advocates say this should have been in place all along, but are nonetheless calling this move a victory.

In our previous reporting, we learned that doctors-in-training have practiced these exams, most often pelvic, on anesthetized patients as a teaching tool.

Some students said this didn't sit right with them but didn't know how to speak up.

Many patients wouldn't know it happened to them at all because it's not part of their medical care, and merely for the educational benefit of the student.

We spoke with Ashley Weitz, who, in 2007, received a pelvic exam she didn't consent to, which left her feeling extremely violated.

That experience lead to advocacy work, and Weitz testified in multiple state legislatures, including Kansas and Missouri, to help pass laws requiring consent.

Scripps News checked in with Weitz on Monday, who says it's a relief that the federal government is providing a framework for accountability.

"It's incredibly validating. It's a huge relief," Weitz said. "Putting this into CMS rule, I think, is the most effective and also it doesn't leave it up for discussion. Patient autonomy is not up for discussion."

HSS credits reporting like the Scripps News Kansas City investigative team's coverage for the actions.

A spokesperson told Scripps News hospitals around the country received a letter detailing the recommendations on Monday.

If hospitals do not have consent policies and processes in place, they could lose Medicare funding.

The guidelines say CMS "surveyors must ensure that a hospital's patient informed consent policy and process, as well as its informed consent forms, contain elements and information that allow for a patient, or his or her representative, to make fully informed decisions about their care."

"Continuing to empower patients and providers to have these conversations is really good," Weitz said. "It's really positive."

This story was originally published by Sarah Plake at Scripps News Kansas City.