Apr 1, 2024 - Health

HHS orders hospitals to get patient consent for invasive exams

Illustration of a stethoscope with a heart as the bell.

Illustration: Aïda Amer/Axios

Federal health officials on Monday ordered hospitals to get patients' consent before they undergo breast, pelvic and other sensitive examinations, citing "increasing concerns" about the absence of such permissions in educational settings.

Why it matters: Media reports and medical literature have documented instances where medical students subjected anesthetized patients to invasive exams without proper consent, Health and Human Services Secretary Xavier Becerra and other officials wrote to teaching hospitals and medical schools.

  • A growing number of states have bolstered protections, adding requirements to supplement the hospital forms patients usually sign that consent to medically necessary procedures while anesthetized.

State of play: The government has long required that hospitals in Medicare and Medicaid obtain patient consent in order to remain in the programs.

  • A 2020 New York Times report chronicled how physicians are not required to obtain explicit consent for pelvic exams, and how in some cases they are only done for teaching purposes in the presence of medical trainees.
  • The health department on Monday clarified that informed consent includes the right to not agree to sensitive examinations conducted for teaching purposes and the right to refuse consent to any previously unagreed examinations to treatment while under anesthesia.
  • It further stated that federal privacy protections under HIPAA give individuals the right to restrict who has access to their personal health information, including when they may be unconscious during a medical procedure.

What they're saying: "While we recognize that medical training on patients is an important aspect of medical education, this guidance aligns with the standard of care of many major medical organizations, as well as state laws that have enacted explicit protections as well," Becerra wrote with Medicare administrator Chiquita Brooks-LaSure and HHS Office for Civil Rights director Melanie Fontes Rainer.

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