Louisiana 2020 Regular Session

Louisiana House Bill HB596 Latest Draft

Bill / Introduced Version

                            HLS 20RS-89	ORIGINAL
2020 Regular Session
HOUSE BILL NO. 596
BY REPRESENTATIVE IVEY
HEALTH/MEDICAL TREATMENT:  Provides relative to nonconsensual pelvic or rectal
examinations by healthcare providers and medical students
1	AN ACT
2To enact Subpart B-1 of Part II of Chapter 5-D of Title 40 of the Louisiana Revised Statutes
3 of 1950, to be comprised of R.S. 40:1160.1 through 1160.3, relative to
4 nonconsensual pelvic and rectal examinations; to provide methods by which
5 informed consent shall be obtained by the patient or patient's representative; to
6 provide for definitions; to provide for exceptions to obtaining informed consent from
7 the patient or patient's representative; to prohibit a medical resident, intern, or
8 student from observing or performing a pelvic or rectal examination on a patient
9 without the patient's informed consent; to provide for penalties and fines for
10 healthcare providers; and to provide for related matters.
11Be it enacted by the Legislature of Louisiana:
12 Section 1. Subpart B-1 of Part II of Chapter 5-D of Title 40 of the Louisiana Revised
13Statutes of 1950, comprised of R.S. 40:1160.1 through 1160.3, is hereby enacted to read as
14follows: 
15 SUBPART B-1. INFORMED CONSENT TO MEDI CAL EXAMINATIONS 
16 §1160.1. Short title
17	This Subpart shall be known and may be cited as the "Informed Consent to 
18 Medical Examinations Act".
19 §1160.2. Definitions
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1	As used in this Subpart, the following terms have the meanings ascribed to
2 them unless otherwise provided for or unless the context otherwise indicates: 
3	(1) "Anesthesia" means a drug-induced loss of consciousness, by use of any
4 anesthetic induction agent or otherwise, during which patients are not arousable even
5 by painful stimulation, as defined by the Louisiana State Board of Medical
6 Examiners.
7	(2) "Examination" means a pelvic or rectal examination.
8	(3) "Healthcare provider" means a person, partnership, limited liability
9 partnership, limited liability company, corporation, facility, or institution that
10 provides health care or professional services to individuals.
11	(4) "Patient" means a person who receives or has received medical treatment
12 or services from an individual or institution licensed to provide medical treatment
13 in this state.
14	(5) "Pelvic examination" is the physical examination of an individual's
15 reproductive organs performed by a healthcare provider.
16	(6) "Rectal examination" is an internal examination of the rectum performed
17 by a healthcare provider.
18	(7) "Representative" means the parent of a minor patient, tutor, curator, or
19 other legal agent of the patient.
20 §1160.3. Informed consent to medical examinations; anesthetized patients; penalties
21	A. A healthcare provider licensed or certified to practice a profession, or a
22 medical resident, intern, or student undergoing a course of instruction or
23 participating in a clinical training or residency program, shall not perform a pelvic
24 or rectal examination on an anesthetized or unconscious patient unless at least one
25 of the following conditions is met:
26	(1) The patient or the patient's representative provides informed consent to
27 the examination, and the examination is necessary for instructional, preventive,
28 diagnostic, or treatment purposes.
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HB NO. 596
1	(2) The patient or the patient's representative has provided written consent to
2 a surgical procedure or diagnostic examination to be performed on the patient, and
3 the performance of an examination is within the scope of care ordered for the
4 surgical procedure or diagnostic examination.
5	(3)(a) The patient is unconscious and incapable of providing consent, and the
6 examination is medically necessary.
7	(b) A healthcare provider who performs an examination pursuant to 
8 Subparagraph (a) of this paragraph shall inform the patient that an additional
9 examination was performed and the nature of the examination. The healthcare
10 provider shall notify the patient of the examination at a reasonable time before the
11 patient is discharged from his care.
12	B. In order to obtain informed consent to perform an examination on an
13 anesthetized or unconscious patient, the healthcare provider shall do all of the
14 following:
15	(1) Provide the patient or the patient's representative with a separate written
16 or electronic document that provides all of the following:
17	(a) A notice that states at the top of the document in not smaller than
18 eighteen-point bold face type: "CONSENT FOR EXAMINATION OF PELVIC
19 REGION" or "CONSENT FOR EXAMINATION OF RECTUM AREA".
20	(b) A statement that specifies the nature and purpose of the examination.
21	(c) A statement that states the name of the healthcare provider who the
22 patient or patient's representative may authorize to perform the examination.
23	(d)  A statement that states whether there may be a resident, intern, or student
24 whom the patient or patient's representative authorizes to perform an additional
25 examination for educational or training purposes.
26	(e) A series of check boxes that allow the patient or patient's representative
27 to do one of the following:
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1	(i) Consent to the examination for diagnosis or treatment and an additional
2 examination performed by a medical resident, intern, or student for an educational
3 or training purpose.
4	(ii) Consent to the examination only for diagnosis or treatment and not
5 consent to an additional examination to be performed by a medical resident, intern,
6 or student for educational or training purposes.
7	(iii) Decline to consent to the examination.
8	(2) Sign and date the written or electronic document.
9	C. A healthcare provider who fails to comply with the provisions of this
10 Subpart shall be subject to disciplinary action pursuant to R.S. 37:1285 and R.S.
11 37:1285.2.
12	D. Whoever violates any provisions of this Subpart shall, for each offense,
13 be fined no less than two hundred and fifty dollars nor more than five hundred
14 dollars, or imprisoned for not less than ten days nor more than five months, or both.
DIGEST
The digest printed below was prepared by House Legislative Services.  It constitutes no part
of the legislative instrument.  The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent.  [R.S. 1:13(B) and 24:177(E)]
HB 596 Original 2020 Regular Session	Ivey
Abstract:  Prohibits nonconsensual pelvic and rectal examinations on patients performed
by healthcare providers and medical residents, interns, or students. 
Proposed law provides that healthcare providers or medical residents, interns, or students
shall not perform pelvic or rectal examinations on an anesthetized or unconscious patient
without informed consent. 
Proposed law requires that informed consent shall be given by the patient or patient's
representative prior to the examination. Further requires that the examination is necessary
for educational,  preventive, diagnostic, or treatment purposes. 
Proposed law provides one or more of the following conditions shall be met in obtaining
informed consent:  (1) The examination is necessary for preventive care for the patient; (2)
Informed consent has been given and the examination is within the scope of care for the
patient; or (3) The examination is medically necessary. If the examination is medically
necessary then the healthcare provider shall inform the patient that an additional examination
was performed and the nature of the such examination. Further provides that the healthcare
provider shall notify the patient of the examination at a reasonable time before the patient
is discharged
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HB NO. 596
Proposed law requires the healthcare provider to obtain informed consent by a written or
electronic document where the document specifically states what the document is, the nature
and reason for the examination, and the healthcare provider and medical resident, student,
or intern assisting with the examination. 
Proposed law provides for ways to consent to an examination in which a medical resident,
student, or intern would either be present during the examination for educational purposes
or to not be allowed to do so. 
Proposed law provides that any healthcare provider who violates proposed law shall be
subject to disciplinary action and investigation pursuant to present law.
Proposed law provides that any healthcare provider who violations proposed law shall be
fined no less that $250 and no more than $500. Further provides that a healthcare provider
may be imprisoned for no less than 10 days and no more than 5 months, or both.  
(Adds R.S. 40:1160.1-1160.3)
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