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HOUSE DOCKET, NO. 210 FILED ON: 1/11/2023
HOUSE . . . . . . . . . . . . . . . No. 2203
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Hannah Kane and Carole A. Fiola
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act relative to informed consent for concurrent surgical procedures.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Hannah Kane11th Worcester1/10/2023Carole A. Fiola6th Bristol1/24/2023Kimberly N. Ferguson1st Worcester1/26/2023David Allen Robertson19th Middlesex2/6/2023William M. Straus10th Bristol2/6/2023David Paul Linsky5th Middlesex2/7/2023Paul McMurtry11th Norfolk2/15/2023 1 of 6
HOUSE DOCKET, NO. 210 FILED ON: 1/11/2023
HOUSE . . . . . . . . . . . . . . . No. 2203
By Representatives Kane of Shrewsbury and Fiola of Fall River, a petition (accompanied by bill,
House, No. 2203) of Hannah Kane, Carole A. Fiola and others relative to informed consent for
concurrent surgical procedures. Public Health.
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 2328 OF 2021-2022.]
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Third General Court
(2023-2024)
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An Act relative to informed consent for concurrent surgical procedures.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Section 70E of chapter 111 of the General Laws, as appearing in the 2016
2Official Edition, is hereby amended by inserting after the first paragraph the following
3paragraph:-
4 As used in this section, the terms “Attending physician”, “Concurrent surgical
5procedure”, “Elective surgical procedure”, “Emergency surgical procedure”, and “Secondary
6emergency surgical procedure” shall have the same meanings as defined in section 70i.
7 SECTION 2. Said section 70E of said chapter 111, as so appearing, is hereby further
8amended by striking out, in line 105, the word “and”. 2 of 6
9 SECTION 3. The fifth paragraph of said section 70E of said chapter 111, as so
10appearing, is hereby amended by striking out clause(o) and inserting in place thereof the
11following 2 clauses:-
12 (o) if the patient is a female rape victim of childbearing age, to receive medically and
13factually accurate written information prepared by the commissioner of public health about
14emergency contraception; to be promptly offered emergency contraception; and to be provided
15with emergency contraception upon request; and
16 (p) to refuse to undergo a concurrent surgical procedure, except in cases of an emergency
17surgical procedure.
18 SECTION 4. The sixth paragraph of said section 70E of said chapter 111, as so
19appearing, is hereby amended by striking out clause (h) and inserting in place thereof the
20following 3 clauses:-
21 (h) in the case of a patient suffering from any form of breast cancer, to complete
22information on all alternative treatments which are medically viable;
23 (i) in the case of a patient scheduled for an elective concurrent surgical procedure, to
24written notice and informed consent of such concurrent scheduling, and a detailed account of the
25attending physician’s participation in the surgical procedure, at least 14 days prior to the surgical
26procedure pursuant to section 70i; and
27 (j) in the case of a patient scheduled for a secondary emergency concurrent surgical
28procedure, to written notice and informed consent of such concurrent scheduling, and a detailed 3 of 6
29account of the attending physician’s participation in the surgical procedure, at least 48 hours
30prior to the surgical procedure pursuant to section 70i.
31 SECTION 5. Said chapter 111 is hereby further amended by inserting after section 70H
32the following section:-
33 Section 70I. (a) As used in this section, the following words shall have the following
34meanings:
35 “Attending physician”, the physician licensed under sections 2 through 9B of chapter
36112, who has been credentialed by the facility to independently perform the patient’s procedure
37and to supervise physician trainees or physician extenders.
38 “Concurrent surgical procedure”, any surgical procedure during which the attending
39physician is scheduled to leave the operating room at any point between incision and skin closure
40of the procedure to participate in the performance or supervision of a different surgical procedure
41on a different patient in a different operating room, where critical portions of the operations are
42performed concurrently.
43 “Elective surgical procedure”, a surgical procedure that is scheduled at least 14 days in
44advance, that is not urgent in nature and is not an emergency procedure.
45 “Emergency surgical procedure”, an urgent surgical procedure that must be performed
46immediately upon the patient’s arrival at the facility, and is not scheduled in advance.
47 “Facility”, any hospital, institution for the care of unwed mothers, clinic, infirmary
48maintained in a town, convalescent or nursing home, rest home, or charitable home for the aged,
49licensed or subject to licensing by the department; any state hospital operated by the department; 4 of 6
50any “facility” as defined in section 3 of chapter 111B; any private, county or municipal facility,
51department or ward which is licensed or subject to licensing by the department of mental health
52pursuant to section 19 of chapter 19; or by the department of developmental services pursuant to
53section 15 of chapter 19B; any “facility” as defined in section 1 of chapter 123; the Soldiers
54Home in Holyoke, the Soldiers’ Home in Massachusetts; and any facility set forth in section 1 of
55chapter 19 or section 1 of chapter 19B.
56 “Overlapping surgical procedure”, a surgical procedure during which the attending
57physician is scheduled to leave the operating room at any point between incision and skin closure
58of the procedure to participate in the performance or supervision of a different surgical procedure
59on a different patient in a different operating room at the same time, where critical portions of the
60operations are not performed concurrently.
61 “Physician”, a person licensed to practice medicine under sections 2 through 9B of
62chapter 112.
63 “Physician Extender”, a person who is participating in the patient’s procedure who is
64under the direct supervision of the attending physician. A physician extender may be a resident, a
65fellow, a physician assistant, an advanced practice registered nurse or other person authorized by
66the facility to participate in the procedure, and who is directly supervised by the attending
67physician.
68 “Secondary emergency surgical procedure”, a surgical procedure that is scheduled at least
6948 hours in advance, but is still more urgent in nature than an elective surgical procedure.
70 “Staggered surgical procedure”, a surgical procedure during which the attending
71physician performs different surgical procedures on different patients in different operating 5 of 6
72rooms, one procedure directly after another, where no portions of the operations are performed
73concurrently.
74 (b) At least 14 days before the attending physician operates on a patient scheduled for an
75elective concurrent surgical procedure, and at least 48 hours before the attending physician
76operates on a patient scheduled for a secondary emergency concurrent surgical procedure, the
77attending physician shall inform the patient, in writing, of the concurrent scheduling and the
78involvement of the attending physician in the patient’s procedure, and shall obtain written
79informed consent from the patient prior to performing such procedure; provided, that the
80attending physician shall provide to the patient, in writing, a detailed description of what specific
81steps of the surgery said physician will and will not be performing, including, but not limited to
82critical surgical steps. The department shall develop a standardized written summary and
83consent form for use in obtaining informed consent for concurrent surgical procedures. This
84summary and consent form shall be written in a manner designed to permit a person unfamiliar
85with medical terminology to understand its purpose and content and shall inform the patient that
86they are scheduled to undergo a concurrent surgical procedure. The department shall update the
87form as necessary, and distribute such forms to each facility in the commonwealth in which the
88department knows or has reason to know concurrent surgical procedures are performed.
89 (c) The attending physician shall include in the patient’s medical record written
90documentation of the attending physician’s presence or absence during the surgical procedure. If
91the attending physician was absent for any part of the surgical procedure, the medical record
92shall accurately reflect the time of the absence or absences and who was the attending physician
93during the absence, if any. 6 of 6
94 (d) Any facility that performs concurrent surgical procedures shall publish, on their
95website, notice that said facility performs concurrent surgical procedures, and shall publish such
96notice on the individual webpages of each physician who performs concurrent surgeries at said
97facility.
98 SECTION 6. The department of public health shall promulgate rules and regulations
99necessary to implement this act.