SB 1470 — Informed Consent

Florida Senate - 2020 CS for SB 1470 By Senatorthe BookCommittee 32-00942A-20on 20201470__Health APolicy; bill to be entitled An act relating to informed consent for pelvic examinations;

and Senator Book 588-03846A-20 20201470c1 A bill to be entitled An act relating to informed consent;

definingrequiring health care practitioners to obtain written informed consent from the termspatient “healthor the patient’s legal representative in order to perform examinations on or provide medical care provider”or andtreatment “pelvicto examination”;the patient, with exceptions;

specifying circumstances under which aan attending health care providerpractitioner may performallow acertain pelvicindividuals examinationto onobserve anor anesthetizedparticipate in the provision of medical care or unconscioustreatment patient;to a patient under anesthesia;

specifyingrequiring proceduresthe forattending obtaininghealth consentcare forpractitioner ato pelvicobtain examination;from the patient or the patient’s legal representative separate written informed consent to do so;

specifying requirements for the written informed consent form;

prohibitingrequiring athe studentattending orhealth residentcare frompractitioner observingto orinform performingthe apatient pelvicof examinationspecified oninformation aand patientto withoutdocument specified information in the patient’s consent;medical record under certain circumstances;

requiringproviding afor healthdisciplinary careaction provideragainst toattending notifyhealth thecare patientpractitioners ofor certainsupervising informationmedical beforeeducators thewho patientfail isto anesthetizedcomply andwith renderedcertain unconscious;provisions;

providing for disciplinary action against a health care provider who fails to comply with certain provisions;

2127 Be It Enacted by the Legislature of the State of Florida:

2329 Section 1. Section 456.51, Florida Statutes, is created to read:

456.51 Health456.51 Informed consent.— (1) A health care providers;practitioner may not perform an examination of or provide medical care or treatment to a patient, with or without anesthesia, unless:

(a) The health care practitioner first obtains written informed consent from the patient or the patient’s legal representative for pelvicall examinations.—medically (1) Asnecessary usedexaminations inor thismedical section,care or treatment to be performed on or provided to the term:patient, with or without anesthesia;

(a) “Health(b) A carecourt provider”orders meansthe aperformance healthof an examination of or the provision of medical care practitioneror astreatment definedto inthe s.patient, with or without anesthesia;

456.001 or a(c) The paramedicperformance orof an emergencyexamination or the provision of medical techniciancare certifiedor undertreatment partis IIImedically ofnecessary chapterto 401.diagnose or treat the patient in a medical emergency.

(b) “Pelvic(2) A examination”patient’s meansattending health care practitioner may not allow a medical examinationor thatnursing requiresstudent, contacta withresident physician, an intern, or a fellow in fellowship training to observe or participate in the patient’sprovision sexualof organs.medical care or treatment to his or her patient while the patient is under anesthesia for any purpose, unless:

(2) A(a) A healthcourt careorders providerthe mayperformance notof performan aexamination pelvicof examinationor onthe anprovision anesthetizedof medical care or unconscioustreatment patientto unless:the patient, with or without anesthesia;

(a) The(b) The healthperformance of an examination or the provision of medical care provideror obtainstreatment consentis frommedically thenecessary patientto diagnose or treat the patient’spatient representative in accordancea withmedical subsectionemergency; (3);

(b) Aor court(c) The ordersattending performancehealth ofcare thepractitioner pelvicobtains examinationa forseparate written informed consent form from the collectionpatient ofor evidence;the patient’s legal representative in accordance with subsection (3) authorizing medical or nursing students, resident physicians, interns, or fellows in fellowship training to:

(c) The1. Be performancepresent ofonly for the pelvicpurpose examinationof isobserving within the scopeprovision of medical care foror atreatment procedureby orthe diagnosticattending examinationhealth scheduledcare practitioner to bethe performedpatient onwhile the patient;patient is under anesthesia;

or (d) The2. For pelvicthe examinationpurpose isof immediatelyconducting necessaryresearch foror diagnosisclinical andtraining, treatmentparticipate, under the direct supervision of the patient.attending health care practitioner or the supervising medical educator, in the provision of medical care or treatment by the attending health care practitioner to the patient while the patient is under anesthesia.

(3) To(3) The obtainseparate consentwritten toinformed performconsent aform pelvicrequired examinationunder onparagraph an(2)(c) anesthetized or unconscious patient, the health care provider must doinclude all of the followingfollowing: before the patient is anesthetized or rendered unconscious:

(a) Provide(a) The name and title of the patient’s attending health care practitioner who is responsible for the medical care and treatment of the patient orwhile the patient’spatient representativeis withunder aanesthesia, writtenas orindicated electronicby documentthe that:patient’s medical care and treatment plan.

1. Is(b) The providedname separatelyand fromtitle of any othersupervising noticemedical educator who will be present or agreement.will be providing direct supervision to any medical or nursing student, resident physician, intern, or fellow in fellowship training during the provision of medical care or treatment to the patient while the patient is under anesthesia.

2. Contains(c) A statement that any observation or participation by a headingmedical ator thenursing topstudent, ofa theresident documentphysician, an intern, or a fellow in atfellowship leasttraining 18-pointin boldthe typeprovision whichof statesmedical care or treatment to the following:patient while the patient is under anesthesia will be:

“CONSENT1. Directly FORrelated EXAMINATIONto OFthe PELVICpatient’s REGION”.diagnosis and medical care and treatment plan established by the patient’s attending health care practitioner;

3. Specifies2. Part theof naturemedical andresearch purposebeing ofconducted by the pelvicmedical examination.or nursing student, resident physician, intern, or fellow in fellowship training;

4. Listsor the3. Part name and title of onethe orclinical moretraining healthbeing careprovided providersto whom the patientmedical or thenursing patient’sstudent, representativeresident mayphysician, authorizeintern, toor performfellow thein pelvicfellowship examination.training.

5. States(d) A whetherseries thereof maycheck beboxes athat studentallow or resident who the patient or the patient’s legal representative authorizes to performindicate anwhether additionalhe pelvic examination or observeshe orconsents otherwise be present at the pelvic examination, either in person or throughwithholds electronicconsent means,to: for educational or training purposes.

6. Provides1. The thepresence patientof medical or thenursing patient’sstudents, representativeresident withphysicians, ainterns, seriesor fellows in fellowship training to observe the provision of checkmedical boxescare thatand allowtreatment to the patient orwhile the patient’spatient representativeis to:under anesthesia only for the purpose of conducting medical research or receiving clinical training;

a. Consentor to2. The theparticipation pelvicof examinationmedical foror diagnosisnursing students, resident physicians, interns, or treatmentfellows in fellowship training in the provision of medical care and treatment to the presencepatient of,while orthe anpatient additionalis examinationunder performedanesthesia by,for athe studentpurpose orof residentconducting formedical educationalresearch or trainingreceiving purposes;clinical training.

b. Consent(e) A tosignature theline pelvicdesignated examination only for diagnosis or treatment and refuse to consent to the presencepatient of, or anthe additionalpatient’s examinationlegal performedrepresentative. by, a student or resident for educational or training purposes;

or(f) A c. Refusesignature toline consentdesignated tofor the pelvicpatient’s examination.attending health care practitioner and the supervising medical educator, if different from the patient’s attending health care practitioner.

(b) Obtain(4) A thepatient signaturemay ofamend theor patientrevoke his or theher patient’sconsent, representativeverbally onor in writing, at any time before the writtenprocedure begins or electronicbefore documentthe whileanesthesia witnessedis byadministered, awhichever thirdoccurs party.earlier.

(c) Sign(5) If a patient consents to have medical or nursing students, resident physicians, interns, or fellows in fellowship training observe or participate in the writtenprovision of medical care or electronictreatment document.to the patient while under anesthesia, the patient’s attending health care practitioner must do all of the following:

(4) A(a) Inform the patient mayof revokehis or amendher hisright orto heramend consent,or verballyrevoke his or inher writing,consent at any time before beingthe anesthetizedprocedure begins or renderedbefore unconscious.anesthesia is administered, whichever occurs earlier.

(5) A(b) Document studentin orthe residentpatient’s maymedical notrecord observethe orname performof aeach pelvicmedical examinationor onnursing astudent, patientresident unlessphysician, theintern, patientor hasfellow executedin afellowship consenttraining formwho inobserved accordanceor withparticipated subsectionin (3)the authorizingprovision theof studentmedical care or residenttreatment to dothe so.patient while the patient was under anesthesia.

(6) If(6) A apatient’s patientattending consentshealth tocare havepractitioner aand student or resident observe or perform a pelvicsupervising examinationmedical oneducator, theif patient,different beforefrom the patientattending is anesthetized and rendered unconscious, the health care providerpractitioner, mustwho notifyfails theto patientcomply ofwith thethis namesection ofis eachsubject studentto ordiscipline residentby whothe willapplicable beboard, observing or performing a pelvic examination on the patientdepartment andif informthere theis patientno ofboard. the right to amend or revoke his or her consent.

(7) A health care provider who fails to comply with this section is subject to discipline by the applicable board, or the department if there is no board.