Doctors would need to get patient consent for invasive examinations performed on unconscious patients under new proposed legislation.
The bill requires doctors to let patients know about pelvic, prostate, or rectal examinations being done before they happen.
The U.S. Department of Health and Human Services released guidance in 2024 for hospitals regarding informed consent.
Patient advocates have for years pushed for guidelines around informed consent. Of particular concern are cases where exams are performed on a patient while they are unconscious to help train students, sometimes without the patient even knowing that it is happening.
Indiana’s proposal largely brings the state in line with the federal guidance, requiring patients to sign a consent form before a pelvic, prostate, or rectal examination can be performed.
Bill author Sen. Michael Crider (R-Greenfield) said the measure is in response to a patient who was a survivor of sexual assault and underwent a procedure without her prior knowledge.
“Essentially, what I'm trying to do is make sure that we don't end up in situations where a patient feels like they've received some level of examination that they did not consent to,” he said.
Crider described his own personal experience having examinations as part of a prostate cancer diagnosis last year.
“I would say that the medical providers at all levels were very diligent about making sure I understood what the next steps were and what was involved in that,” he said. “I think overall, overwhelmingly, this is happening.”
Still, Crider said the bill is an important way to ensure procedures protecting a patient's privacy and consent are in place.
Some lawmakers worried that the bill could open up providers to more liability.
Representative Brad Barrett (R-Richmond), who is a retired surgeon, said there were many instances he could think of that might cause a patient discomfort, but still be medically necessary.
“That's what worries me with this legislation, is that everybody has their own sense of their privacy,” Barrett said. “When I first read this bill, I made a list of about twenty things that bothered me. You know, the delirious patient, the pediatric patient, the Foley catheter, the rectal and the breast exam.”
The bill includes exceptions for cases of medical emergency.
At the same time, other lawmakers worried the bill wouldn’t go far enough in holding doctors accountable. As written, the bill includes the possibility of imposing fines against doctors who are found to be in violation.
Robin Shackleford (D-Indianapolis) noted that a proposed amendment would cut out that disciplinary section of the bill altogether.
“I don't know if that's the path where we're going, that there is no repercussion if a doctor does not do this?” Shackleford asked.
The amendment has not yet been filed.
Barrett argued that doctors were ultimately accountable to licensing boards if there was a problem with not getting patient consent.
“This does not remove that accountability,” he said. “It's just not heaping on additional disciplinary actions. It's including that accountability, with licensure, with liability, with everything.”
The bill was heard in committee but isn’t expected to receive a vote until next week.
Contact Government and Health Reporter Benjamin Thorp at bthorp@wfyi.org