AZ state senators vote to require consent for pelvic exams

The Arizona Senate voted unanimously Tuesday to require doctors and medical students to get explicit consent before performing pelvic exams on women under anesthesia.

The approval puts Arizona a step closer to joining a growing list of states requiring explicit and informed consent from women before undergoing gynecological and other surgeries. Identical legislation is also moving quickly through the House.

It comes amid scrutiny of just how much information women are given about sensitive and invasive exams before being knocked out for surgery. Medical ethics guidelines require informed consent for treatment and exams. But some medical students instructed to practice on unconscious women have questioned how much the women really knew.

“In this situation, a patient is unconscious, and they would then be subjected to a procedure that they did not consent to or perhaps a procedure that is not directly related to why they are in the hospital,” said Sen. Heather Carter, a Republican who sponsored the Arizona legislation. “That’s why it’s important to close this loophole.”

A pelvic exam is standard practice before gynecologic surgeries to determine the position and mobility of the organs. It involves inserting fingers of a gloved hand in the patient’s vagina to feel her uterus and ovaries. Medical students sometimes do the exams as part of their training.

It’s not clear how often patients are clearly told of student involvement ahead of time, or if the consent is buried in vague terms on a lengthy form.

Arizona’s bill does not go as far as those in some other states, which require large type on consent forms authorizing pelvic exams.

The bill did not garner organized opposition. Nobody has spoken publicly against it.

Doctors, physician assistants or nurse practitioners could be sanctioned by the state medical or nursing board if they or their student violate the informed consent requirements.

The legislation includes an exemption for unconscious sexual assault victims so law enforcement can ask medical staff to gather evidence for a rape kit.

Rebecca Baker of the Maricopa County Attorney’s Office, told lawmakers on the House and Senate health committees last month that the authority would rarely be used, but it’s important that evidence be collected and preserved in situations where women are rendered unconscious by a violent assault.

Senate Bill 1027
informed consent; pelvic examinations


Associated Press writer Bob Christie contributed to this report.