Fiedler, Hanbidge pelvic exam bill headed to governor’s desk

Philadelphia House Delegation    November 15, 2023 | 6:08 PM

HARRISBURG, Nov. 15 – The PA House today passed legislation (H.B. 507) that requires medical facilities in Pennsylvania to obtain consent before performing pelvic, prostate or rectal exams on anesthetized patients. The legislation, introduced by state Reps. Elizabeth Fiedler, D-Phila., and Liz Hanbidge, D-Montgomery, now goes to Gov. Josh Shapiro for his signature.

In Pennsylvania, medical students are currently permitted to perform these invasive exams on unconscious patients for training purposes. The legislators said this unethical practice undermines patient-doctor relationships, which require a foundation of trust, respect and transparency.

“This year, we’ve seen millions of women and people across the country stand up for reproductive freedom and bodily autonomy,” said Fiedler. “It’s never been more important to empower patients to make decisions about their own bodies and lives. I am elated to see this bill pass, and I look forward to Governor Shapiro signing it into law.”

“When patients arrive at the hospital for surgeries or treatments that require anesthesia, they are understandably worried or anxious about the outcome of their procedure, rarely thinking that an unrelated internal and intimate exam by a medical student might be part of the process,” Hanbidge said. “House Bill 507 puts the power back in the hands of the patient, giving them the final say in the care they receive while under treatment. Representative Fiedler and I have been working on this bill since we both joined the House in 2019, and I am pleased to finally see this critical bill for patient privacy go to Governor Shapiro for his signature.”

The practice was first brought to Fiedler’s attention by a constituent, Keren Sofer, who believes an exam was performed on her without her consent.

“Secrecy, lack of transparency and the subsequent justification for it should never be a part of a person’s medical care,” Sofer said. “A patient’s explicit consent protects patients, doctors and medical students. This is a practice which, despite being condemned by American professional medical associations, is shockingly still occurring across the Commonwealth. I'm grateful to the Senate for taking action. Requiring explicit consent is a common-sense step that will ensure that patients like me feel respected and empowered in their healthcare decisions.”

Amal Bass, co-executive director of Women’s Law Project, said the practice of nonconsensual exams is rooted in a long history of medical racism.

"We are grateful for the passage of H.B. 507," she said. "Eliminating the heinous, paternalistic practice of nonconsensual pelvic exams in Pennsylvania is long overdue. This bill rids medical care of a racist and sexist practice and protects patient autonomy.”

The bill passed with unanimous support in the House and in the Senate. Fiedler credits its success to support from bipartisan legislators, medical professionals and patient advocacy groups.

“The trust between patients and their medical providers is sacred, and this important legislation protects that relationship,” said House Health Committee Chair Dan Frankel, D-Allegheny. “It will also give patients peace of mind and allow them to focus on the already stressful experience of getting a medical procedure, rather than have them worry about being subjected to unnecessary, invasive exams as they lay unconscious.” 

"As chair of the [Senate] Health and Human Services Committee, I was stunned to learn that medical students and institutions were able to perform these pelvic, rectal or prostate exams on patients without their knowledge while under anesthesia for unrelated procedures,” said state Sen. Michele Brooks, R-Crawford/Mercer/Lawrence. “I would like to acknowledge the efforts of Representative Fiedler and her companion sponsors Senators Muth and Collett, in helping us bring an end to any such procedures happening to patients without their knowledge or permission.”

“House Bill 507 is such an important bill to protect patients’ right and to respect human dignity because no one’s body should be used for an invasive practice exam unless they consent to it,” said state Sen. Katie Muth, D-Chester/Montgomery/Berks. “We have tried to move this bill through the process for multiple sessions now, and I am grateful that it is finally headed to the governor’s desk."

“Unauthorized pelvic exams are a gross violation of the privacy and autonomy of patients,” said Stefan Turkheimer, vice president of public policy for the Rape, Abuse & Incest National Network. “The solution is as simple as requiring a patient’s informed consent prior to the examination, which will prioritize the patient’s comfort, safety and autonomy.”

A recent study found that 75% of medical students supported obtaining explicit consent for educational pelvic, prostate, rectal and breast exams performed under anesthesia. Requiring consent will restore dignity to patients and integrity to medical professionals.

“As a nurse, I know just how critical it is that practitioners can learn how to administer care on actual patients – but that training should never come at the expense of a patient’s opportunity to provide consent,” said state Sen. Maria Collett, D-Montgomery, minority chair of the Senate Health and Human Services Committee. “This bill will close an archaic loophole in Pennsylvania, requiring medical students to obtain consent from patients undergoing anesthesia before conducting a pelvic, prostate or rectal exam for training purposes. As a proud prime sponsor of the Senate version of this bill, I’m thrilled to see it advance to the governor’s desk for his signature.”  

The Pennsylvania Coalition to Advance Respect expressed support for the bill.

“Nonconsensual physical contact in medical and all other situations can be deeply traumatizing,” according to the coalition. “Together we have moved one step closer to ending sexual violence.”

The passage of the bill comes at a crucial moment for bodily autonomy across the country, following the Supreme Court’s Dobbs decision and ongoing attempts to block access to medication used for abortions and miscarriage management.

With the governor’s signature, Pennsylvania will join at least 20 states that ban nonconsensual pelvic exams. This is the first piece of legislation introduced by Fiedler to pass both chambers of the state legislature.