By Dukes                                              H.B. No. 3152
       74R958 KLL-D
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to informed consent before the performance of a
    1-3  hysterectomy.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Title 2, Health and Safety Code, is amended by
    1-6  adding Subtitle I to read as follows:
    1-7            SUBTITLE I.  PERFORMANCE OF MEDICAL PROCEDURES
    1-8                     CHAPTER 173.  HYSTERECTOMIES
    1-9        Sec. 173.001.  DEFINITION.  In this chapter, "physician"
   1-10  means a person licensed to practice medicine under the Medical
   1-11  Practice Act (Article 4495b, Vernon's Texas Civil Statutes).
   1-12        Sec. 173.002.  INFORMED CONSENT REQUIRED.  A physician may
   1-13  not perform a hysterectomy on a patient unless the physician has
   1-14  first obtained oral and written informed consent from the patient
   1-15  or a person authorized to consent for the patient.
   1-16        Sec. 173.003.  EXCEPTION.  Section 173.002 does not apply if
   1-17  the hysterectomy is performed in a life-threatening situation in
   1-18  which the physician determines prior informed consent is not
   1-19  possible.  In that case, a written statement signed by the
   1-20  physician certifying the nature of the emergency must be included
   1-21  in the patient's medical records.
   1-22        Sec. 173.004.  RULES GOVERNING INFORMED CONSENT PROCEDURES.
   1-23  The board, with the advice of the Texas Medical Disclosure Panel,
   1-24  shall adopt rules that establish oral and written informed consent
    2-1  procedures to be followed before a hysterectomy is performed and
    2-2  that indicate the medically accepted justifications for the
    2-3  performance of a hysterectomy.
    2-4        Sec. 173.005.  CONTENTS OF INFORMED CONSENT PROCEDURE.  The
    2-5  informed consent procedures adopted under Section 173.004 shall
    2-6  ensure that at least all of the following information is given
    2-7  orally and in writing to the patient or a person authorized to
    2-8  consent for the patient:
    2-9              (1)  advice that the patient or a person authorized to
   2-10  consent for the patient is free to withhold or withdraw consent to
   2-11  the procedure at any time before the hysterectomy or treatment
   2-12  without affecting the right to future care or treatment and without
   2-13  the loss or withdrawal of any state or federally funded program
   2-14  benefits to which the patient might be otherwise entitled;
   2-15              (2)  a description of the type of surgery and other
   2-16  procedures involved in the proposed hysterectomy and a description
   2-17  of any known available and medically appropriate alternatives to
   2-18  the hysterectomy;
   2-19              (3)  advice that the hysterectomy procedure is
   2-20  considered to be irreversible and that infertility will result for
   2-21  a patient who is not previously sterile or postmenopausal;
   2-22              (4)  a description of the discomforts and risks that
   2-23  may accompany or follow the performance of the procedure, including
   2-24  an explanation of the type and possible effects of any anesthetic
   2-25  to be used;
   2-26              (5)  a description of the benefits or advantages that
   2-27  may be expected as a result of the hysterectomy;
    3-1              (6)  approximate length of hospital stay;
    3-2              (7)  approximate length of time for recovery; and
    3-3              (8)  the physician's fee.
    3-4        Sec. 173.006.  WRITTEN STATEMENT.  (a)  A patient on whom a
    3-5  hysterectomy is to be performed or a person authorized to consent
    3-6  for the patient shall sign a written statement before the procedure
    3-7  is performed indicating that the patient or other person has read
    3-8  and understood the written information provided under Section
    3-9  173.005 and that the information has been discussed with the
   3-10  patient or other person by the patient's physician.
   3-11        (b)  The statement shall indicate that the patient or the
   3-12  person authorized to consent for the patient has been advised by
   3-13  the patient's physician that the hysterectomy will make the patient
   3-14  permanently sterile unless the patient was previously sterile or
   3-15  postmenopausal.
   3-16        Sec. 173.007.  DISCIPLINARY ACTION.  A physician who fails to
   3-17  comply with Section 173.002 is subject to disciplinary action under
   3-18  Section 4.01, Medical Practice Act (Article 4495b, Vernon's Texas
   3-19  Civil Statutes).
   3-20        SECTION 2.  This Act takes effect September 1, 1995.
   3-21        SECTION 3.  The importance of this legislation and the
   3-22  crowded condition of the calendars in both houses create an
   3-23  emergency and an imperative public necessity that the
   3-24  constitutional rule requiring bills to be read on three several
   3-25  days in each house be suspended, and this rule is hereby suspended.