By Dukes H.B. No. 723 75R9790 SKB-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. Subchapter F, Medical Liability and Insurance 1-6 Improvement Act of Texas (Article 4590i, Vernon's Texas Civil 1-7 Statutes), is amended by adding Section 6.08 to read as follows: 1-8 Sec. 6.08. INFORMED CONSENT FOR HYSTERECTOMIES. (a) The 1-9 panel shall develop and prepare written materials to inform a 1-10 patient or person authorized to consent for a patient of the risks 1-11 and hazards of a hysterectomy and the availability of alternatives 1-12 to a hysterectomy. 1-13 (b) The materials shall be available in English, Spanish, 1-14 and any other language the panel considers appropriate. The 1-15 information must be presented in a manner understandable to a 1-16 layperson. 1-17 (c) The materials must include: 1-18 (1) a notice that a decision made at any time to 1-19 refuse to undergo a hysterectomy will not result in the withdrawal 1-20 or withholding of any benefits provided by programs or projects 1-21 receiving federal funds or otherwise affect the patient's right to 1-22 future care or treatment; 1-23 (2) the name of the person providing and explaining 1-24 the materials; 2-1 (3) a statement that the patient or person authorized 2-2 to consent for the patient understands that the hysterectomy is 2-3 permanent and nonreversible and that the patient will not be able 2-4 to become pregnant or bear children if she undergoes a 2-5 hysterectomy; 2-6 (4) a statement that the patient has the right to seek 2-7 a consultation from a second physician; 2-8 (5) a statement that the patient or person authorized 2-9 to consent for the patient has been informed that a hysterectomy is 2-10 a removal of the uterus through an incision in the lower abdomen or 2-11 vagina and that additional surgery may be necessary to remove or 2-12 repair other organs, including an ovary, tube, appendix, bladder, 2-13 rectum, or vagina; 2-14 (6) blank spaces to list the procedures to be 2-15 performed; 2-16 (7) a statement that the patient or person authorized 2-17 to consent for the patient was informed of available and medically 2-18 appropriate alternatives and blank spaces to list the alternatives; 2-19 (8) a description of the discomforts and risks that 2-20 may accompany or follow the performance of the procedure; 2-21 (9) a description of the risks, hazards, and potential 2-22 side effects of any anesthetic to be used; 2-23 (10) a blank space to indicate the approximate length 2-24 of hospital stay and time of recovery; 2-25 (11) a statement of the physician's fee and other 2-26 related costs; and 2-27 (12) a written statement to be signed by the patient 3-1 or person authorized to consent for the patient indicating that the 3-2 materials have been provided and explained to the patient or person 3-3 authorized to consent for the patient and that the patient or 3-4 person authorized to consent for the patient understands the nature 3-5 and consequences of a hysterectomy. 3-6 (d) The physician or health care provider shall obtain 3-7 informed consent under this section and Section 6.04 of this Act 3-8 from the patient or person authorized to consent for the patient 3-9 before performing a hysterectomy unless the hysterectomy is 3-10 performed in a life-threatening situation in which the physician 3-11 determines obtaining informed consent is not reasonably possible. 3-12 If obtaining informed consent is not reasonably possible, the 3-13 physician or health care provider shall include in the patient's 3-14 medical records a written statement signed by the physician 3-15 certifying the nature of the emergency. 3-16 (e) The panel may not prescribe materials under this section 3-17 without the approval of the Texas State Board of Medical Examiners. 3-18 SECTION 2. (a) This Act takes effect September 1, 1997. 3-19 (b) The Texas Medical Disclosure Panel shall prescribe the 3-20 form and content of the materials required to be distributed under 3-21 Section 6.08, Medical Liability and Insurance Improvement Act of 3-22 Texas (Article 4590i, Vernon's Texas Civil Statutes), as added by 3-23 this Act, not later than January 1, 1998. 3-24 (c) This Act applies only to a hysterectomy that is 3-25 performed at least 90 days after the date that notice of the 3-26 adoption of the initial form and content of the materials required 3-27 to be distributed under Section 6.08, Medical Liability and 4-1 Insurance Improvement Act of Texas (Article 4590i, Vernon's Texas 4-2 Civil Statutes), as added by this Act, is published in the Texas 4-3 Register. 4-4 SECTION 3. The importance of this legislation and the 4-5 crowded condition of the calendars in both houses create an 4-6 emergency and an imperative public necessity that the 4-7 constitutional rule requiring bills to be read on three several 4-8 days in each house be suspended, and this rule is hereby suspended.