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.