1-1 By: Dukes (Senate Sponsor - Wentworth) H.B. No. 723 1-2 (In the Senate - Received from the House April 18, 1997; 1-3 April 22, 1997, read first time and referred to Committee on Health 1-4 and Human Services; May 18, 1997, reported adversely, with 1-5 favorable Committee Substitute by the following vote: Yeas 9, Nays 1-6 0; May 18, 1997, sent to printer.) 1-7 COMMITTEE SUBSTITUTE FOR H.B. No. 723 By: Nelson 1-8 A BILL TO BE ENTITLED 1-9 AN ACT 1-10 relating to informed consent before the performance of a 1-11 hysterectomy. 1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-13 SECTION 1. Subchapter F, Medical Liability and Insurance 1-14 Improvement Act of Texas (Article 4590i, Vernon's Texas Civil 1-15 Statutes), is amended by adding Section 6.08 to read as follows: 1-16 Sec. 6.08. INFORMED CONSENT FOR HYSTERECTOMIES. (a) The 1-17 panel shall develop and prepare written materials to inform a 1-18 patient or person authorized to consent for a patient of the risks 1-19 and hazards of a hysterectomy. 1-20 (b) The materials shall be available in English, Spanish, 1-21 and any other language the panel considers appropriate. The 1-22 information must be presented in a manner understandable to a 1-23 layperson. 1-24 (c) The materials must include: 1-25 (1) a notice that a decision made at any time to 1-26 refuse to undergo a hysterectomy will not result in the withdrawal 1-27 or withholding of any benefits provided by programs or projects 1-28 receiving federal funds or otherwise affect the patient's right to 1-29 future care or treatment; 1-30 (2) the name of the person providing and explaining 1-31 the materials; 1-32 (3) a statement that the patient or person authorized 1-33 to consent for the patient understands that the hysterectomy is 1-34 permanent and nonreversible and that the patient will not be able 1-35 to become pregnant or bear children if she undergoes a 1-36 hysterectomy; 1-37 (4) a statement that the patient has the right to seek 1-38 a consultation from a second physician; 1-39 (5) a statement that the patient or person authorized 1-40 to consent for the patient has been informed that a hysterectomy is 1-41 a removal of the uterus through an incision in the lower abdomen or 1-42 vagina and that additional surgery may be necessary to remove or 1-43 repair other organs, including an ovary, tube, appendix, bladder, 1-44 rectum, or vagina; 1-45 (6) a description of the risks and hazards involved in 1-46 the performance of the procedure; 1-47 (7) a written statement to be signed by the patient or 1-48 person authorized to consent for the patient indicating that the 1-49 materials have been provided and explained to the patient or person 1-50 authorized to consent for the patient and that the patient or 1-51 person authorized to consent for the patient understands the nature 1-52 and consequences of a hysterectomy. 1-53 (d) The physician or health care provider shall obtain 1-54 informed consent under this section and Section 6.05 of this Act 1-55 from the patient or person authorized to consent for the patient 1-56 before performing a hysterectomy unless the hysterectomy is 1-57 performed in a life-threatening situation in which the physician 1-58 determines obtaining informed consent is not reasonably possible. 1-59 If obtaining informed consent is not reasonably possible, the 1-60 physician or health care provider shall include in the patient's 1-61 medical records a written statement signed by the physician 1-62 certifying the nature of the emergency. 1-63 (e) The panel may not prescribe materials under this section 1-64 without first consulting with the Texas State Board of Medical 2-1 Examiners. 2-2 SECTION 2. (a) This Act takes effect September 1, 1997. 2-3 (b) The Texas Medical Disclosure Panel shall prescribe the 2-4 form and content of the materials required to be distributed under 2-5 Section 6.08, Medical Liability and Insurance Improvement Act of 2-6 Texas (Article 4590i, Vernon's Texas Civil Statutes), as added by 2-7 this Act, not later than January 1, 1998. 2-8 (c) This Act applies only to a hysterectomy that is 2-9 performed at least 90 days after the date that notice of the 2-10 adoption of the initial form and content of the materials required 2-11 to be distributed under Section 6.08, Medical Liability and 2-12 Insurance Improvement Act of Texas (Article 4590i, Vernon's Texas 2-13 Civil Statutes), as added by this Act, is published in the Texas 2-14 Register. 2-15 SECTION 3. The importance of this legislation and the 2-16 crowded condition of the calendars in both houses create an 2-17 emergency and an imperative public necessity that the 2-18 constitutional rule requiring bills to be read on three several 2-19 days in each house be suspended, and this rule is hereby suspended. 2-20 * * * * *