S-3761.2 _______________________________________________
SENATE BILL 6077
_______________________________________________
State of Washington 53rd Legislature 1994 Regular Session
By Senators Skratek, Wojahn, McAuliffe, Loveland, Hargrove, Sheldon, Quigley, Drew, Haugen, Prentice, M. Rasmussen, Franklin, Fraser, Pelz, Winsley and Spanel
Read first time 01/12/94. Referred to Committee on Health & Human Services.
AN ACT Relating to informed consent for hysterectomies; adding a new section to chapter 18.71 RCW; adding a new section to chapter 18.57 RCW; adding a new section to chapter 48.20 RCW; adding a new section to chapter 48.21 RCW; adding a new section to chapter 48.44 RCW; and adding a new section to chapter 48.46 RCW.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec. 1. A new section is added to chapter 18.71 RCW to read as follows:
(1) Prior to the performance of a hysterectomy, physicians and surgeons regulated under this chapter and osteopathic physicians and surgeons regulated under chapter 18.57 RCW shall obtain verbal and written informed consent from the patient. Spousal consent shall not be required. The informed consent procedure shall ensure that all of the following information is given to the patient verbally and in writing, and that the patient has adequate opportunity to discuss questions she may have about the procedure, its alternatives, possible side effects, and outcomes.
(a) Advice that the individual is free to withhold or withdraw consent to the procedure at any time before the hysterectomy, without affecting the right to future care or treatment and without loss or withdrawal of state or federally funded program benefits to which the individual might be otherwise entitled.
(b) A description of the type or types of surgery and other procedures involved in the proposed hysterectomy, and a description of any known available and appropriate alternatives to the hysterectomy itself.
(c) Except as provided in subsection (2) of this section, advice that the hysterectomy procedure is considered to be irreversible, and that infertility will result. This information shall be presented in simple, layperson language. If the patient is unable to read or understand English, the information shall be provided in the patient's native language or through an interpreter.
(d) A description of the discomforts and risks that may accompany or follow the performing of the procedure, including an explanation of the type and possible effects of any anesthetic to be used.
(e) A description of the benefits or advantages that may be expected as a result of the hysterectomy.
(f) Approximate length of hospital stay.
(g) Approximate length of time for recovery.
(h) Financial cost to the patient of the physician and surgeon's fees.
(2) A woman shall sign a written statement prior to the performance of the hysterectomy procedure, indicating she has read and understood the written information provided pursuant to subsection (1) of this section, and that this information has been discussed with her by her physician and surgeon, or his or her designee. The statement shall indicate that the patient has been advised by her physician or designee that the hysterectomy will render her permanently sterile and incapable of having children.
(3) The informed consent procedure shall not pertain if the hysterectomy is performed in a life-threatening emergency situation in which the physician determines prior written informed consent is not possible. In this case, a statement, signed by the attending physician, certifying the nature of the emergency, shall accompany the claim.
(4) The department of health may develop rules establishing verbal and written informed consent procedures that shall be obtained prior to performance of a hysterectomy and that indicate the medically accepted justifications for performance of a hysterectomy.
NEW SECTION. Sec. 2. A new section is added to chapter 18.57 RCW to read as follows:
(1) Prior to the performance of a hysterectomy, osteopathic physicians and surgeons regulated under this chapter shall obtain verbal and written informed consent from the patient. Spousal consent shall not be required. The informed consent procedure shall ensure that all of the following information is given to the patient verbally and in writing, and that the patient has adequate opportunity to discuss questions she may have about the procedure, its alternatives, possible side effects, and outcomes.
(a) Advice that the individual is free to withhold or withdraw consent to the procedure at any time before the hysterectomy, without affecting the right to future care or treatment and without loss or withdrawal of any state or federally funded program benefits to which the individual might be otherwise entitled.
(b) A description of the type or types of surgery and other procedures involved in the proposed hysterectomy, and a description of any known available and appropriate alternatives to the hysterectomy itself.
(c) Except as provided in subsection (2) of this section, advice that the hysterectomy procedure is considered to be irreversible, and that infertility will result. Information shall be presented in simple, layperson language. If the patient is unable to read or understand English, the information shall be provided in the patient's native language or through an interpreter.
(d) A description of the discomforts and risks that may accompany or follow the performing of the procedure, including an explanation of the type and possible effects of any anesthetic to be used.
(e) A description of the benefits or advantages that may be expected as a result of the hysterectomy.
(f) Approximate length of hospital stay.
(g) Approximate length of time for recovery.
(h) Financial cost to the patient of the physician and surgeon's fees.
(2) A woman shall sign a written statement prior to the performance of the hysterectomy procedure, indicating she has read and understood the written information provided pursuant to subsection (1) of this section, and that this information has been discussed with her by her physician and surgeon, or his or her designee. The statement shall indicate that the patient has been advised by her physician or designee that the hysterectomy will render her permanently sterile and incapable of having children.
(3) The informed consent procedure shall not pertain if the hysterectomy is performed in a life-threatening emergency situation in which the physician determines prior written informed consent is not possible. In this case, a statement, signed by the attending physician, certifying the nature of the emergency, shall accompany the claim.
(4) The department of health may develop rules establishing verbal and written informed consent procedures that shall be obtained prior to performance of a hysterectomy and that indicate the medically accepted justifications for performance of a hysterectomy.
NEW SECTION. Sec. 3. A new section is added to chapter 48.20 RCW to read as follows:
In establishing rates of provider payment, insurers under this chapter shall consider cost implications of the requirements contained in sections 1 and 2 of this act. This should include estimates of both additional provider time required to comply with the requirements of sections 1 and 2 of this act and any reduction of unneeded medical procedures that may occur.
NEW SECTION. Sec. 4. A new section is added to chapter 48.21 RCW to read as follows:
In establishing rates of provider payment, insurers under this chapter shall consider cost implications of the requirements contained in sections 1 and 2 of this act. This should include estimates of both additional provider time required to comply with the requirements of sections 1 and 2 of this act and any reduction of unneeded medical procedures that may occur.
NEW SECTION. Sec. 5. A new section is added to chapter 48.44 RCW to read as follows:
In establishing rates of provider payment, contractors under this chapter shall consider cost implications of the requirements contained in sections 1 and 2 of this act. This should include estimates of both additional provider time required to comply with the requirements of sections 1 and 2 of this act and any reduction of unneeded medical procedures that may occur.
NEW SECTION. Sec. 6. A new section is added to chapter 48.46 RCW to read as follows:
In establishing rates of provider payment, organizations under this chapter shall consider cost implications of the requirements contained in sections 1 and 2 of this act. This should include estimates of both additional provider time required to comply with the requirements of sections 1 and 2 of this act and any reduction of unneeded medical procedures that may occur.
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