Pennsylvania bans nonconsensual pelvic exams on unconscious patients

Medical students in Pennsylvania can no longer perform pelvic, prostate or rectal exams on unconscious patients without their consent.

Last week, Gov. Josh Shapiro, a Democrat, signed House Bill 507 into law, ending what Democratic Rep. Elizabeth Fiedler called a “horrific, archaic practice” that “never should have been allowed to continue in the first place.”

“For too long, patients in Pennsylvania have been denied the right to make important decisions about their own bodies, about their medical care and what happens to them while they’re under anesthesia,” Fiedler, one of the bill’s lead sponsors, said during a press conference celebrating the bill signing on Monday.

Passed unanimously by the state House and Senate earlier this month, the legislation requires medical facilities in Pennsylvania to obtain consent before performing pelvic, prostate or rectal exams on anesthetized patients. Previously, medical students had been permitted to perform these invasive exams on unconscious patients without their explicit consent for training purposes.

PBS reported earlier this year that 29 states still permitted these non-consensual exams. The commonwealth joins at least 20 states that have banned the practice. A recent study found that 75% of medical students in the U.S. support obtaining explicit consent for educational pelvic, prostate and rectal exams performed under anesthesia.

“Many patients will never know these exams have been performed on their bodies, but many will question for days, weeks and years after the exam: what happened while they were under anesthesia?” Fiedler said during Monday’s press conference.

The practice can leave psychological scars for any patient, according to the Pennsylvania Coalition to Advance Respect, which works to end sexual violence and advocates for sexual assault victims.

“Nonconsensual physical contact in medical and all other situations can be deeply traumatizing,” the coalition said in a prepared statement.

For four years, Democratic women lawmakers including Fiedler, Rep. Liz Hanbidge, Sen. Maria Collett, and Sen. Katie Muth have been advocating for the passage of this legislation. The bill’s passage is emblematic of a growing movement of people calling for bodily autonomy following the U.S. Supreme Court overturning Roe v. Wade and state legislatures’ ongoing efforts to restrict and altogether ban pregnant people’s right to manage their own health care, lawmakers said.

“This year, we’ve seen millions of women and people across the country stand up for reproductive freedom and bodily autonomy,” Fiedler said in a prepared statement issued following the House’s vote on the bill. “It’s never been more important to empower patients to make decisions about their own bodies and lives.”

During Monday’s press conference, Hanbidge emphasized that the legislation is especially meaningful to women.

“While this legislation affects all patients, it will have the greatest impact on women,” Hanbidge continued. “When Senators Collett and Muth and Representative Fiedler and I were elected in 2019, Pennsylvania had recently been ranked 49th in the country for women in government. We and subsequent classes of elected officials have worked hard along with our colleagues to create and support impactful legislation that empowers women of all ages in the commonwealth.”

The Women’s Law Project, a Philadelphia-based nonprofit, was a strong proponent of the bill and noted in a statement on its website that these invasive and nonconsensual exams “are deeply rooted in racism and sexism, violate a patient’s right to bodily autonomy, disproportionately affect women generally and Black women in particular, and harm medical students as well as patients.” The organization went on to explain that the history of gynecology is rooted in the exploitation and abuse of enslaved Black women and that the “practice of nonconsensual pelvic exams is rooted in slavery.”

“Today, Black people are more likely to use teaching hospitals and are therefore more likely to be subjected to nonconsensual pelvic, rectal and prostate exams, representing a continuation of medical racism,” the Women’s Law Project wrote.