State lawmakers are taking action to prevent healthcare workers from sexually assaulting patients following high-profile cases in which doctors abused patients under the guise of medical treatment or took advantage of disabled adults.
In Arizona, Democratic state Rep. Jennifer Longdon has filed a bill that would require healthcare workers who care for vulnerable adults to undergo yearly training about neglect and abuse. A second bill would classify the failure to report abuse of a vulnerable person as a felony rather than a misdemeanor, bringing it into line with the failure to report sexual abuse against a child.
The bills, which have Republican co-sponsors, were proposed in reaction to a high-profile incident in which a nurse raped a woman who had been in a vegetative state for more than 10 years at a nursing facility. Healthcare workers said they didn’t know about the rape, or that it had resulted in a pregnancy, until the woman unexpectedly gave birth. Police arrested and charged Nathan Sutherland, a 36-year-old nurse, with rape and vulnerable adult abuse after his DNA was found to match the baby’s.
Arizona regulators told the facility that male employees now must always have a chaperone with them when they see patients, a requirement already in effect in seven other states.
In Maryland, Democratic state Del. Heather Bagnall has introduced a bill that would ban doctors from performing pelvic, rectal, or prostate exams on patients if they are under anesthesia. Doctors who break the rule could be disciplined with a reprimand, suspension, or revocation of their license. Doctors could perform the exams if they receive written consent beforehand or if the exam is medically necessary. California, Hawaii, Illinois, Oregon, and Virginia already have similar laws on the books.
Lawmakers are reacting to shocking reports of abuse by those in the medical profession, including Larry Nassar, who was was convicted of sexually assaulting young girls as a sports doctor for the Olympics and Michigan State University. In December, 17 women sued Columbia University and its hospitals saying they had been negligent and had committed fraud by covering up patient sexual assault committed by Robert Hadden, an obstetrician, for more than two decades.
Stories about sexual abuse in the doctor’s office provide another dimension to the #MeToo era, in which more women and men are speaking out about assault and harassment and revealing that their pleas for help were ignored. Sex between doctors and their patients, even when consensual, is forbidden by medical codes of ethics because of the uneven power structure.
“People view physicians as authority figures,” said Kristen Houser, spokeswoman for the National Sexual Violence Resource Center. “You are there oftentimes because you have a problem you do not have the expertise to fix on your own. Many physicians abuse that trust and power.”
Houser pointed out that patients are in a vulnerable situation, wearing a hospital gown in a small medical exam room that is a semiprivate space.
Investigations by the Atlanta Journal-Constitution and the Associated Press have revealed cases where doctors were not held accountable for sexual misbehavior and patients have reported cases where hospitals ignored reports of sexual assault, handled them quietly, or failed to report them to the police or to medical boards. Doctors disciplined in one state can still go on to practice in another.
California last year became the first state to require doctors to disclose to patients before an appointment whether they have been disciplined for hurting patients, whether through sexual assault or through other misconduct such as improper prescribing or a problem with substance abuse.
States have different laws about how to discipline doctors, including where and whether to post information so that patients can access it and just how detailed that information is. For instance, a listing that says a doctor was disciplined for “unprofessional conduct” can mean anything from sexual misconduct to failure to keep proper medical records to failure to undergo regular medical training. Not all states require regulators to alert the police following sexual misconduct.
The national organization overseeing state medical boards is taking its own action. The Federation of State Medical Boards plans to update its 2006 guidelines for how state medical boards should handle sexual misconduct cases. Joe Knickrehm, spokesman for the group, said a final report and recommendations would be released in 2020.
“Addressing sexual misconduct is a top priority for state boards, and in recent years boards have advocated for strengthened reporting requirements to ensure individuals or organizations who are aware of, or witness, inappropriate behavior come forward to report the problem,” he said.
