Florida Senate - 2020 COMMITTEE AMENDMENT Bill No. SB 1470 Ì544728DÎ544728 LEGISLATIVE ACTION Senate . House Comm: RCS . 02/18/2020 . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Health Policy (Book) recommended the following: 1 Senate Amendment (with title amendment) 2 3 Delete everything after the enacting clause 4 and insert: 5 Section 1. Section 456.51, Florida Statutes, is created to 6 read: 7 456.51 Informed consent.— 8 (1) A health care practitioner may not perform an 9 examination of or provide medical care or treatment to a 10 patient, with or without anesthesia, unless: 11 (a) The health care practitioner obtains written informed 12 consent from the patient or the patent’s legal representative 13 for all medically necessary examinations of or medical care or 14 treatment to be provided to the patient, with or without 15 anesthesia; 16 (b) A court orders the performance of an examination of or 17 the provision of medical care or treatment to the patient, with 18 or without anesthesia; or 19 (c) The examination or medical care or treatment is 20 medically necessary for the diagnosis or medical care or 21 treatment of the patient in a medical emergency. 22 (2) A patient’s attending health care practitioner may not 23 allow a medical or nursing student, a resident physician, an 24 intern, or a fellow in fellowship training to observe or 25 participate in the provision of medical care or treatment to his 26 or her patient while the patient is under anesthesia for any 27 purpose, unless: 28 (a) A court orders the performance of an examination of or 29 the provision of medical care or treatment to the patient, with 30 or without anesthesia; 31 (b) The examination or medical care or treatment is 32 medically necessary for the diagnosis or medical care or 33 treatment of the patient in a medical emergency; or 34 (c) The attending health care practitioner obtains a 35 separate written informed consent form from the patient or the 36 patient’s legal representative in accordance with subsection (3) 37 authorizing medical or nursing students, resident physicians, 38 interns, or fellows in fellowship training to: 39 1. Be present only for the purpose of observing the 40 provision of medical care or treatment by the attending health 41 care practitioner to the patient while the patient is under 42 anesthesia; or 43 2. For the purpose of conducting research or clinical 44 training, participate, under direct supervision of the attending 45 health care practitioner or the supervising medical educator, in 46 the provision of medical care or treatment by the attending 47 health care practitioner to the patient while the patient is 48 under anesthesia. 49 (3) The separate written informed consent form required 50 under paragraph (2)(c) must include all of the following: 51 (a) The name and title of the patient’s attending health 52 care practitioner who is responsible for the medical care and 53 treatment of the patient while the patient is under anesthesia, 54 as indicated by the patient’s medical care and treatment plan. 55 (b) The name and title of any supervising medical educator 56 who will be present or will be providing direct supervision to 57 any medical or nursing student, resident physician, intern, or 58 fellow in fellowship training during the provision of medical 59 care or treatment to the patient while the patient is under 60 anesthesia. 61 (c) A statement that any observation of or participation by 62 a medical or nursing student, a resident physician, an intern, 63 or a fellow in fellowship training in the provision of medical 64 care or treatment to the patient while the patient is under 65 anesthesia will be: 66 1. Directly related to the patient’s diagnosis and medical 67 care and treatment plan established by the patient’s attending 68 health care practitioner; 69 2. Part of medical research being conducted by the medical 70 or nursing student, resident physician, intern, or fellow in 71 fellowship training; or 72 3. Part of the clinical training being provided to the 73 medical or nursing student, resident physician, intern, or 74 fellow in fellowship training. 75 (d) A series of check boxes that allow the patient or the 76 patient’s legal representative to indicate whether he or she 77 consents or withholds consent to: 78 1. The presence of medical or nursing students, resident 79 physicians, interns, or fellows in fellowship training to 80 observe the provision of medical care and treatment to the 81 patient while the patient is under anesthesia only for the 82 purpose of conducting medical research or receiving clinical 83 training; or 84 2. The participation of medical or nursing students, 85 resident physicians, interns, or fellows in fellowship training 86 in the provision of medical care and treatment to the patient 87 while the patient is under anesthesia for the purpose of 88 conducting medical research or receiving clinical training. 89 (e) A signature line designated for the patient or the 90 patient’s legal representative. 91 (f) A signature line designated for the patient’s attending 92 health care practitioner and the supervising medical educator, 93 if different from the patient’s attending health care 94 practitioner. 95 (4) A patient may amend or revoke his or her consent, 96 verbally or in writing, at any time before the procedure begins 97 or before the anesthesia is administered, whichever occurs 98 earlier. 99 (5) If a patient consents to have medical or nursing 100 students, resident physicians, interns, or fellows in fellowship 101 training observe or participate in the provision of medical care 102 or treatment to the patient while under anesthesia, the 103 patient’s attending health care practitioner must do all of the 104 following: 105 (a) Inform the patient of his or her right to amend or 106 revoke his or her consent at any time before the procedure 107 begins or before anesthesia is administered, whichever occurs 108 earlier. 109 (b) Document in the patient’s medical record the name of 110 each medical or nursing student, resident physician, intern, or 111 fellow in fellowship training who examined the patient or 112 observed or participated in the provision of medical care or 113 treatment to the patient while the patient was under anesthesia. 114 (6) A patient’s attending health care practitioner and a 115 supervising medical educator, if different from the attending 116 health care practitioner, who fails to comply with this section 117 is subject to discipline by the applicable board, or the 118 department if there is no board. 119 Section 2. This act shall take effect July 1, 2020. 120 121 ================= T I T L E A M E N D M E N T ================ 122 And the title is amended as follows: 123 Delete everything before the enacting clause 124 and insert: 125 A bill to be entitled 126 An act relating to informed consent; creating s. 127 456.51, F.S.; requiring health care practitioners to 128 obtain informed consent from the patient or the 129 patient’s legal representative in order to perform 130 examinations on or provide medical care or treatment 131 to the patient, with exceptions; specifying 132 circumstances under which an attending health care 133 practitioner may allow certain unlicensed individuals 134 conducting medical research or receiving clinical 135 training to observe or participate in the provision of 136 medical care or treatment to a patient under 137 anesthesia; requiring the attending health care 138 practitioner to obtain from the patient or the 139 patient’s legal representative separate written 140 informed consent to do so; specifying requirements for 141 the written informed consent form; providing that a 142 patient may revoke or amend consent verbally or in 143 writing within a specified timeframe; requiring the 144 attending health care practitioner to inform the 145 patient of specified information and to document 146 specified information in the patient’s medical record 147 under certain circumstances; providing for 148 disciplinary action against attending health care 149 practitioners or supervising medical educators who 150 fail to comply with certain provisions; providing an 151 effective date.