Act 346 of 2021

Act 346 of 2021, titled “An Act to Prohibit the Performance of a Pelvic Examination on an Unconscious or Anesthetized Patient without the Prior Consent of the Patient,” was passed during the regular session of the 2021 Arkansas General Assembly. The law included Arkansas in a growing number of states that had begun to outlaw a practice long used for the training of medical students.

Before the early twenty-first century, conducting pelvic examinations upon women who were anesthetized was common practice in the training of medical students. Many women would not even be aware that they had undergone such an examination, as it would not show up on any hospital billing. However, changing cultural norms began to call this practice into question. By the time Elle magazine ran an exposé of the practice in its August 2019 issue, nine states had outlawed such non-consensual examinations; these states tended to be more politically progressive but also included Iowa and Utah, with Virginia and Maryland being the only southern states included. Elle reported that sixty-one percent of medical students it had surveyed had reported performing such a pelvic examination on an unconscious female patient without explicit consent.

HB1137, the bill to outlaw non-consensual pelvic examinations in Arkansas, was sponsored by Representative DeAnn Vaught, a Republican of Horatio (Sevier County), and co-sponsored by Representative Michelle Gray, a Republican of Melbourne (Izard County). The bill was filed in the House on January 11, 2021, and, after being amended, passed the House on February 25, 2021, with no nay votes. The bill passed the Senate on March 10, 2021, again with no opposition, and was signed into law by Governor Asa Hutchinson on March 15, 2021. The law requires that any pelvic examination conducted on an unconscious or anesthetized person be performed only after receiving explicit consent. Also, it must be medically related to the procedure being undertaken, performed only by someone “who has been made known to the patient,” and conducted under supervision. Violations are to be referred to the “appropriate licensing board or medical education program.”

A 2023 NBC News report estimated that more than 3.5 million patients had been subjected to non-consensual pelvic examinations within the previous five years. By the time of the NBC News report, twenty-five states had outlawed such examinations. In 2024, the U.S. Department of Health and Human Services issued official guidance requiring that doctors receive written, informed consent from patients for any breast, pelvic, prostate, and rectal examinations that are conducted for “educational and training purposes,” especially if the patient will be unconscious during the examination.

For additional information:
Bose, Devna. “Hospitals Must Obtain Written Consent for Pelvic and Similar Exams, the Federal Government Says.” Associated Press, April 2, 2024. https://apnews.com/article/pelvic-exams-consent-federal-government-hhs-52331c180249daa1aa12c470f8d70061 (accessed August 22, 2024).

HB1137 of 2021. Arkansas General Assembly. https://www.arkleg.state.ar.us/Bills/Detail?id=HB1137&ddBienniumSession=2021%2F2021R#status (accessed August 22, 2024).

“More than 3.5 Million Patients Given Pelvic Exams without Consent, Study Estimates.” NBC News, September 19, 2023. https://www.nbcnews.com/nightly-news/video/more-than-3-5-million-patients-given-pelvic-exams-without-consent-study-estimates-193321541876 (accessed August 22, 2024).

Plantak, Mihael, Scott M. Alter, Lisa M. Clayton, Patrick G. Hughes, Richard D. Shih, Monica Mendiola, and Joshua J. Solano. “Pelvic Exam Laws in the United States: A Systematic Review.” American Journal of Law and Medicine 48, no. 4 (2022): 412–419. Online at https://doi.org/10.1017/amj.2023.4 (accessed August 22, 2024).

Tsai, Dr. Jennifer. “Medical Students Regularly Practice Pelvic Exams on Unconscious Patients. Should They?” Elle, August 2019. https://www.elle.com/life-love/a28125604/nonconsensual-pelvic-exams-teaching-hospitals/ (accessed August 22, 2024).

Staff of the CALS Encyclopedia of Arkansas