Professor Wilson’s work on health law and bioethics legal reforms stems from her work as a health law attorney at the Texas-based law firm of Fulbright & Jaworski, LLP, as well as her work on hospital ethics committees, which serve as a resource for healthcare professionals, patients, and families. She has been involved in two different law reform efforts, the first on patient dignity and informed consent—namely, requiring specific consent to do intimate exams for teaching purposes on patients—and the second on patient safety, disclosing the role and experience levels of healthcare professionals caring for patients in teaching hospitals.
A Spotlight on Virginia
In 2007, Professor Wilson received the Citizen’s Legislative Award, presented by Virginia Delegate Robert Bell, for work on a bill ensuring meaningful informed consent in pelvic exams in teaching hospitals. In 2003, Professor Wilson used an invitation by law professor David Hyman, then special counsel to the Federal Trade Commission, to testify during the Joint Hearings on Health Care and Competition Law and Policy held by the Federal Trade Commission and the Department of Justice on June 10, 2003, to draw attention to the practice of unauthorized physical exams. Professor Wilson documented the scope and degree to which teaching hospitals in the U.S. have historically used women under anesthesia to teach intimate exams, without their knowledge and consent. In a pair of articles, Professor Wilson refuted justifications by teaching faculty for dispensing with consent. The American College of Obstetrics and Gynecology (ACOG) -- reversed course from a 1997 position that patients have “an obligation to participate in the teaching process." In 2003, the ACOG issued a one-paragraph statement affirming the importance of informed consent. If the exam offers a woman “no personal benefit and is performed solely for teaching purposes,” ACOG declared, “it should be performed only with her specific informed consent, obtained when she has full decision-making capacity.” A day after DOJ and FTC hearings in 2003, the AAMC issued a “Statement on Patient Rights and Medical Training” that labeled the performance of “pelvic examinations on women under anesthesia, without their knowledge and approval ... unethical and unacceptable.”
In 2005, Professor Wilson partnered with Delegate Robert Bell of the Virginia House of Delegates to change Virginia's informed consent law to allow medical students in clinical training programs to perform intimate exams on female patients only after obtaining “informed consent.” Va. Code Ann. § 54.1-2959.
Are Med Students Practicing on You?, Men's Health
Autonomy Suspended: Using Female Patients to Teach Intimate Exams without their Knowledge or Consent, 8 Journal of Health Care Law & Policy 240 (2005)
Unauthorized Practice: Regulating the Use of Anesthetized, Recently Deceased, and Conscious Patients in Medical Teaching, 44 Idaho Law Review 423 (2008)
Professor Wilson has sparked renewed attention on this continuing practice through her recent Opinion-Editorial and resulting news reports.
Additional Laws Requiring Permission to Do Intimate Exams for Teaching Purposes
ADDITIONAL LAWS REQUIRING PERMISSION TO DO INTIMATE EXAMS FOR TEACHING PURPOSES
At the request of a fourth-year medical student in Hawaii who was asked to do pelvic exams on unconscious patients, Professor Wilson reached out to Professor Fran Miller at the University of Hawaii School of Law to assemble a team of advocates for changing Hawaii’s law. The compelling testimony provided by two courageous students, together with empirical evidence in Professor Wilson’s scholarship, helped the measure to succeed in 2012.
Other States have adopted laws patterned on Virginia’s and Hawaii’s.
As of January 2019, ten similar bills have been introduced in eight states:
Connecticut (2019 CT S.B. 16, introduced January 11) (Robin’s testimony)
Maryland (2019 MD H.B. 364, introduced January 30) (Robin’s testimony)
Missouri (2019 MO H.B. 486, introduced January 8)
New Hampshire (2019 NH H.B. 422, introduced January 8; 2019 NH S.B. 117, introduced January 3) (Robin’s testimony)
New York (2019 NY S.B. 1092, introduced January 10) (Robin’s testimony)
Oklahoma (2019 OK H.B. 1452, introduced February 4; 2019 OK S.B. 621, introduced February 4) (Robin’s testimony)
Washington (2019 WA S.B. 5282, introduced January 16) (Robin’s testimony)
Utah (2019 UT S.B. 188, introduced February 19) [Passed the Senate unanimously March 4, 2019] (Robin’s testimony)
Disclosure of Trainee Status to Patients in Teaching Hospitals
South Carolina (2004-2005)
In 2002, Professor Wilson was approached by Helen Haskell, whose fifteen-year-old son, Lewis Blackman, had died at the Medical University of South Carolina. Helen asked Professor Wilson to assist her to fashion a package of patient protections designed to avert tragic deaths like her son’s, such as requiring health professionals to wear name tags identifying their role on the healthcare team and posting notices about how to reach an attending professional. Helen and Professor Wilson met with the Democratic Minority Leader of the South Carolina House of Representatives, Representative James Smith, who co-sponsored the bill, as well as other stakeholders in the community. Across two legislative cycles, Professor Wilson commented on draft legislation and testified in support of what ultimately became the Lewis Blackman Hospital Patient Safety Act. S.C. Code Ann. § 44-7-3410 et. seq. (Westlaw 2012).