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Bipartisan bill reintroduced to require informed consent for pelvic exams under anesthesia

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A bipartisan bill in the state Legislature would align Wisconsin with a growing number of states that require explicit informed consent before medical students practice pelvic exams on patients under anesthesia, a procedure sometimes done as part of training.

Co-sponsors and proponents of the bill spoke Thursday during an Assembly Committee on Health public hearing to urge lawmakers to join the more than one dozen other states in the country that require hospitals to get written and verbal consent from patients before pelvic exams are done under anesthesia for the educational benefit of medical students. Currently, some hospitals rely on general consent forms that don’t specify procedures done for training.

“This is going to be the easiest bill of the day,” bill co-author Rep. Rachael Cabral-Guevara, R-Appleton, said. “We’re not asking for anything but consent here.”

Speaking at Thursday’s meeting, Sarah Wright, a science teacher from Madison, recounted her experience in 2009 when she felt significant vulvar sensitivity after a surgery to remove ovarian cysts by UW doctors at UnityPoint Health-Meriter.

Nine years later in 2018, Wright needed to have another ovarian lesion removed, which went fine. Wright, who worked with former Rep. Chris Taylor, D-Madison, to bring the bill forward last session, said patients need to be informed and able to provide or deny consent before any sort of pelvic exam occurs.

“If you’re a first-time patient, it’s too much to expect that someone even knows what to ask,” Wright said. “The only way I knew what to ask is because I learned the hard way.”

Pelvic exams involve inserting fingers of a gloved hand into a patient’s vagina to examine organs including the uterus and ovaries. Surgeons do the exams before gynecologic surgeries to determine the positioning of the organs, and medical students sometimes do the exams for training.

Medical students train at academic medical centers, such as UW Hospital and Froedtert Hospital in Wauwatosa, and at some community hospitals. UW School of Medicine and Public Health in 2019 adopted a policy related to “educational sensitive exams,” including breast, pelvic, urogenital, prostate and rectal exams on patients under anesthesia or otherwise sedated.

Under the policy, doctors must obtain and document informed consent before allowing medical students to do the exams, which must be a routine part of the patient’s procedure.

In 2003, when California became the first state to pass a law requiring consent before pelvic exams on unconscious patients for teaching purposes, the American College of Obstetricians and Gynecologists said “specific informed consent” should be required. The Association of American Medical Colleges called the procedures “unethical and unacceptable” if done without consent.

When a version of the legislation was introduced last session, the Wisconsin section of the American College of Obstetricians and Gynecologists, the Medical College of Wisconsin, Wisconsin Hospital Association and Wisconsin Medical Society filed in opposition to the bill.

For the current bill, the Wisconsin Nurses Association and Wisconsin Coalition Against Sexual Assault support the measure and no groups have filed in opposition.

Nobody spoke against the measure Thursday, but bill co-sponsor Sen. Andre Jacque, R-De Pere, said some opponents of the measure have pushed back against added restrictions on medical practice. Jacque said 18 states have already passed laws requiring explicit informed consent, with Texas being the most recent.

“This is an invasive procedure and I think it clearly merits specific consent for the procedure to be performed,” he said.

Krabbe testing

Another bipartisan bill before the committee Thursday would require newborn screenings to include testing for Krabbe disease, a genetic disorder that damages the nervous system in infants.

Proponents of the bill, including the parents of children who have died as a result of the disease, said, if detected early, the disorder can be treated to provide a better quality of life.

“When it comes to detection, time is of the essence,” bill co-sponsor Rep. Todd Novak, R-Dodgeville, said.

The bill would allow an exception to testing if the child’s parents or legal guardian object on the basis of religious practices or personal convictions.

The state Department of Health Services estimated the cost of adding Krabbe disease to newborn screening tests would be $11 per infant. With roughly 61,000 births in the state in 2020, the total cost is estimated at $671,000.

Year in review: The top Madison-area stories of 2020

It started out well enough. The Badgers were making a late-in-coming run at the Final Four. Hometown insurance behemoth American Family announced it was boosting its starting minimum wage to $20 an hour. Madison East Siders welcomed a new Pinney branch library.

The first two and a half months of the year feel like a different era, when news of a strange new virus infecting people in China was safely tucked away in the back pages of the newspaper and the heart-breaking images of a white Minneapolis police officer kneeling on the neck of a 46-year-old Black man had yet to go viral.

Then came March and successive waves of closures, cancellations, lockdowns, furloughs, layoffs, infections and deaths. If the subsequent uprisings over the killing of George Floyd weren't enough to remind America that it has plenty of work to do to overcome racism, the shooting of Jacob Blake in Kenosha tragically emphasized the point. And a divisive presidential election carried the tone of the year at the end.

While it may not be a year to look back on with particular fondness, 2020 no doubt is one to remember. Here's a look back at some of the top stories in the Madison area as they occurred.

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It marked the fourth consecutive loss in the Rose Bowl for UW, and the first time since 2013 that the program lost its final two games of the year.

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Madison police spokesman Joel DeSpain said Sunday the victim who officers found in an apartment at 1905 McKenna Blvd. shortly after 2:30 p.m. Saturday was a 20-year-old African American male.

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With the Green Bay defense failing to lay a hand on 49ers running back Raheem Mostert for much of the first half and the Aaron Rodgers-led offense committing two turnovers and failing to convert a third down yet again during a scoreless first 30 minutes, the Packers dug themselves a 27-0 halftime deficit on their way to a demoralizing 37-20 loss.

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Gutierrez, superintendent of the school district in Seguin, Texas, was announced Friday as the Madison School Board's pick to lead the district.

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The person returned to Dane County Regional Airport after a trip to Beijing Jan. 30 and went directly to UW Hospital's emergency room, officials said.

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Officers found the victim, believed to be an adult male, in the 100 block of North Blair Street about 3:45 p.m. Saturday after receiving a report that a person had been shot.

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This weekend's performances at the Alliant Energy Center will be the last with elephants in Dane County as a contract between the circus and the venue expires. 

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Tony Evers said he vetoed the legislation, which uses surplus revenue, because it doesn't invest in the state's schools. 

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Despite no Wisconsin cheeses finishing in the final top three, state producers dominated the competition, earning 45 gold medals out of 132 categories.

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This decision is unprecedented for Wisconsin's largest university and taken to slow the spread of COVID-19 coronavirus.

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The closure order, to take effect no later than 5 p.m. on March 18, affects nearly 1 million Wisconsin children in grades K-12 in public and private schools.

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One was a man in his 50s from Fond du Lac County; the other was a man in his 90s from Ozaukee County.

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David A. Kahl, 53, is charged with first-degree intentional homicide.

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Tony Evers’ “safer at home” order represents a shift from the governor's position last week, when he said he did not plan on issuing such an order.

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A jogger saw a man and a woman lying in a ditch at about 6:30 a.m. Tuesday.

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Most voting locations saw few lines and smooth operations. But other places, notably Milwaukee, experienced significant delays, chaos and conditions that made it impossible for some voters to cast a ballot.

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Jill Karofsky's win over Dan Kelly cuts the court's conservative majority to 4-3, giving liberals a chance to take back control in 2023.

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The U.S. Air Force announced the final selection of the Wisconsin Air National Guard’s 115th Fighter Wing, capping more than three years of study and deep community division over the planes, which come with the promise of jobs and new construction but also noise and pollution.

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While applauded as a good first step, Democratic members, as well as public safety and health officials, have criticized the bill for not allocating more state funding to respond to the pandemic.

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For 30 years, "Ms. Milele" was the publisher of UMOJA magazine and a prominent leader in Madison's black community. She was "short in stature but mighty in force." 

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Free community testing for COVID-19 started at the Alliant Energy Center in Madison on Monday morning.

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Gov. Tony Evers and legislative Republicans will need to work quickly to come up with a replacement plan.

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Authorities identified the victim of a Friday night homicide as Nang Yee Lee, who died Monday. The suspect is hospitalized.  

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The Vilas Zoo, Goodman Pool, beaches and movie theaters are among the places not opening yet.

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There were signs early Sunday that the violence was spreading into other parts of the city.

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"It’s clear they have important process issues to work out," the candidate said.

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Protesters tore down statues of Forward and a Union Civil War colonel, assaulted a state senator and set a small fire in a city building Downtown on Tuesday night after the arrest of a Black activist seen causing a disturbance in a restaurant earlier in the day.

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School Board President Gloria Reyes said the decision to pull police from Madison's four main high schools is effective immediately. 

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Madison police are investigating a shooting Tuesday night at a Far East Side motel that left one man with life-threatening injuries.

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The Madison School Board chose Carlton Jenkins, a superintendent of a suburban Twin Cities school district, over another finalist for the job. He starts Aug. 4.

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As a Dane County public health order requiring face coverings in all indoor spaces outside the home took effect Monday, businesses offered mixed views on mandates, though for many retailers it was business as (the new) usual.

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There was no update on the second victim from the shooting at Schroeder Road and Chapel Hill Road Saturday night. 

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Travis M. Christianson, 44, is tentatively charged with first-degree intentional homicide.

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Republican President Donald Trump also has caused controversy for saying he might deliver acceptance speech at White House.

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The girl was in a car that was struck by gunfire late Tuesday morning on East Washington Avenue.

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The conference decided — after meetings between presidents and athletic directors, and outcry from players, coaches, politicians and fans — to cancel the fall sports season and will attempt to move football to the spring semester.

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"The video that came out of Kenosha is absolutely horrific. I don’t understand how people can watch it and not be here," one Madison protester said. 

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The fifth-seeded Heat finished off an upset of the NBA’s best regular-season team Tuesday, topping the Milwaukee Bucks 103-94 in Game 5 of their East semifinal series — while Giannis Antetokounmpo, the league’s reigning MVP, couldn’t play because of a sprained right ankle.

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UW-Madison is pausing in-person instruction for at least two weeks and quarantining more than 2,200 students living in two dorms.

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After 69 years as one of the leading attractions in the Wisconsin Dells area, the Tommy Bartlett Show announced Wednesday that it would close permanently after losing the 2020 season to the COVID-19 pandemic.

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Police are not recommending charges against Althea Bernstein, saying there is a difference between someone trying to deceive law enforcement and not being able to corroborate a report of a crime.

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The alternate care facility at State Fair Park in West Allis may begin taking patients Thursday.

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The two victims, ages 17 and 18, who were taken to a local hospital, suffered significant injuries but were expected to survive, acting Police Chief Vic Wahl said Saturday night.

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A small crowd Downtown Saturday morning before the race was called turned into hundreds of people honking horns, cheering and waving signs after Biden was declared the winner, while some Trump supporters turned out in protest.

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"We understand the eyes of the world will be on these Wisconsin counties over the next few weeks,"  Wisconsin Elections Commission administrator Meagan Wolfe said.

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Isai Morocho, 16, was “a caring friend and family member with a ready smile and great sense of humor,” his principal said. 

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The jet from the Wisconsin Air National Guard’s 115th Fighter Wing at Truax Field in Madison crashed Tuesday night. The status of the pilot remains unknown.

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St. Mary's and Meriter expect to get vaccine soon.

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The flurry of activity caps off a tumultuous post-election saga in Wisconsin that has now concluded.

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A look back at the year 2020 through the lens of Wisconsin State Journal photographers John Hart, Amber Arnold and Steve Apps

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