LRB-3809/1
MED:eev:jm
2013 - 2014 LEGISLATURE
January 31, 2014 - Introduced by Representative Czaja, cosponsored by Senators
Grothman, Lasee and Tiffany. Referred to Committee on Judiciary.
AB692,1,4
1An Act to renumber and amend 448.695 (1); and
to create 446.02 (11), 446.08,
2447.02 (2) (f), 447.40, 448.695 (1) (b), 448.697 and 449.25 of the statutes;
3relating to: a duty of podiatrists, chiropractors, dentists, and optometrists to
4inform patients of treatment options and granting rule-making authority.
Analysis by the Legislative Reference Bureau
Under Wisconsin's physician informed consent law, a physician who treats a
patient has a duty to inform the patient about treatment options. A physician who
fails to so inform a patient about modes of treatment may be held civilly liable for
damages under tort law. This common law duty, as it relates to physicians, has been
codified as a statutory duty.
In the case Hannemann v. Boyson, 2005 WI 94, the Wisconsin Supreme Court
wrote that this duty to inform a patient about treatment options was not necessarily
limited to physicians, and the court held in Hannemann that a chiropractor had such
a duty to inform a patient. The duty, as it relates to chiropractors or any other types
of health care professionals other than physicians, has not previously been codified
as a statutory duty.
2013 Wisconsin Act 111 modified the codified duty of physicians to inform a
patient about treatment options in a number of ways, including: 1) providing that
the "reasonable physician standard," as defined in the act, is the standard for
informing a patient and 2) providing that the physician's duty does not require the
disclosure of information about alternate medical modes of treatment for any
condition the physician has not included in his or her diagnosis at the time the
physician informs the patient.
This bill codifies into the statutes a similar duty to inform a patient about
treatment options with respect to the following types of health care professionals:
1) chiropractors; 2) dentists; 3) podiatrists; and 4) optometrists.
Specifically, the bill provides that any chiropractor, dentist, podiatrist, or
optometrist who treats a patient must inform the patient about the availability of
reasonable alternate modes of treatment and about the benefits and risks of these
treatments. The bill provides that the reasonable chiropractor, dentist, podiatrist,
or optometrist standard, whichever is applicable, is the standard for informing a
patient under that duty. The bill provides that this standard requires disclosure only
of information that a reasonable chiropractor, dentist, podiatrist, or optometrist
would know and disclose under the circumstances. The bill provides that a
chiropractor's, dentist's, podiatrist's, or optometrist's duty to so inform the patient
does not require disclosure of any of the following:
1) Detailed technical information that in all probability a patient would not
understand.
2) Risks apparent or known to the patient.
3) Extremely remote possibilities that might falsely or detrimentally alarm the
patient.
4) Information in emergencies where failure to provide treatment would be
more harmful to the patient than treatment.
5) Information in cases where the patient is incapable of consenting.
6) Information about alternate modes of treatment for any condition the
chiropractor, dentist, podiatrist, or optometrist has not included in his or her
diagnosis at the time the chiropractor, dentist, podiatrist, or optometrist informs the
patient.
Also under current law, the Medical Examining Board must promulgate rules
implementing the physician's duty to inform a patient about treatment options, as
codified into the statutes. This bill similarly requires the Chiropractic Examining
Board, the Dentistry Examining Board, the Podiatry Affiliated Credentialing Board,
and the Optometry Examining Board to promulgate rules implementing the
chiropractor's, dentist's, podiatrist's, and optometrist's duties to inform a patient
about treatment options, as those duties are codified into the statutes by the bill.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB692,1
1Section
1. 446.02 (11) of the statutes is created to read:
AB692,2,32
446.02
(11) The examining board shall promulgate rules implementing s.
3446.08.
AB692,2
1Section
2. 446.08 of the statutes is created to read:
AB692,3,9
2446.08 Informed consent. Any chiropractor who treats a patient shall inform
3the patient about the availability of reasonable alternate modes of treatment and
4about the benefits and risks of these treatments. The reasonable chiropractor
5standard is the standard for informing a patient under this section. The reasonable
6chiropractor standard requires disclosure only of information that a reasonable
7chiropractor would know and disclose under the circumstances. The chiropractor's
8duty to inform the patient under this section does not require disclosure of any of the
9following:
AB692,3,11
10(1) Detailed technical information that in all probability a patient would not
11understand.
AB692,3,12
12(2) Risks apparent or known to the patient.
AB692,3,14
13(3) Extremely remote possibilities that might falsely or detrimentally alarm
14the patient.
AB692,3,16
15(4) Information in emergencies where failure to provide treatment would be
16more harmful to the patient than treatment.
AB692,3,17
17(5) Information in cases where the patient is incapable of consenting.
AB692,3,20
18(6) Information about alternate modes of treatment for any condition the
19chiropractor has not included in his or her diagnosis at the time the chiropractor
20informs the patient.
AB692,3
21Section
3. 447.02 (2) (f) of the statutes is created to read:
AB692,3,2222
447.02
(2) (f) Provisions implementing s. 447.40.
AB692,4
23Section
4. 447.40 of the statutes is created to read:
AB692,4,5
24447.40 Informed consent. Any dentist who treats a patient shall inform the
25patient about the availability of reasonable alternate modes of treatment and about
1the benefits and risks of these treatments. The reasonable dentist standard is the
2standard for informing a patient under this section. The reasonable dentist standard
3requires disclosure only of information that a reasonable dentist would know and
4disclose under the circumstances. The dentist's duty to inform the patient under this
5section does not require disclosure of any of the following:
AB692,4,7
6(1) Detailed technical information that in all probability a patient would not
7understand.
AB692,4,8
8(2) Risks apparent or known to the patient.
AB692,4,10
9(3) Extremely remote possibilities that might falsely or detrimentally alarm
10the patient.
AB692,4,12
11(4) Information in emergencies where failure to provide treatment would be
12more harmful to the patient than treatment.
AB692,4,13
13(5) Information in cases where the patient is incapable of consenting.
AB692,4,16
14(6) Information about alternate modes of treatment for any condition the
15dentist has not included in his or her diagnosis at the time the dentist informs the
16patient.
AB692,5
17Section
5. 448.695 (1) of the statutes is renumbered 448.695 (1) (intro.) and
18amended to read:
AB692,4,2019
448.695
(1) (intro.) The affiliated credentialing board shall promulgate
all of
20the following rules
defining:
AB692,4,22
21(a) Rules defining the acts or attempted acts of commission or omission that
22constitute unprofessional conduct under s. 448.60 (5).
AB692,6
23Section
6. 448.695 (1) (b) of the statutes is created to read:
AB692,4,2424
448.695
(1) (b) Rules implementing s. 448.697.
AB692,7
25Section
7. 448.697 of the statutes is created to read:
AB692,5,7
1448.697 Informed consent. Any podiatrist who treats a patient shall inform
2the patient about the availability of reasonable alternate modes of treatment and
3about the benefits and risks of these treatments. The reasonable podiatrist standard
4is the standard for informing a patient under this section. The reasonable podiatrist
5standard requires disclosure only of information that a reasonable podiatrist would
6know and disclose under the circumstances. The podiatrist's duty to inform the
7patient under this section does not require disclosure of any of the following:
AB692,5,9
8(1) Detailed technical information that in all probability a patient would not
9understand.
AB692,5,10
10(2) Risks apparent or known to the patient.
AB692,5,12
11(3) Extremely remote possibilities that might falsely or detrimentally alarm
12the patient.