Process

1. Always provide an appropriate gown, allow privacy for undressing and dressing, and employ appropriate disrobing and draping practices to maximize the patient’s physical privacy.
2. Students or other parties are not to observe or conduct sensitive examinations, treatment, procedures, or consultations without the patient’s informed consent.
3. Universal Precautions shall be followed for sensitive examinations, treatments, procedures, or consultations, or direct digital contact with oral mucosal areas.
4. A clear explanation of the nature of any examination or treatment must be given to the patient, and, as applicable, the Chaperone, Support Person, parent, and/or the patient’s legally authorized representative.
   1. Written explanations stating how and why sensitive examinations, treatments, procedures, or consultations are to be performed will be provided to patients.
5. Informed consent will be obtained prior to beginning any sensitive examinations, treatments, procedures, or consultations.
   1. If the patient is under the age of 18, lacks decision-making capacity, or declines to participate in decision-making, the provider will obtain informed consent from the patient’s legally authorized representative.
   2. If the patient is under the age of 18, the provider will obtain informed consent from the patient's parent or guardian, except where the minor patient is legally permitted to consent to care.
   3. No sensitive examination, treatment, procedure, or consultation can be performed until informed consent is obtained, or a provider makes a determination that the patient needs immediate medical care and further delay would increase the risk to the patient's life or health.
   4. Informed consent to a sensitive examination, treatment, procedure, or consultation will be documented in the medical record.
   5. Patients will have an opportunity to consult with the Provider to resolve any questions or concerns prior to treatment.
   6. Patients will be notified of the right to terminate an examination, treatment, procedure, or consultation at any time.
6. For any physical examinations of a patient under the age of 18, the parent, guardian, legally authorized representative, must be present unless:
   1. the minor is legally permitted to consent to the care and has chosen not to involve a parent or guardian;
   2. the parent or guardian is unavailable; or
   3. the presence of the parent or guardian may interfere with the examination or
      the patient's care, including circumstances involving suspected abuse,
      reproductive health, or mental health services.
      • When a parent, guardian, legally authorized representative is not
        present, the circumstances supporting the exception should be
        documented in the medical record.
7. A patient’s request to have a Support Person present will always be honored.
8. Education on the role of a Chaperone will be provided to patients.
9. Patients will be notified of the availability of a Chaperone in a clinic’s “welcome letter” and posting in examination rooms.
10. A Chaperone will be made available to any patient upon request, even if the patient has a Support Person present. Patients, parents, legally authorized representatives, Support Persons, and Providers may request a Chaperone at any time.
11. If a Chaperone is requested and none is available at that time, the patient must be given the opportunity to reschedule their appointment within a reasonable timeframe.
12. The patient’s wishes and comfort should determine the gender of the Chaperone. To the extent practicable, the patient’s request for a same gender Chaperone will be accommodated.
13. Chaperones are required for all sensitive examinations, treatments, procedures, or consultations unless specifically declined in writing by a patient, parent, guardian, or legally authorized representative.
    1. The name of the Chaperone must be documented in the medical record.
    2. If a patient, parent, guardian, or authorized legal representative declines a Chaperone for a sensitive examination, treatment, procedure, or consultation, the declining patient, parent, guardian, or authorized legal representative must sign a document indicating that they were offered a Chaperone, but declined, before the examination, treatment, or procedure may proceed.
    3. In the event a patient requires successive visits for the same sensitive examination, treatment, procedure, or consultation, a conditional waiver may be used, given that the duration of the waiver does not exceed six months.
       • Clinics wishing to use a conditional waiver must obtain approval from MSU Health Care Executive Leadership, MSU Health Care Compliance and Risk, Title IX, and the MSU Health Care Governing Board.
14. Providers who violate this Policy will be subject to disciplinary action, up to and including termination of employment or appointment with MSU. MSU Health Care reserves the right to administratively reassign or revoke privileges should a policy violation be determined.