Informed Consent: Disturbing Details from Larry Nassar Case

Gavel and stethoscope depicting informed consent

New details from the Larry Nassar case continue to emerge as a 233-page investigation into the Larry Nassar scandal has been released.

If you have been following this infamous Michigan-centered case, you won’t be surprised by these details or the culture of cover-up they reveal.

The investigation shows how the organizations involved – from USA Gymnastics to Michigan State University, and even the law enforcement officers who investigated Nassar – failed to protect the innocent girls who were Nassar’s victims.

The Michigan NPR podcast Believed does a good job of explaining the thing those of us on the outside can have trouble understanding.

How does a man get away with abusing young girls – in many cases in front of their parents – for so many years?

It’s not a simple answer, which is why it makes a good 8-part story. However, one of the issues central to this case is called “informed consent.”

Informed Consent

By now you may know that Larry Nassar pleaded guilty to 7 counts of sexual abuse of young girls. His sentencing hearing – where he was sentenced to 40 – 175 years in prison – ran for seven days.

As part of his plea agreement, he agreed to allow every victim who wanted to confront him to his face to do so in court.

More than 150 women and girls gave victim impact statements.

If Nassar’s case had gone to trial, his lawyers would likely have centered their defense on the question of informed consent. The Informed Consent Law governs medical treatment in this country.

Even though Nassar didn’t have a trial, the story told through the Believed podcast and other media outlets show how Nassar was able to evade detection for so long. It also shows how he routinely flouted the law of informed consent.

He Said She Said

So, how did Larry Nassar get away with his abuse for so long?

As you may know, most of the allegations brought against Nassar had to do with a practice Nassar claimed was common to the treatment of back pain and pelvic floor dysfunction. This treatment included digital penetration of the vagina or anus of a patient to manipulate muscles not otherwise accessible.

However, what many of the young girls knew at the time, and what in some cases they told their parents was happening, was a very different story.

Informed consent would have looked like this:

Nassar would have explained the procedure in detail to the patient and her parents and obtained consent, in writing. During the treatment, a parent would be present and able to view everything that was happening, and Nassar would use gloves.

The story that emerged was far different, and hard to hear.

Nassar was often alone with young girls in his office, home, or in a back room of the gym with the windows covered. When he was with girls and their parents, he would cover the girl with a towel and place his body between her and her parent who was seated in a chair.

The abuse would be hidden from the parent under the towel. And no “consent” was asked for or given.

Nassar would often proceed almost immediately to penetrate the girl, often also massaging her breasts, with no gloves and without explaining what he was going to do beforehand.

Convincing Deception

When Nassar was caught, the story he gave police was close enough to the girl’s story to convince police the girl had been mistaken. In addition, he was reported several times over the years before he was finally brought to justice.

He never denied he had penetrated the girl in question. He just brought along a PowerPoint to convince police that it was a common medical treatment.

For many years, it worked.


Ultimately, it took repeated reports of Nassar’s abuse to MSU investigators and the FBI to finally bring Nassar to justice.

Kyle Stephens, the family friend of Nassar’s whom he abused apart from his medical practice, was also instrumental in convincing police of Nassar’s crimes. The testimony led investigators to finding child pornography in Nassar’s trash.

Then there were the women who brought lawsuits against Nassar at a time when many of his victims were still afraid to do so. Remember, Nassar was extremely well-respected in his field.

Hopefully, this case sheds light on the practices of the institutions involved and how informed consent is obtained in sports medicine from now on.