pelvic exams without consent = sexual assault

[jsgoddess]

Some of the nation?s leading medical schools have abandoned a little-known, decades-old practice of letting students perform pelvic exams on women without their consent while they are under anesthesia. The schools are asking permission first.


http://www.msnbc.com/news/883838.asp?0cl=cR


My position: A pelvic exam without consent is sexual assault. Women anesthetized in these hospitals should file a class-action lawsuit and the "doctors" who promote the practice should be barred from practice.


Julie

[Archergal]

I think it's useful to note that it was the medical STUDENTS who objected to the practice.

Changes in that practice have taken place over the past five years after complaints from students who felt the exams without consent were unethical. (emphasis added)

It's encouraging, actually.

Because I'd be mad as h*ll if I found out that something like that had happened to me while I was unconscious and in no condition to say "Yea" or "Nay."

Of course if they asked me ahead of time and told me what it was for, I'd probably say "Sure! Go ahead!"

Being able to decide for myself makes all the difference.

[In Conceivable]

Anesthetized women are the perfect subjects, doctors said, because they are relaxed and unable to feel the sometimes painful mistakes of novice examiners.

This really bothered me. I don't know if I would call it sexual assault since there isn't anything sexual about a pelvic exam by a doctor. However, it is unethical preform unneeded medical exams on unconsious women with out their consent. Especially exams where there might be "painful mistakes".

[scout1222]

It's not sexual in my mind, just horribly stupid. It just happens that the procedure they're doing under anesthesia happens to be on sexual parts.

My eyes about popped out of my head when I read this yesterday in the WSJ. Whoever thought this was appropriate in the first place? I can't imagine ANY woman being happy to find this out after the fact.

But even if it was a different procedure (I don't know what off the top of my head), I think it would still be in just as bad taste.

[Janie Jones]

It should be pointed out that these procedures were only done on women who signed consent forms stating : because you are in a "teaching hospital", doctors may use your stay here to teach medical students.

So, the hospitals had [i]something to cover their arses, but still, this stuff was put in such general terms that I seriously doubt that the women agreeing to this had any idea that this kind of procedure might happen.

This is called "informed consent" -- but is it really? I find it shocking that this kind of "consent" procedure would be approved by a hospital's IRB*

I mean, how many women would sign up for such medical exams if it were specifically spelled out for them? I sure wouldn't.

I'll donate my body to science, 'coz only then would I truly not care.

* Institutional Review Board, a supposedly independent committee that rules on whether medical procedures, especially clinical trials, are handled ethically.

[Eva Luna]

I would definitely consider a pelvic exam under these circumstances to be assault. When I am giving consent to be used as a teaching tool, IMO any procedure they perform on me should be directly related to the reason I am in the hospital. If I need a pelvic exam for related medical reasons, it is reasonable to inform me of this possibility before subjecting me to one. If there is no reason for me to have a pelvic otherwise, then don't let a medical student give me one.

I mean, geez, what other unnecessary and invasive stuff are they going to do to me while I'm out cold? I understand and support the purpose of teaching hospitals, but I'm a person, not a demonstration dummy!

[Cat Fight]

Eww. Creepy. It reminds me of that extremely disturbing episode of Law&Order where Dr. Olivet is anaesthetised and raped by a gyno (shudder).

[Finagle]

Just to be clear, a careful reading of the article indicates that the women were undergoing gynecological procedures, and that the surgeon would have done an exam previous to the operation to verify that the condition being corrected existed. So the problem is not that the women were undergoing, say, gall bladder surgery and had their private parts examined. It's that given the extremely private nature of the part of the anatomy being examined, the students felt that the patients should be giving informed consent before more than the absolute minimum required number of people did the exam.

So, sexual assault? No, no more than having a student test knee reflexes would be considered assault and battery. Insensitivity on the part of the medical establishment? Yup.

[Avalonian]

Originally posted by Cat Fight
Eww. Creepy. It reminds me of that extremely disturbing episode of Law&Order where Dr. Olivet is anaesthetised and raped by a gyno (shudder).

Damn, I still remember that episode. The tape they played was the worst part. Yuch.

The OP isn't on that level of creepiness, though. I agree with Finagle and scout1222 that I wouldn't really consider it "sexual" assault. It's incredibly short-sighted and insensitive to the women for the hospital not to have considered this before, but not really sexual in nature.

And like Archergal, I'm also encouraged that the students are the ones pushing for change. This says to me that they see their patients (even the "learning experience" ones) as more than pieces of meat. It's a good thing.

[jsgoddess]

Originally posted by Avalonian
The OP isn't on that level of creepiness, though. I agree with Finagle and scout1222 that I wouldn't really consider it "sexual" assault. It's incredibly short-sighted and insensitive to the women for the hospital not to have considered this before, but not really sexual in nature.


To me, the nature of the examination turns this into sexual assault. Because the areas being touched are "sexual" areas.

And I don't really consider it akin to a student checking for reflexes. Obviously, not only are our cultural standards different when it involves nudity and genitalia, but the standards in the medical profession are different. I might be in the examination room with only a doctor if he's banging my knee with a hammer, but if he's giving me a pelvic exam there will always be a female person present.

To call this "insensitive" seems to diminish the grossness of the violation, to me. This isn't insensitive. It is a gross violation of the patient's trust and privacy.

Julie

[Merneith]

QUOTE]It's not sexual in my mind, just horribly stupid. It just happens that the procedure they're doing under anesthesia happens to be on sexual parts.[/QUOTE]

an anesthetized patient offers a terrific opportunity for medical students to practice colonoscopies, inserting penile catheters, IV shunts, nasal feeding tubes, prostate exams - heck, all sorts of potentially difficult, uncomfortable and painful tests that doctors need to practice.

So are the students performing those tests too and we just haven't heard about it yet?

Or are they only practicing on women's sexual organs?

If it's the latter, I don't see how this can possibly be consider a non-sexual matter.

(not jumping on the poster I've quoted, only it made a useful starting point)

[drachillix]

Originally posted by jsgoddess
A pelvic exam without consent is sexual assault. Women anesthetized in these hospitals should file a class-action lawsuit and the "doctors" who promote the practice should be barred from practice.

So med students should be able to perform surgical procedures but not perform the exam to evaluate the situation before they start cutting? Did you notice your link specified gynecological procedures?

The medical profession does not have a lot of the "body hang ups" that many commonly do. I saw unclothed people all the damn time.

To me, the nature of the examination turns this into sexual assault. Because the areas being touched are "sexual" areas. If it is relevant to the procedure is no more assault than the procedure itself.

I might be in the examination room with only a doctor if he's banging my knee with a hammer, but if he's giving me a pelvic exam there will always be a female person present.

Uh huh.

To call this "insensitive" seems to diminish the grossness of the violation, to me. This isn't insensitive. It is a gross violation of the patient's trust and privacy. When I was an EMT student I helped work on plenty of unconscious people. All aspects of the medical profession use supervised hands on training to some degree or another.

A patient could have easily encountered a trainee surgical tech who trimmed her pubic hair. Maybe a nursing student who is assisting with the procedure, might also perform the exam (and no not all nursing students are female).

The nature of the procedure does not make it somehow inappropriate for students to participate in it. In fact its usually better that a student encounters something this "controversial" as a student, so they are not so timid about it if they need to do it later on their own. Something else to note, its not like you get a line of 20 students checking someone. Students doing the practical portion of their training are usually 1-1 or 2-1 with a licenced staff member.

Would it matter to you if these students were student obstetricians or gynecologists? All of these people are required to do X number of exams as part of their training and its not like they are stopping by to fist the lady on the table for a quick thrill. The 3-4 mentioned is a little excessive, I would be willing to bet that a rotation was ending and several people were "short" on exams. Otherwise there would be no reason to do anything of the sort.

[buttonjockey308]

Here's my 2 cents...

1. There is no sexual assault in this case, because the root cause for the battery (not assault) is not sexual.

2. If someone touches you without your consent, it is battery. Period.

However...

Somewhere, someone has drafted a hold harmless agreement making sure that docs aren't jammed up when this kind of things takes place, so it's quite likely that these women are agreeing to these exams, whether they know it or not.

[papergirl]

I would consider it battery, and the fact that it was not specifically spelled out in whatever documents patients signed tells me that the hospital was aware that at least some patients would hold the same viewpoint.

Other options:
1. Ask me in clinic, during my gyno exam, if a student can examine me. Sure, no problem.
2. Ask me, before I undergo surgery, if a student may examine me while I'm under. Sure, if I feel comfortable with the doctor and the situation.
3. Bring in a med student without my knowledge and allow him/her to examine me while I'm out like a light: Oh no. Don't think so.

I admire the standards of the students who came forth about it.

[DreadCthulhu]

If the women signed a form saying they could be used for teaching med students, I have no problem with this or any other type of exam.

[drachillix]

Originally posted by bodypoet
I would consider it battery, and the fact that it was not specifically spelled out in whatever documents patients signed tells me that the hospital was aware that at least some patients would hold the same viewpoint.

:smack:

Or it would be a total nightmare to have a form spelling out the details of every step of every procedure, technique, drug, and tool that may be used in any given one of thousands of procedures that a hospital might perform on a given day for you to review and authorize every step of. You have questions or concerns, ask your doctor before it happens.

What part of "students may participate in your care" does not cover this exam.

[drachillix]

Originally posted by jsgoddess
I might be in the examination room with only a doctor if he's banging my knee with a hammer, but if he's giving me a pelvic exam there will always be a female person present.

upon later reflection I decided my "Uh huh" might be misinterpreted without the :rolleyes:

I asked my wife about this last night. Her hospital has no such policy. I seriously doubt its common policy for acute care hospitals in general.

Upon what basis do you demand that a "woman" must be present. Think hard, the easy obvious answer is pretty much irrelevant.

[irishgirl]

jsgoddess, I'm a medical student, and um, female.
As is 60% of my class.
Some of the students (and doctors) performing these examinations (which BTW I agree are unethical) were almost definitely women.

The exam would have been carried out by the surgeon anyway, they were letting the students do one too, as a teaching experience...the practice is in the best interests of patients BUT, INFORMED CONSENT SHOULD ALWAYS BE OBTAINED.

Also, it is your right to refuse a chaperone, should you wish to (in the UK 15% of women refuse chaperones when offered).

[papergirl]

Originally posted by drachillix
Or it would be a total nightmare to have a form spelling out the details of every step of every procedure, technique, drug, and tool that may be used in any given one of thousands of procedures that a hospital might perform on a given day for you to review and authorize every step of. You have questions or concerns, ask your doctor before it happens.

What part of "students may participate in your care" does not cover this exam.

Note that I didn't suggest a form "spelling out the details," etc, and I don't believe anyone else is suggesting that either.

Some of us are suggesting, however, that a patient should be informed if a student will be performing a pelvic exam. Pelvics are, frankly, not exactly on par with having a student observe the bump I have on my forehead.

I don't believe it would be a "total nightmare" at all. How hard is it to add "...including gyneclogical procedures and exams" to the consent form signed by gyno patients? Most doctors take a few moments to discuss the procedure with the patient beforehand; it would be simple enough to explain the situation and get permission then.

Considering what a big surprise this is to most people, I don't imagine that everyone would have had the foresight to ask their doctors beforehand.

Re: chaperones. I've never requested one, but they have always been available (with prominent signs stating this policy) in my doctors' offices. I did have one doctor who wouldn't do pelvics at all without a chaperone (he was a ob gyn). The availability of chaperones seems to be pretty standard here.

[Maximum C]

Do you all really want to suggest that a doctor has to treat your genitals differently from the rest of your body because we generally cover them with cloth when we're around other people?

A doctor is in the business of examining and fixing the human machine. To the extent that everyone is uncomfortable when told to turn their head and cough, there is some socail unpleasentness with the procedure sometimes. But if the doctor is just doing his job, what the hell is the problem? If I was in the hospital for surgery after I'd gotten my johnson stuck in the vaccuum cleaner, and I agreed that students could watch my care, am I gonna bitch afterwards that I was sexually assulted when they grab ahold of my pork and beans?

I know the context of the discussion is just educational examinations, but look at the consequences of the philosophy you're suggesting. Doctors (and nurses, even MORE so) are already held at gunpoint by malpractice law in America today, to the point where we're getting a shortage of qualified medical personal in alot of places. Do we really want to add MORE liability to their job because some people feel like their vagina is a magical portal into the realm of fairies and unicorns? Do you want a doctor to hestitate to check your crotch for injuries after you're in an automobile accident because it's a sacred zone?

Or would you rather the doctor finds everything wrong with you and then fixes it?

-C

[Lamia]

I would hesitate to call this sexual assault. I mean, if some guy you meet at a bar decides he's going to give you a "pelvic exam" whether you like it or not then that's certainly sexual assault, but this is a legitimate medical examination performed by qualified medical students under proper supervision.

However, I think it is a violation of professional ethics. It sounds like in many of these cases the pelvic exam by the medical student is not actually a necessary part of the patient's care (although the exam by the physician might be). Patients have the right to make an informed decision as to what will be done to their bodies, especially when it comes to exams that are more for the benefit of the medical students than the patient herself.

[papergirl]

I would happily let students poke around my nether regions, as long as I am informed beforehand.

I think that the reaction of women to the idea is going to be quite varied. Personally, I don't have qualms about the practice exams themselves, but I do have an issue with the idea that they might be performed without my informed consent.

And I'm not even all that private about such things. I know several women who would be terribly upset to find out that something like this occurred, regardless of the medical context in which it happened. Perhaps they have religious beliefs about the sanctity of their bodies, maybe they are just intensely private, maybe they feel that the pelvic exam is a fairly invasive procedure that they don't want anyone but their trusted doctor to perform. If my mother found out that this happened to her, she would have an absolute cow.

Like it or not, not all women are going to be as cavalier about their bodies as you might be after that...um...vacuum cleaner incident.