Keep your fingers out of other people's pies

[Guinastasia]

@Kobal2

They’re not. I’m just saying, just because the patients are unconscious, doesn’t make the pelvic training useless from a medical point of view.

No, but without consent, it DOES make it unethical.

[Mama_Zappa]

There was a bit brouhaha about this in the US a couple of years back and the practice was stopped.

Done without consent, without any reason to do so for the patient’s benefit, it is assault, pure and simple.

Edited to add: done with consent, go for it. I’ve had procedures done in teaching hospitals and my assumption is that the primary doctor is there hovering over the student’s shoulder and making sure it’s done right. While gyno stuff hasn’t been a factor yet, I would assume the same would apply.

How many men would expect a prostate exam if they were having hemorrhoids worked on?

[Shot_From_Guns]

@Kobal2

From an objective perspective, yes, it’s the same thing.

No, one is a picture, the other is the real thing. By your reasoning, I can fuck every guy I’ve ever seen in a porno without his consent.

@MeanOldLady

[C]an someone explain why I’ve consented to every pelvic exam I’ve ever undergone, but were I to have to be unconscious for whatever reason, they can just neglect to inform me about an upcoming exam while unconscious, and that’s totally cool?

Exactly.

@mhendo

If exams like this are “no big deal,” why can’t the med students practice on each other? The women can act as guinea pigs for the Ob/Gyn exams, and the guys can be the test dummies for proctological exams.

Winner.

@MOIDALIZE

Maybe final exams were coming up and the students were cramming.

Only if they were going three at a time.

@Waenara

Speaking as someone who has undergone several surgeries with general anesthesia, and as a nursing student, all of the pre-surgery informed consent forms I have personally seen that are used in my area include a statement to the effect that students may be involved in the procedure.

Exactly–the students are involved in the procedure that you know you’re going to undergo and have consented to. Not this other procedure that you know nothing about and they’re just going to sneak in any way, because, hey, that makes it easier for them.

@Kobal2

Look, it’s beyond obvious that if they can afford the luxury of asking consent for the exams without the percentage of refusals affecting the quality of their teaching, then yes, of course they should ask for consent. My point is that, if as I suspect the *actual *number of people giving their consent to be touched by students is abysmal, and thus the choice is between quality teaching for doctors and not offending you, then better doctors wins hands down IMO. Needs of the few, needs of the many, all that jazz.

Well, those doctors probably need to practice appendectomies, too. So why don’t they just remove your appendix while you’re in there? After all, it’s not like you need it for anything. And it might even benefit you, because now you’ll never have appendicitis! Needs of the few, needs of the many, all that jazz.

In case you couldn’t tell, I think you’re unethical *and *retarded.

[Malthus]

@Waenara

The newspaper article says “unrelated”, but as someone with a little bit of medical knowledge (but definitely not a doctor and only halfway to being a nurse), IMHO a pelvic exam during a hysterectomy would be “not required” but not “unrelated”. If you’re already up in stirrups and having an invasive surgery through your vagina, I can see how some doctors and med schools might justify doing a pelvic exam. Not that I necessarily agree with them, and if I were one of those students I would have to think about it, but I can see where they’re coming from.

As for “without your knowledge”, we haven’t seen the consent forms and we weren’t present when the patient was given the informed consent. The newspaper article paints it as if none of these patients had any clue what was going on and that practically every med school and med student does this. However, from my experience and from reading the comments of physicians and med students at the bottom of the linked article, failing to get informed consent is not standard practice in Canada. Maybe it happens at a few places, and maybe the informed consent needs to be more thorough.

To follow up on the “specific consent” idea - many consent forms are vague and try to cover the broad brushstrokes of what will occur. They don’t detail every person who may or may not be present in the OR and what each person will or will not do. “Informed consent” versus “specific consent” for every detail is somewhat different. I feel very strongly that getting informed consent is important and making sure that patient’s fully understand the procedure is important, but everyone will draw a different line on how detailed it needs to be. It’s hard to judge after the fact from a newspaper opinion piece that’s scant on details and verifiable facts.

Yup, to my mind this is the issue: we don’t know the specifics of the informed consent procedure. The issue in the article is lack of sufficiently specific consent, which may be a perfectly valid concern; it may not however be totally straightforward, as we do not know what the patients were told or what they signed.

[Kobal2]

@Shot_From_Guns

No, one is a picture, the other is the real thing.

Ah. So there’s no invasion of privacy if it’s “just a picture”. Got it. Glad you could clear that up for us.

Well, those doctors probably need to practice appendectomies, too. So why don’t they just remove your appendix while you’re in there? After all, it’s not like you need it for anything. And it might even benefit you, because now you’ll never have appendicitis! Needs of the few, needs of the many, all that jazz.

Hmmm. Tell you what : I’m going to wait until you get a head of steam, get your rhetorical shit really in gear, and compare me to Mengele or the Tuskegee doctors. C’mon, you *know *you can do better than appendixes ! So, do over. Second chance. Go !

[billfish678]

I always though pie holes were on the other end. The phrase “quit stuffing your pie hole” will never have quit the same ring to it for me after this.

[Shot_From_Guns]

@Kobal2

Ah. So there’s no invasion of privacy if it’s “just a picture”. Got it. Glad you could clear that up for us.

It’s about what usually requires consent. Presumably, you’ve consented to have the x-rays, test results, etc. shared.

A gynecological exam absolutely requires consent if the person is conscious. There should be no difference when the person is unconscious. “Unable to give consent” does not equal “automatic consent for anything that would be convenient for us.” It’s one thing to perform a necessary procedure on a patient who is currently unable to give consent because there was no opportunity; it’s another entirely to not ask for consent for an unecessary (for the patient) procedure when you have plenty of opportunity to do so, simply because it would be inconvenient for you if the patient declines.

Hmmm. Tell you what : I’m going to wait until you get a head of steam, get your rhetorical shit really in gear, and compare me to Mengele or the Tuskegee doctors.

I apologize–I was busy with actual work yesterday, so I was rushing. I really should have said that you should practice circumcisions or de-clawing.

A bris in in every operating theater!

@billfish678

I always though pie holes were on the other end.

Well, there’s your pie, and there’s your pie hole. The difference is subtle, yet key.

[JohnT]

Every time I read the thread title, I subconciously hear Paul McCartney sing “Penny Lane!” at the end of it.

That makes me sad.

[Honesty]

@statsman1982

As Kobal2 said, I would think that someone who went to a teaching hospital for surgery would expect some level of education to be going on there.

I am probably old school but I think health care is a personal relationship between you and the specific doctor(s) involved. If med students are going to be apart of the picture, then my medical care should be free. When I call 911, I expect an officer not an officer with a clown-car-full of Police Academy recruits; similarly, when I go to the doctors office, I expect to see a real doctor not a medical student or any variation thereof. Not that I don’t think medical students wouldn’t provide good health care but that’s not what I am paying for. I’m paying for a doctor. As for the OP, I think consent should be explicitly required. General consent should** only** be allowed in select hospitals that are directly affiliated with a medical school (e.g. University of Philadelphia Hospital, UCLA Medical Center, etc etc).