Those who want to treat this like any other procedure ignroe the fact that some
parts of the body are more private than others. In fact, the doctor who tried to
argue we should disregard mores and run roughshod over the populace has so
little understanding of the human body they should be driven from the
profession.Should eye exams and pelvic exams be treated the same? Of
course not. To even suggest that examing any part of the body has the same
social impact as examing any other type of the body is to treat patients as
The Larry Nassar case showed us that rules about having a second person present
for some procedures are disregarded even when imposed as part of TItle IX
adjudication. There is a reason why the Federal government still is running
Title IX invesigations against MSU.However while Larry Nassar is
hopefully an outlier in actions, the fact that other doctors stuck up for him so
much shows that in medicine the patient is not the primary focus for too
many.We need to shift from doing these sorts of things with limited
informed consent that is often not given with full knowledge to a situation. We
need more medical models and to have them be more key in the process, and to
also pay those who are mock patients a living wage.
It is this desire to do end runs around family beliefs that causes so many to
dislike doctors. It is this sort of condescending attitudes towards
patients that allow Larry Nassar to continue to abuse patients for almost 20
years after the first time people reported objections to his procedure. Even
more so it allow him to continue two years after a formal inquiry that started
with allegations that should have been unquestioned signs of sexual abuse.
At the University of Utah, slim women were paid to act as models for pelvic
exams. They were usually other med students making extra money.We
learned on a rubber like manikin. Then a woman would tell us whether we were
inserting the speculum correctly without hurting her and if we were doing the
bimanual exam correctly reaching the organs of the reproductive system.All very professional with instant feedback. We had paid models for taking
histories correctly and doing the rest of the physical...so models made sense.
Granted my experience is 30 years old. But it did happen, and was absolutely
appalling. My daughter was a 12 year old patient at Primary Children's
Hospital. The first night she was there I went home to sleep. The next morning
she told me that two medical students had awakened her in the middle of the
night to practice medical exams including a pelvic exam. There was no medical
reason for the exam. I insisted that no medical students be involved at all in
her care, but I was shutting the barn doors after the horse escaped.
This is so hideously wrong. We are still in the Dark Ages in women's
medicine.It's time for people to be allowed to designate a family
member to observe surgeries and procedures where the patient will be
anesthetized, to protect patients.
I have to say that this report shocks me. I am a gynecologist. It is actually my
job to perform pelvic exams on a daily basis. And from medical school through
residency I have never even heard of this being done. I did the pelvic exams
every student did on a paid live model in medical school then a few times in the
schools Gynecology clinic. It really wasn’t until my OB/GYN residency that
I really had any training to do this. My questions are where are they teaching
like this? And what in the world is the advantage for students to do it?
Especially if they have no interest in it? If it at all has anything to do with
what you will see in your specialty then you will get it in your residency in
the appropriate setting. Maybe that’s just where I trained.
Doing a pelvic exam on a dead body is significantly different from doing it on
an unconscious patient. When I have signed consent forms for
surgeries, I read them and they have appeared to be specifically referring to my
surgery and needs during surgery. Doing an unnecessary procedure without patient
consent is assault. Medical personnel can’t do anything without the
expressed consent of a patient. Using the excuse that the patient might say no
so they don’t ask is unethical at the very least. It’s certainly
very arrogant.Frankly, I think many women would be ok with it, if
asked. I would, because I believe in education. But don’t you dare do it
without my consent. For those who say no, there is usually a very good reason
behind it. Performing a pelvic exam on an unconscious patient for no other
reason than for practice without consent is violating the integrity of a
person’s body. These exams need to be done ONLY with the
expressed consent of the patient.
I have actually seen multiple articles on this topic. Zdogg MD on facebook has
brought this to light quite a few times. The problem is that it IS happening.
Yes it sounds HORRIBLE and unethical. Many doctors want to say, oh no it
isn't happening, look at the research and many coming forward, it is! There
was even a documentary on it! It's time to make this illegal across
the board... Ask the patient for consent, if you don't have consent then
don't be doing it! Until then I guess we have to educate all of our
families/friends/daughters etc on what to say when they go into a hospital and
under anesthesia on what to allow and not allow.
I can't believe this is happening. I completely agree and understand that
learning has to happen. Of course it does! This is completely logical. But, to
perform unnecessary exams without consent is unreal! I wouldn't want a
student touching me without my consent. I wouldn't want any doctor
performing an exam of my feet while I was unconscious for a knee surgery without
consent. If they asked me, I'd be fine to offer consent in nearly all
cases. I want the students to learn; however, my body is not an open laboratory
for use whenever I go in for care. My consent to be treated, is not consent to
be used. Unbelievable!
To those who are saying no harm done- not true. Women are more susceptible to
infections the more pelvic exams performed, and our midwives for all of our
homebirths limited these intrusive exams. If a woman can’t consent,
that’s a no.
In 10 years of medical training at 3 different universities in 3 different areas
of the country (including Utah) and 20 years of practice and involvement in
physician training in 6 different hospitals in Utah, I have never even heard of
a rumor of such despicable practices. I am not saying it doesn’t occur,
but it also can’t be widespread. And informed consent really means
informed in my experience. Each section of the form is reviewed and explained
until the patient is satisfied. I have never seen one that would make such exams
allowable. Again, I am not saying it doesn’t occur, but more of us would
know about it if it were widespread.
If those supervising and performing such procedures really feel that there is no
ethical concern with doing so then they should have no problem explaining that
to the patient or their family prior to the exam/procedure happening. The mere
fact that they hide it shows that they know many people would not agree to it.
My experience is the same as Dr.GTR81. In 8 yrs of training, (Univ of Wash and
Univ of Ariz) I never witnessed or even heard of the practice of practice pelvic
exams in unconsented, anesthetized patients. My training came through live,
awake, consenting patients or consenting, paid models. In this day and age,
consent is paramount, and doing a pelvic exam on an anesthetized patient for
say, a knee arthroscopy, without specific consent would amount to assault and
should be prosecuted. I just can’t believe this would happen as
often as the author implies. It certainly didn’t happen at my medical
school or residency.
This may be true, but my guess is that it is not true in general in most
hospitals or clinics. Each state should pass laws to prohibit such an offensive
things and if known these have happened without consent, I feel the individuals
involved and especially those supervising should be prosecuted to the fullest
extent of the law.
Is it out of the question to offer compensation for women to have a pelvic exam
as a teaching tool? Seems a few hundred bucks is cheaper than potential
lawsuits. Turn this around and would men feel violated finding out they had a
student give them a prostate exam while under anesthesia? I know i'd feel
pretty weird about it.
I was taught in OR’s in 3 states as a medical student and then as a
resident, including intermountain healthcare facilities along the wasatch front.
Not once was it ever suggested that I should do an unnecessary pelvic (or any
other type of) exam under anesthesia without consent. The only
times I did pelvic examinations under anesthesia were for gynecological
surgeries where the exam was indicated, and when the patient had been informed I
would be present and agreed to my participation in their procedures. There were myriad opportunities to learn the female pelvic exam with conscious
and consented patients in the office setting. I must’ve done 100 of them
in the OBGyn clinic alone. There is no reason for a student or resident to do
what’s described in the article. And I think the article is a bit hyped
up most likely. In my 8 years of medical training, I never once saw this happen
anywhere, nor did I hear of it happening.
Quite frequently, that "consent" is buried under a bunch of
bureaucratic stack of fine print verbose legalize "sign here"s at the
"But you gave consent in the pre-treatment forms."That would
easily be destroyed in a court of law. Anyone requiring treatment serious
enough to require a hospital stay, and being presented with a form that *must*
be signed before the treatment could take place, would obviously be signing
Any time anything is done without a person's reasonable knowledge and
consent it is wrong. Period. It doesn't have to be a pelvic exam, though
that seem egregious.Personally, though different, it still comes too
close to Dr. Larry Nassar of USA Gymnastics who performed unnecessary pelvic
exams on young girls. It opens the door for potential for abuse.
@SirbobgDear Mr. Scientist. Apparently you do not know what
"anecdotally" means. Otherwise, you would understand that "in your
experience" is anecdotal evidence, and doesn't preclude the possibility
or fact that this does, indeed, happen in other places, or outside of "your
experience."If, however, you are correct, then there would be no
harm in enacting a law against the practice of unauthorized pelvic exams..
Gotta admit - on the few occasions when I've been asked to sign a consent
form, I've pretty much signed it without reading it. I can certainly see
both sides of the argument, but would hope such practices would be clarified to
the subject-patients a little better.I'm also curious - one of
the people in the story mentioned that they saw "something on her
cervix." Suppose an undisclosed exam resulted in a health-threatening
condition that was still treatable... would the subject of the exam still be
offended that it had taken place?
For $50 cash the hospital can have a line of willing women to volunteer then
this practice that makes students and victims out of women could end immediately
How is this controversial?Patients should be informed as to what is
going to be done as reasonably possible (sometimes things don't go
according to plan), and should be informed after-the-fact as to how things went
and what was done different from the plan. And yes, this should include any
medically unnecessary "teaching" moments such as pelvic exams. This
should be obvious.And to the degree possible, consent should be
acquired *before* any non-emergency procedure. Again, this should include any
medicially unnecessary "teaching" moments such as pelvic exams. And
again, this should be obvious.And if your teaching hospital
can't find enough women willing to be pelvically-examined for free,
that's a solvable problem: offer them money.Same with the
cadaver-emergency room thing. If not enough people and/or their families
won't consent for the body to be used by students to test procedures on for
free, then offer them money.This isn't complicated and
shouldn't be controversial. That it is says very bad things about our
Oh my goodness. This is insane.
I am very supportive of the opportunity for these students to learn...WITH
permission. I am surmising that the physicians who are so positive about this
practice would be unequivocally positive about said practice being unknowingly
performed on them??
This story is the classic example of how those who think they have a "good
reason" and are given any power will abuse that power and make it a
"standard practice." Simply exposing this practice, every rational
person is appalled. It is not the worst thing in the world, but definitely a
violation of privacy and ethics. Remember that no test, procedure, or
examination is without some risks: accidental damage, infection, etc.
Here at the University of Utah and a other academic medical centers around the
country, there is an option clearly indicated on treatment forms for physician
trainees such as residents and medical students to assist in the treatment
given. I have never seen any questionable practices that are anecdotally
referenced in this article here or at other training hospitals. Consent is an
ethical pillar to medical practice, and I t sounds as though the people in this
somewhat hyped-up article may have simply signed without reading/listening and
been surprised afterward. People certainly have a right to decide what happens
with their bodies, so please pay attention to what your doctors and treatment
team are discussing with you and be forthcoming with the questions on your mind.
No one is keeping any secrets from you.