Have you had gynecological surgery at a teaching hospital? If you have, it’s possible that students — not residents, students — performed a pelvic or prostate exam on you without your consent. Yes, really. It’s 2021, and horrific shit like this is still happening.
This has had nothing to do with your care. It has offered you no benefit. It’s solely done as a teaching tool, with you as the CPR dummy. Though they’ve been banned in several states, nonconsensual pelvic and prostate exams are still happening three years after #MeToo.
It doesn’t even have to happen during gynecological surgery. The New York Times spoke with one woman, Janine, who went into an Arizona teaching hospital for stomach surgery in 2017. Despite explicitly telling her physician she didn’t want students directly involved in her care, a resident turned up to inform her she’d started her period — which she’d discovered during a nonconsensual pelvic exam conducted during Janine’s surgery. Her doctor also said the surgical team had noticed she was due for a pap smear. She began having panic attacks over the incident. “I have a history of sexual abuse, and it brought up bad memories,” she told The New York Times.
Only fifteen states fully ban nonconsensual pelvic and prostate exams, says The Connecticut Mirror. Seven states have introduced legislative bills banning them in 2021. Connecticut’s is being blocked from public hearing by members of their state’s Public Health Committee under pressure from physicians.
How Often Do Nonconsensual Pelvic Exams Happen?
Too many of us undergo too many surgeries at too many teaching hospitals. This can’t happen regularly, right?
Medscape reports one online forum participant saying, “When I was doing Ob/gyn as a med student, the attending would have me do a pelvic right after the patient was under and before we started surgery… We didn’t exactly get permission but it was for teaching purposes.”
A 2005 study by The University of Oklahoma found that the majority of medical students had “performed pelvic exams on unconscious patients, and in nearly 3 of 4 instances thought informed consent had not been obtained,” says The New York Times. In “Don’t Ask, Don’t Tell,” a study published in the American Journal of Obstetrics and Gynecology, found that 90% of the 401 students surveyed from five Pennsylvania medical schools had performed pelvic exams on unconscious patients. Students who had performed those exams, the study discovered, found consent less important than those who hadn’t done the exams.
Performing nonconsensual pelvic and prostate exams erodes medical students’ ideas about consent.
One recent graduate told The New York Times students were frequently told to check consent forms patients signed before surgery when they were told to perform the exams. However, he says, he “would not be surprised if now and then people didn’t check.”
Robin Fretwell Wilson, a professor of law and associate dean at University of Illinois College of Law, who deals with informed consent law, has interviewed doctors in a dozen states about nonconsensual pelvic and prostate exams. People often told her that, according to The New York Times, “patients implicitly consented to being enlisted in medical teaching when visiting a teaching hospital, or that consent for one gynecological procedure encompassed consent for any additional, related exams.”
What About Those Pesky Consent Forms Again?
Sometimes consent for pelvic and prostate exams doesn’t have to be listed in the consent form… like in most states. Many hospitals fall back on the “this is a teaching institution” argument, even if the operation isn’t related to the patient’s reproductive health care. Others use the vague “students may be involved in my care” language most people encounter in a teaching hospital, and have the right to consent or not consent to.
But some doctors actually defend the procedures. Dr. Jennifer Goedken, an obstetrician-gynecologist at Emory University, said that it’s important to give students experience in pelvic and prostate exams, and told The New York Times that legislative debates “may stigmatize the procedure.” She said she didn’t want to make them “taboo.”
Sarah Burns, a third-year student at the Ohio State University College of Medicine, told The New York Times that doing pelvic and prostate exams over and over was like “learning to drive.” More like eroding notions of consent, like the study from the American Journal of Obstetrics and Gynecology found.
Irony: Nonconsensual Pelvic and Prostate Exams Are Essentially Useless
The Journal of the American Medical Association states that apart from any ethical concerns, which are enough to ban nonconsensual pelvic and prostate exams, they have limited teaching value: “the educational value of pelvic examinations under anesthesia is limited at best.” More educational: the use of paid non-patient volunteers. Moreover, even traditional pelvic exams are being questioned as vaginal ultrasound probes improve.
The Journal goes on to admit that even they have no idea, despite their continued outcry against the procedure, how much it survives.
So you go to sleep and random students come by to sexually assault you in the name of education. Um, no thanks. This practice should be banned in all fifty states, since it involves someone inserting their fingers into another person’s rectum or vagina while they’re unconscious and nonconsenting, under current sexual assault laws. We shouldn’t need a separate law covering it. Unfortunately, because some medical professionals think they’re above the legal ramifications for their behavior and the erosion of consent, we do.
Speak up. Tell your doctor you do not consent to students participating in your care, since this is how your body may be used. And be honest: no, students may not participate in your care if there is a risk that they may perform nonconsensual pelvic or prostate exams on you without consent.
Only when we all speak up can this hideous practice be stopped for good.