Pelvic Exams Done on Anesthetized Women Without Consent: Still Happening

Arthur L. Caplan, PhD

Disclosures

May 02, 2018

In This Article

Pelvic Exams Are Being Done Without Prior Consent

Not too long ago, a medical student sent me an email. He was concerned that he had been asked to learn to perform a pelvic exam on a woman who had been anesthetized before having a surgical procedure. He said he and three other students had done the exam without incident, but it still bothered him that he thought there had been no prior consent from the patient for serving in this role.

I had thought this sort of teaching practice had ended. But apparently it has not.

In many teaching hospitals around the world, students doing their gynecology rotation "practice" a pelvic exam on a surgical patient after they're put under anesthesia. Sometimes, more than one student will practice the exam, with many sets of gloved fingers in the patient's vagina without their knowledge.

In April of this year, Phoebe Friesen, then a researcher at NYU School of Medicine and now at the University of Oxford, published an article about the practice in many medical schools of medical students being asked to accompany female patients into surgery, and perform a pelvic exam for educational purposes, while the patient was unconscious. The patient had neither been asked for nor gave prior consent.[1]

Friesen noted that the examination takes place without any attention paid to the patient's desires and wishes, which were never elicited, and so violates any chance for her to express her autonomous preferences with regard to her body.

Currently, the practice is illegal in only four states: Hawaii, California, Illinois, and Virginia. Friesen argues that the practice of performing pelvic examinations on women who are under anesthesia and have not consented is unjust.

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