UK teaching hospitals allowing students to carry out pelvic examinations on women having surgery without consent?

[stealthsquirrelnutkin]

I just read an article about how New York and Utah are voting to make it illegal for teaching hospitals to get students to carry out non-consensual pelvic exams on anaesthetized women.

Someone on the GenderCritical reddit forum posted "This is routinely done in some teaching hospitals while a woman is receiving surgery NOT related to anything vaginal. In other words, you go in for a shoulder repair surgery, and because you have med students, the surgeon decides all the students, be sure you read that, ALL the students can do a vaginal exam of the patient.(Examples including 4-6 students lining up to shove their fingers into an unconscious, unconsenting womans vagina and rectum) No specific consent has been asked for, much less given for that examination, and the patients are never told it even occurred. "

I thought it must just be something insane that only happens in the third world and USA, but then someone posted a link to this article www.forbes.com/sites/paulhsieh/2018/05/14/pelvic-exams-on-anesthetized-women-without-consent-a-troubling-and-outdated-practice/#79db45b47846 that mentions a paper by Phoebe Friesen in the journal Bioethics, she notes that “that the practice is alive and well” in many US and UK medical schools. It’s difficult to know exactly how often this is happening. Most medical school faculty and students don’t talk about it publicly, and affected patients are (by definition) unaware this is happening.

The article goes on to say that a UK survey “reported that at least 24% of intimate examinations they performed on anaesthetized patients occurred without any consent and that ‘on many occasions, more than one student examined the same patient’.”

A common argument for these non-consensual pelvis exams is that many patients would say no—which is really a further reason for why they should be asking. If patients are not willing to be used as test subjects, medical school should hire people to practice on who are informed and willing.

So that's one more thing to worry about if you are going for surgery in a teaching hospital. Find out in advance what their policy is, so you can make it clear if you don't consent to having your private parts used as a teaching aid while you are unconscious.

This makes me feel physically sick. I actually have no words.

Anyone who has done this to an unconscious woman without their consent needs arresting and convicting for a sexual assault. If it has ever happened in the UK it needs to be exposed and those responsible held to account. There should be outcry about it, but there won't be.

When I started medical school nearly 30 years ago, the student had to get written consent from the women in advance, and you were only allowed to ask if she was going to theatre for a relevant gynae procedure. It was made very clear to us that consent was essential, and without consent it was assault. That was one of the larger medical schools.

How would that not be sexual assault?

doubt this is true.

This used to happen when I was training as a nurse over 30 years ago.It doesn't happen now and any surgeon trying this would be challenged and reported by the theatre staff.

Yes the same when I was at medical school 10 years ago. Written consent was needed and we only asked women who were having relevant Gynae procedures and they were absolutely free to say no.

You do hear many, many stories of poor consent and violating experience during childbirth that sometimes it does feel like there’s this ingrained culture of not really seeing women as autonomous humans with rights when it comes to their health and procedures. If some drs have been shown this as the norm from their student days then it would help explain a lot.

This doesn't happen in the UK anymore. As a student midwife 5+ years ago on my gynae surgical placement, I observed several surgeries and only saw one pelvic exam by a med student. I watched the med student discuss it with the patient in advance and obtain written consent.

I would be amazed if this was still happening in any UK medical school - it was absolutely outlawed at GKT when I was at med school (late 90s) - we were told in no uncertain terms that if anyone even suggested it, we were to report it. It has also been absolutely outlawed in every other teaching hospital I’ve worked at subsequently (and I’ve worked at most of the London ones).

It goes completely against modern ethics, and I really cannot see medical students going along with it these days (I can’t imagine any surgeons suggesting it, but I suppose there are always outliers). But med students are normally terrified of putting a foot wrong ethically, so I just cannot see them doing it.

I woke up during my colonoscopy and a bit of surgery to remove polyps.
The colonoscopy guy was swapping over with surgical guy so my legs are up in stirrups, no one sat between them.
There were three male students (looked about 15yrs old) stood leaning on the wall like they were waiting for the bus.
All three staring up my very exposed chuff.
I politely asked who they were actual wording was who the fuck are they and was breezily told they are just students.
One of the nurses pulled the corner of the paper down to cover me up a bit (and gave me a cuddle Bessie was shaking) but I was still pissed off.
Waking up to that was a real shock.

No idea where Bessie came from it should be because.

How would that not be sexual assault?

I think the argument would be that it is medical battery, not sexual assault. But that is still an offence, indeed it’s arguable a more serious one in terms of repercussions (being sacked, struck off, possible custodial sentence, vs sexual assault where more than likely the police wouldn’t do anything about it).

This was covered in an episode of This American Life (great podcast if anyone is looking for new podcast recs). A trainee doctor discovered that pelvic exams were being carried out without consent of female patients and she was horrified. No-one took her complaints seriously at the time but apparently the practice is dying out now finally, even in the US.
podcast episode

Certainly hasn’t happened for at least the last 15 years in my teaching hospital. Women sign a separate consent to agree to medical students examining them while anaesthetised, and it’s only during gynae procedures where they’ll be examined vaginally anyway. There’s no pressure on patients to agree.

Echoing other posters, this wasn’t happening when I was a medical student early 2000s. We didn’t have to obtain written consent but verbal consent from patients prior to surgery and only on relevant gynae placements. I would be very surprised if this was routinely happening. A surgeon in an unrelated specialty encouraging students to perform examination on an area of the body unrelated to the procedure being done would cause an outcry amongst other staff and lead to disciplinary procedures.

Another one who’s never witnessed this. As a medical student I always had to get consent before doing a gynaecological examination, and only did it where it was relevant.

In any case, in an operating theatre there’ll be a whole team present. I really think that even one individual did try to encourage students to perform an irrelevant examination on an unconscious woman someone else would speak up and stop it. I certainly would.

I never saw anything like that when I was at med school (which I left 3 years ago). I did see some shitty things from male med students (like being treating female cadavers disrespectful, or rating their patients and colleagues on looks, and for this reason I will never see a male doctor) but certainly consent was a big deal and I never saw it violated in that way.

There was an excellent ny times or American life podcast about this practice.

To be honest I went to an end of year review with medical students and I was so disgusted about their jokes (ones about people with brain tumours really got me as a parent of mine died of one) and complete objectification and awful sexism.

It put me off doctors for life .. and yes I would always say now if going for surgery hey I want you to explicitly tell me you want to be doing any internal exams if you are operating on my shoulder or whatever.

I always get a chaperone if having a medical procedure for sure.

I see he American life podcast has been posted already.

Well worth a listen even if it isn't easy to listen to at times..

Doubt this is true in the UK.

When I trained in the mid-90s we needed to have personally got consent from the woman ourselves. It only ever happened it situations were an examination was going to happen anyway and there are usually only max 2 students in theatre as you just get in the way, hold things up and don't learn anything.

Sheer practicality would mean you couldn't do it for someone having a shoulder op for example - whole theatre set up would have to be changed just for a student. Not going to happen in a busy list. Plus who is actually going to teach? No ortho consultant has a clue how to do a vaginal exam.

This is without the total uproar it would cause from all the theatre staff present - and the fact that the majority of students are now women.

That’s a good point.. the majority of medical students are now female, perhaps that has helped a great deal in these types of practices ending?

It happened in the mid 1980s

eusers put you off doctors or only male ones? Around half of medics are female now.

Ditto (and including in the UK) you might have your surgery filmed for subsequent review/learning for trainee surgeons. Takes place with no consent or knowledge of the person on the operating table. I was staggered when I heard this but was looked at very nonplussed and like I was a loon by a Director of Patient Safety that it was all entirely normal and absolutely staggered that anyone would think it wasn't acceptable. This was only 5 years ago so unlikely that that type of culture would have come to an end within that timeframe; these things take a long long time to be eradicated. The thing is, is there a relevant opposing similar thing going on with men? Are people lining up to shove their fingers up guys asses to assess the state of their prostates? I wonder if you asked questions of people that they would make different comments in justification of doing it to the women, as they would in not doing it to the men?