New Federal Guidelines Ban Pelvic and Prostate Exams Without Patient Permission
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Some medical schools and teaching hospitals train students by having them perform pelvic, breast, prostate, or rectal examinations on people who are under anesthesia for surgery — all without patient consent.
It is critically important that hospitals set clear guidelines to ensure providers and trainees obtain and document informed consent from patients before performing sensitive examinations in all circumstances, the letter stated. That includes giving the patient the right to refuse.
Research Revealed 3.6 Million Americans Received Pelvic or Prostate Exams Without Their Consent
These changes come in large part due to the research and advocacy of Lori Bruce, associate director of the Yale Interdisciplinary Center for Bioethics in New Haven, Connecticut.
They also found that Black patients are 4 times more likely than white patients to report having received such unconsented exams. Men and women were equally likely to have an exam without their consent, according to the study.
A Lot of Medical Knowledge in the U.S. Has Come From Experimenting on Black People
The issue here is finding a way to help medical students get the education they need without harming patients, says Keisha Ray, PhD, associate professor in humanities and ethics and director of the medical humanities concentration at the McGovern Medical School in Houston. “Sometimes in the pursuit of education people can do things that they think are for the greater good, but it can harm individual patients,” she says.
This issue of gaining medical knowledge by using people without their consent needs to be viewed in light of past abuse by the medical community, says Dr. Ray.
“A lot of what we know about medicine and about the human body comes from researchers, scientists, and clinicians abusing marginalized people, whether that be Black people, Jewish people, poor people, people from low income backgrounds, people with not a lot of political or social power, or people who are in prison,” she says.
Black Enslaved Women Were Exploited for Medical Research
America has a history of performing research on people who were very vulnerable, like enslaved Black women, says Ray. “Much of the knowledge of gynecology and gynecological disorders and illnesses has come from clinicians who performed experiments on enslaved Black women that they would purchase specifically for this purpose,” she says.
Some of the principles of medical ethics came out of these abuses, says Ray. “People started to come out and say, ‘Wait a minute, we can’t just go around using people for their bodies, we have to make sure that certain ethical principles are followed,’” she says.
Unconsented Exams on Black People Likely Due to Medical Racism, Less Access to Insurance and Healthcare
There are many reasons why these sensitive exams without consent are more likely to be performed on Black patients, says Ray. “There’s basic medical racism and having a lack of compassion or lack of seeing the humanity in Black patients,” she says.
Because a legacy of racism has limited many Black individuals’ access to healthcare and health insurance, they may be more likely to seek care at teaching hospitals or state [or] publicly funded hospitals that are more likely to be teaching hospitals, says Ray. “And so if you have a higher Black clientele, then you’re going to have more Black people undergoing these kinds of exams,” she says.
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Exams Without Consent Harm Both Patients and Providers
While medical professionals do not intend harm when conducting intimate examinations on unconscious patients, research shows that it can have a negative impact on medical students, too, because they feel they did something wrong but had no choice but to comply, said Bruce.
“Over time, some students develop moral erosion. They may devalue the importance of informed consent, and this shift in belief extends across all patient care, not just pelvic and prostate exams,” she said in the release.
There’s also evidence that there would still be plenty of opportunities for learning: Several research studies have shown that if asked for permission to conduct an extra training exam, about 90 percent of patients will agree, Bruce said.
Even with these measures in place, unconsented exams may still happen. If you suspect or find out a sensitive exam has been performed on you without your consent, you should contact the institution where it happened, and you can also file a complaint to your state’s medical licensing board, says Ray.
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