I had a different blog planned for today but then I came across a story about pelvic examinations done on women under anaesthesia without their consent. This has stunned me. I am someone that has had 3 very intimate surgeries, I've had back surgery, hip surgery, and a laparoscopic surgery to diagnose my endometriosis.
A pelvic examination can include the vagina, vulva, cervix, ovaries, uterus, rectum and for men, prostate checks (Mayo Clinic).In one article, they did a survey of 101 medical students and had found that 92% of them had performed a pelvic examination on a women while under anaesthesia however, 61% of these students said that they did so without consent. 47% stated that they were uncomfortable with how their educational institutions handled these exams. Yet, "The American College of Obstetricians and Gynaecologists' opinion is that, 'pelvic examinations on an anaesthetised woman that offer her no personal benefit and are performed solely for teaching purposes should be performed only with specific informed consent obtained before her surgery.' And, according to the ACOG, 'informed consent should be looked on as a process rather than a signature on a form" (Dr. Tsai, 2019).
In a survey done in the UK, at least 24% of students had to do a pelvic examination on a woman that was under anaesthesia; on many occasions, they were not the only one that performed that procedure on that same woman (Hsieh, 2018). In 2012, there was a survey taken from 102 participants at the Calgary Pelvic Floor Disorders Clinic in Canada and they found that only 19% of these were aware that a medical student might conduct a pelvic examination while they were under anaesthesia. 72% of the 102 participants believed that they should be asked consent before the procedure is performed (Gibson, Downie).
In the United States, there are currently 9 states that have made this illegal, these include: Hawaii, California, New York, Illinois, Iowa, Utah, Oregon, and Virginia. That still leaves the United States with 41 other states that don't have anything against this. While this shocks the average person, those within medicine don't find this surprising. Stated in Elle, "'The patients have no way of finding out what happened during their procedure, and they'll come out none the wiser'" (Dr. Tsai, 2019).
Another thing that I want to make clear, is that all of these articles seem to have another thing in common and that is they want to justify this by saying that people who are undergoing these unconsented examinations are at teaching hospitals and should know that this type of practice is part of a teaching hospitals expectations of its students. I also want to note that in the article done by Elle, 49% of those students had not even met their patients before performing those pelvic exams (2019).
I don't have a medical degree, I don't even have a bachelors degree in a science field. But I am a survivor of sexual abuse and am a huge advocate for women and children's rights. I believe that this is a major violation of women's rights and is another example of how conventional medicine is dismissing women's right to informed consent. What would be the harm of asking a woman, before any drugs have been administered, if their medical students can perform a pelvic examination while they are in surgery? The point that those in the medical field don't have an issue with patients not knowing what happened to them while they are under completely puts me off the wall.
Our bodies still belong to us regardless of whether or not we are awake or asleep. How does the medical field justify performing a pelvic examination on a women while she is asleep without her ever knowing. This is the United States Department of Justice Archives definition of sexual assault:
“The penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim.”
If a women were to be drugged up or have blacked out due to consuming too much alcohol, inserting fingers into the vagina without consent (in the United States) would be considered sexual assault. But because this is within the 'medical field' someone has managed to convince everyone else that this is an accepted line of practice and should not be questioned. Within my 3 intimate surgeries, would I know if anyone has stuck their fingers into my vagina without my consent? No, and I will never know because it is not recorded in the medical documentation based on where I am from. Unfortunately, this is majority of us women out here, we will never know if this has been done to us because it has gone without having to be written down in anyway.
Finding out this information has made me even more aware of how much we have to advocate and raise awareness about informed consent. I usually talk about the birth control pill on here and medical alternatives given to many us with endometriosis and fibroids, but this falls in line with this. We have to keep pushing for informed consent. You do not have to agree to anything that a medical professional gives you, you are supposed to have a choice. I continue to hear more and more every day about the abuse that happens with women during labour and pressured into different medical treatments that they did not want. Or women that are given a certain type of medication or surgery that have endometriosis and end up with horrific side effects because they weren't completely informed. This has to change!
Medical school establishments need to be held accountable. I blame the system that has allowed this to continue to happen. It also sounds like no one is talking about this, only 9 states have made a change out of the 41. How do we expect to move forward and give women more power if our own medical professionals continue to believe that women's bodies don't need consent?
My opinion on this matter is blunt, there needs to informed consent around this and I am dumb founded that I am even addressing this as an issue. Medical schools need to be held accountable and if woman do say no after asking them whether or not they consent to this, this should be respected regardless of a check mark off of a medical students residency. This makes me so angry and it should make you angry too.
Xoxo,
Moonli
Gibson, E. & Downie, J. (2012) Consent Requirements for Pelvic Examinations Performed for Training Purposes. CMAJ. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394822/>
Hsieh, P. (2018) Pelvic Exams on Anaesthetised Women Without Consent: A Troubling and Outdated Practice. Forbes. <https://www.forbes.com/sites/paulhsieh/2018/05/14/pelvic-exams-on-anesthetized-women-without-consent-a-troubling-and-outdated-practice/#6f0208297846>
Pelvic Exam. Mayo Clinic. <https://www.mayoclinic.org/tests-procedures/pelvic-exam/about/pac-20385135>
Tsai, Dr. J. (2019) Medical Students Regularly Practice Pelvic Exams on Unconscious Patients. Should They? Elle. <https://www.elle.com/life-love/a28125604/nonconsensual-pelvic-exams-teaching-hospitals/>
(2012). An Updated Definition of Rape. The United States Department of Justice Archive. < https://www.justice.gov/archives/opa/blog/updated-definition-rape>