Pelvic-exam consent at issue in Canada

Women routinely examined by trainees while under anesthetic, study says

Women in Canada are being subjected to pelvic examinations by medical trainees while under general anesthetic and without their consent, according to a recent study.

The report from the University of Calgary polled 102 women who were patients at the Calgary Pelvic Floor Disorders Clinic to find out their thoughts on this routinely performed procedure.

An overwhelming number of women—84 percent—said they did not expect medical students to take an active part in the surgery, and 73 percent of women polled wanted to be asked for permission if a medical student was going to perform a pelvic exam.

According to Dr. Sue Ross, one of the authors of the study, it is common practice for medical students to perform pelvic exams on women while they are under anesthetic.

“It’s not that there is anything that’s happening that’s wrong,” Ross told the Georgia Straight from her office in Calgary. “Nobody would ever be doing a pelvic exam unless there was a medical need for one.”

For Ross and her colleagues who conducted the study, the issue is not that an unnecessary procedure is being conducted but that women are not being asked for their consent prior to the exam.

According to the Society of Obstetricians and Gynaecologists of Canada’s Web site, “pelvic examination is a component of the surgical procedure. Consent for a pelvic examination by medical trainees who are part of the surgical team is therefore implicit when consent for participation in the surgical procedure by medical trainees is obtained.”

Ross told the Straight that many in the medical field argue that if women were asked for explicit consent prior to their surgery, many might decline and this might hinder medical students’ ability to learn the necessary procedure.

However, the study found that 62 percent of women would consent to medical students doing pelvic exams. An additional five percent said they would also agree to be examined by female students.

Dr. Robert Liston, the head of the department of obstetrics and gynecology at UBC, told the Straight he was shocked to hear that such practices are still happening, and that strict guidelines at the UBC medical school prohibit pelvic exams without the explicit consent of the patient.

“I can categorically say that is not condoned by UBC medical school,” he said, pointing out that the last time he heard of such a practice was back in the “Dark Ages”.

Second-year UBC medical student Pamela Verma told the Straight that although she has never been asked to perform pelvic exams on patients without their consent, she believes it’s likely that other students in Canada may have had to.

“I don’t doubt that there are situations when students are put in that position,” she said. “It is really difficult if you’re being asked by your superiors to do something that you’re not sure you’re comfortable with.”

She said it’s imperative to understand that experience for medical students shouldn’t come at the cost of patients’ rights.

Comments

3 Comments

This is so wrong!

Feb 4, 2010 at 1:27pm

That is a total vialation of your rights. It reminds me of those stories you would hear about dentists who would molest their patients while under anesthetic. Gross! How can they say “It’s not that there is anything that’s happening that’s wrong.” Wow...they need to retake their ethics coarse.

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Simply Wrong

Feb 9, 2010 at 12:07am

Research has indicated that many women would not approve of this type of examination if asked. By not asking, and just doing it, the rights of those who were not asked and would not have consented are being violated. In fact, the rights of all the women have been violated, because the procedure is being done without explicit consent, which is necessitated in this case because of the nature of the procedure. Sometimes it is ethical to do something with consent, but to do the same thing without consent could be very unethical. Take sex, for instance.

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Mark313

Feb 23, 2010 at 1:26pm

So..... many in the medical field say they don't ask for consent because they expect it would not be given. So they believe the woman would say no, so they don't bother to ask. This is sexual assault.