TIL Hospitals Are Allowing Medical Students to Perform Pelvic Exams on Unconscious Women — Without Their Consent

Read more: https://www.healthywomen.org/your-care/pelvic-exams-unconscious-women

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  1. In my experience as a (Dutch) medical student, I’ve never been in this situation and I think it’s a highly unlikely scenario. Coincidentally though, this topic has been raised at some point during an ethics discussion. There were several points of view. For instance it is well known that placing a catheter is ‘easiest’ to learn on unconscious patients prior to surgery. It’s both functional and a learning experience to have the student do this. This is of course not the same as a pelvic exam, but it’s a step in that direction and it’s completely accepted as normal.

    This is the line of thinking that the act of touching certain body parts in the interest of health, is not fundamentally different than touching any other body part. It is a weird balance, because at the same time you are (have to be) aware that for some patients, having a rash on a foot checked out is not the same as having a rash on private parts checked out. With conscious patients, the general advice is deal with it in a very matter of fact manner. We need to do this because this and that. I have to say for me personally I found this also to be the best approach in reality. This kind of ‘necessary disconnect’ in my experience happens automatically. Having done several pelvic exams and prostate exams, it’s never been ‘weird’ either for me or (I believe) the patient and patients very rarely object to a student doing the exam (or even also doing the exam and having the ‘real doc’ doing it again to verify).

    Now to translate that to an unconscious patient…In general I would say these kind of things are thought about and handled with the proper care in hospitals. When I had my gynecology internship for instance, everything was always discussed with patients, students never did the exams on minors et cetera. Proper thought is given to it. So this particular scenario as well…I wouldn’t say it never happens period, but it’s definitely not common practice and the same kind of thinking will go into it. A student will never do this autonomously (unless something is seriously wrong with the student) but if instructed to do so because there is a medical reason to do it, it maybe could happen…but if so it will be under supervision and in a respectful manner.

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