Texas must impose ban on non-consensual pelvic exams
Imagine you need a gynecological procedure that requires anesthesia or are taken to the hospital in an emergency. While you are hospitalized, your doctor takes advantage of your anesthetized or unconscious body by allowing medical students under their tutelage to take turns performing pelvic exams on you. Do you remember consenting? Probably not, but you might have signed a form acknowledging that medical students may be involved in your care.
Most women are familiar with pelvic exams. Usually, they are performed as part of regular checkups. Women are conscious during the exam and aware of what will occur during the procedure.
However, in Texas and in most other states it is legal for medical students to perform medically unnecessary pelvic exams on women who are unconscious and who did not give meaningful consent for the exam beforehand. The exams have been permitted for decades as a way for students to learn. Years of debate over the ethics of the exams has reduced the use of such non-consensual exams, but it has not ended the practice, though of late some states are correcting that. Texas should join them.
Everyone should have the right to know what will happen to them during a medical procedure. Non-consensual pelvic exams violate patients’ basic rights. Just because they are low-risk procedures does not mean they should be conducted without patient knowledge. Most medical procedures require consent, even if they are simple and noninvasive. Dr. Phoebe Friesen, professor of medical ethics at Canada’s McGill University, notes that consent waivers are usually temporary and specific.
For example, “when consenting to a blood draw ... consent only is given for a single instance of drawing blood, and the waiver of bodily rights only applies to one’s arm, and not any other body parts.”
When women are unconscious, they only consent to the procedure they know will be taking place or to medically necessary procedures; they don’t consent to medically unnecessary pelvic exams.
By removing patients’ ability to say no, or even failing to fully inform them of what will take place while they are unconscious, non-consensual pelvic exams violate the sanctity of the doctor-patient relationship. Physicians hold a unique position in society that comes with power. Patients share informa
tion with physicians about their personal and family history as well as details about their symptoms that they may not share with even their closest family members. Patients need to have trust in medical practitioners who are involved in their care. If patients feel like they cannot trust their doctors to tell them what will happen during a procedure, they may be less likely to
seek care. The solution is simple — banning non-consensual pelvic exams will protect all individuals’ rights and promote doctorpatient trust.
We believe it is key to address this issue, as it impacts many women, both nationwide and in Texas, even if they aren’t aware that it’s happening. A number of surveys have been conducted across the country which reveal that 90 percent of medical students have performed a pelvic exam on an anesthetized woman. A majority of students did
not know if she gave consent beforehand and 40 percent of medical school gynecology departments do not have any policy in place requiring informed consent for students to conduct educational pelvic exams.
We spoke with medical students in Houston who confirmed that this is happening here, so Texas women are at risk of becoming victims of non-consensual pelvic exams. Although surgical consent forms may note that medical students are involved in
patients’ care, that is not enough and offers no protection for women who arrive at the hospital unconscious in an emergency. Doctors need to explicitly explain this procedure and get women’s informed consent before performing the exam. If informed consent cannot be obtained, students should not perform these invasive and medically unnecessary exams.
The law should mandate informed consent for pelvic exams in Texas. Eight states have banned this practice: California,
Illinois, Iowa, Maryland, New York, Oregon, Utah and Virginia. We are working to get a bill passed in Texas, but we need your help to get it passed. Please share this article so people are aware of this practice. Your actions can make a difference — join us in our efforts to protect patients’ rights and the sanctity of the doctor-patient relationship.