Colorado doctors should ask before performing intimate exams
My teenager asked me the other day, ever so nonchalantly, “Mom, did you know that you can have a pelvic exam without knowing it while you are unconscious?”
Assuming she had migrated to some ridiculous, fake news site, I assured my daughter that this could not be true.
But she showed me that, in fact, it is true: while a patient for surgery in hospitals in Colorado, physicians are not required to let you know that your body may be used as a training tool for medical students while a patient is under anesthesia.
What’s unnerving is that if you don’t know this can happen to you, then there is no way to expressly tell your surgeon before you go off to sleep, “I do not want to be probed down there.”
This includes men too with training including breast, pelvic, prostate, and rectal exams.
Anyone reading this is probably in shock, as I was, to learn that the fundamental, universal need to feel safe from strangers or anyone invading our bodies without our knowledge or consent is tossed aside once we are wheeled into the operating room.
As University of Washington assistant professor of gender, women, and sexuality studies Bettina Judd points out, consent isn’t about “whether you can say yes; it’s also whether you can say no.”
And as any student of law knows, what’s legal is not necessarily what’s right.
Which is why a new bill — House Bill 1077 — would fix this egregious wrong in Colorado and halt any licensed healthcare facility from “permitting a licensee, student, or trainee to perform, an intimate examination on a sedated or unconscious patient unless the patient has given specific, informed consent.”
But even if you outrightly do not give consent, things can go wrong.
A nurse calling herself Janine ( not her real name) told the New York Times in 2020 that she strictly told her doctor she did not want medical students to be part of her stomach surgery. Still, postsurgery, she was told offhand by a resident that she had gotten her period. He had conducted a pelvic exam while she was out.
“I started having panic attacks trying to figure out what had happened,” she told the Times. “I had a history of sexual abuse, and it brought up bad memories.”
Colorado’s bill should pass; it’s a no- brainer.
But enacting a new law doesn’t necessarily change culture with any sense of urgency, and that’s a problem when some in the medical community think this is not an issue.
Research shows that the longer students spend in medical school, the less intimate exams without consent seem like a big deal. This seems largely to be true when looking at online medical forums. One current medical student shared his bizarre view: “If we had to ask for consent, people would say no. How else are we supposed to learn?”
This view is taught and cultivated at medical teaching facilities where students are shown this to be a common hidden practice and not taboo. Non- consensual exams are still allowed in 29 states today.
While it’s abhorrent to think that anyone could think this is OK, it’s safe to assume that our teaching hospitals and practitioners- in- training still have the best intentions. There is no malicious motive or ill will here.
I suppose I could even go so far as to understand how once you get into the business of working with naked bodies, it becomes the norm. My own massage therapist told me, “The only good body is a naked one.” And when I was nursing my baby, or going through the millionth pregnancy exam, being naked seemed natural, and there was no shame.
But in this day and age where we teach our kids that no means no, it is unconscionable to think that the people we trust most with our bodies could possibly violate them, and we wouldn’t even know it.
Colorado’s new bill is a good step forward, but what needs to happen is for our institutions of medicine to adopt strong policies from the first day of class that teach and guide their students — even better if in collaboration with a school chaplain — to understand the value of trust between a doctor and a patient no matter if that patient is awake or unconscious.