Medical students and schools are battling with an unsettling, daunting practice: performing pelvic exams on unconscious, non-consenting women. Although considered to be an outdated practice, this phenomenon continues to plague countless women.
Janine, a nurse in downtown Arizona, checked into the hospital for stomach surgery in late 2017. Prior to the procedure, she explicitly told her physician that she did not want medical students to be directly involved. As a patient, Janine had the full right to inform her physician about her preferences. However, after the operation, Janine reported, as the anesthesia wore off, a medical resident stopped by to inform her that she had gotten her period. In fact, the resident had noticed that while conducting a pelvic exam.
Immediately, Janine exclaimed: “What pelvic exam?” Distressed, she tried to piece together the events which had taken place while she was unconscious. Why had her sexual organs been inspected and examined during the brief period in which she was unconscious? Why had this been done by someone other than her surgeon? Later, she reported, her physician explained that the operating team had seen that she was due for a pap smear.
Pelvic exams necessitate physical inspection of the most sensitive areas of a woman’s body. These exams are generally conducted while the patient is conscious and awake, thus consenting, during a gynecologist visit. These exams are routinely connected to screens for particular types of cancers, infections, and other reproductive health issues. However, the issue is that across numerous areas in the United States, physicians are not legally required to obtain explicit consent for this procedure. Sometimes, the exams are conducted—by trained doctors and in-training medical residents—while women, like Janine, are under anesthesia for gynecological and other operations. In such cases, physicians fail to discuss the procedure with patients beforehand or detail its specifics in consent forms, leaving women uninformed. Unaware.
A total of 10 states have banned unauthorized pelvic exams, and as of last spring (Spring 2019), the Association of Professors of Gynecology and Obstetrics recommend that patients who undergo these exams while unconscious have “explicitly consented” to them, with full knowledge that medical students and residents may be involved. Additionally, a 2010 student found that although about half of patients hospitalized for gynecological surgery know that medical students may be present for the procedure, only about 18% know to expect an anesthetized pelvic exam from those students.
“The general public has no awareness of it,” claims Dr. Aris Isenstadt, who conducted such a survey. “When I told my colleagues in medicine about this issue, it did not seem like such a big red flag to them.”
The idea of medical students performing non consensual pelvic exams on women under anesthesia shocks people outside of medicine. However, on the contrary, inside medicine, most view it as routine. “The patients have no way of finding out what happened during their procedure, and they’ll come out none the wiser,” says Donna, a fourth year student at Yale University. “It felt a little weird that I was doing this on somebody anesthetized, but it was the best chance I had to practice,” she finished.
While this procedure can be seen as medically beneficial and a part of a larger medical operation, its performance without consent exposes a disparity between patient and doctor rights. This disparity raises the question: Whose voice is more valued—those being operated on or those operating? Yale medical student, Katie, told Elle Magazine: “The inability to understand that a third of women have been victims of sexual violence, the inability to think about that and respect that, is unbelievable.” It becomes apparent in this case that the preservation of women’s health should not be limited to that of physical health, but instead take into consideration the emotional consequences of non consensual operations. Pelvic exams being conducted without patient input has exposed the lack of holistic consideration that has gone into such decisions.
