Would you like a pelvic exam with that surgery for your finger? I am outraged!!!!! I had no idea this kind of crap went on. What a joke. Lets do a pelvic on someone who has not given consent, is unconscience and with a few classmates....THIS WOULD BE RAPE in any other setting. Ladies: No matter what you are going in for, ask what the policy is. Read the fine print. This is an outrage. If they had nothing to hide, they would not have to do it without consent. http://www.dispatch.com/national-story.php?story=dispatch/news/news03/mar03/1680219.html Schools seek consent for students to check unconscious women Wednesday, March 12, 2003 David B. Caruso Associated Press
PHILADELPHIA -- Some of the nation's leading medical schools have abandoned a little-known, decades-old practice of letting students perform pelvic exams on women without their consent while they are under anesthesia.
The schools are asking permission first.
Previously, these institutions routinely had brought in students -- sometimes as many as three or four -- to conduct pelvic exams on unconscious women just before their gynecological surgeries and often without their consent.
Changes in that practice have taken place after complaints from students who felt the exams without consent were unethical.
"My problem was that if they found out about it they might be really upset, and it was really only being done for my benefit,'' said Dr. Ari Silver-Isenstadt, who refused to examine anesthetized women as a student at the University of Pennsylvania.
"I felt like I would be violating their trust,'' he said.
Students also raised objections in the mid-1990s at Harvard Medical School.
Dr. Daniel Federman, senior dean for clinical teaching at Harvard, said the complaints led to a new policy under which surgical patients had to give consent for a pelvic exam for training purposes.
"Very few patients decline. And when they do, we honor it,'' Federman said.
Ohio State University School of Medicine's policy has long been that only the medical student assigned to a patient's treatment team may conduct pelvic examinations of that patient, OSU Medical Center spokesman David Crawford said.
The attending physician and student meet with the patient to go over her treatment, Crawford said. There is no requirement that a patient be specifically informed that the student will be doing a pelvic exam, "but the idea is to disclose as much as possible,'' he said.
Most medical students working at Columbus hospitals are from OSU.
At the University of California, San Francisco, School of Medicine, complaints by students in the late 1990s led to a line being added to patient consent forms, specifically noting that women having gynecological surgery might be given a pelvic exam while they are under anesthesia.
Typically, the surgeon performing the operation conducts an exam to confirm the problem to be corrected by surgery.
Dr. Patricia Robertson, director of UCSF's obstetrics and gynecology clerkship, said students have also been directed to meet with the patient before each operation and explain how they will be involved in their care.
"The students, I think, were most upset because they felt there were students lining up in the operating room doing pelvic exams, who really had nothing to do with the patient,'' she said.
Most medical students learn the basics of the pelvic exam by practicing on paid volunteers but eventually need to move on to real patients.
Anesthetized women are perfect subjects, doctors said, because they are relaxed and unable to feel the sometimes painful mistakes of novice examiners.
Consent is still far from a universal practice.
At the Washington University School of Medicine in St. Louis, patients are told that students will be part of their care team, but they aren't specifically told the treatment could include a pelvic exam for educational purposes.
There are similar policies at the University of Pennsylvania and the Johns Hopkins School of Medicine.
Many students, however, appear to disagree with such policies: 70 percent surveyed at Philadelphia-area hospitals in 1995 before they completed an obstetrics and gynecology clerkship said it was important to ask women for consent, according to a study published last month in the American Journal of Obstetrics and Gynecology.