Warning: This blog contains descriptions of sexual assault.
From Heart Failure, a book I wrote about my time at Tufts University School of Medicine: “I’m fifth in line, all gloves on. At Tufts, medical students, especially male students, practice pelvic exams on women who have been anesthetized, without their consent or knowledge. When a woman comes in for surgery and they fall asleep, we all come together. The line is to the left…We learn more than just exam skills. We take advantage of women’s advantages. As she lies unconscious and naked on the table, we learn that the patient is a tool to be used for education.”
The use of female patients for pelvic exam guidance without their consent or knowledge remains a “medical school’s dirty little secret.” This is an “age-old” practice that continues to this day in medical schools around the world. This is also known as the “vending machine” model of pelvic exams, where medical students line up to wait their turn. “However, this is not a vending machine, it’s a woman’s vagina.”
This is an “outrageous attack on the patient’s dignity and autonomy…This action shows a lack of respect for the patient as a person and reveals moral insensitivity and abuse of power.” In fact, “This is another example of doctors abusing their power and being reluctant to govern themselves on ethical issues, especially when it comes to female patients.” “I don’t think any of us would even think about that.” It’s so standard in the way medical students are trained.”
What happened when this practice was uncovered in New Zealand? The president of the New Zealand Medical Association appeared on television and said, “‘Until recently, this wasn’t an issue…We’re very sorry that women feel assaulted and violated in this way. That was never our intention.'” At the time, he asked the (TV) host, he had no idea that women might object. “All I can say is that there were no objections…” “Isn’t the reason that it’s very difficult for an anesthetized woman to know what’s going on?” asked the interviewer logically.
This practice has been publicly defended by many medical schools and hospitals, arguing that “this contact is entirely appropriate and clearly falls well within the patient’s ‘tacit consent’ to perform the surgery.” After all, “patients are aware that they are in a teaching hospital, so they know that residents will actively participate in their care.” However, “researchers found that many patients did not know when they interacted with medical students, or even if they were in a teaching hospital.” How could this be? “Intentional lies and deception.”
“A survey of medical students found that 100% of them were introduced to patients as ‘doctor’ by a member of their clinical team.” And, as the title of the journal article notes, as medical students progress through training, there is a “deterioration in medical students’ attitudes toward communicating their student status to patients.” “Additionally, we find that as medical students complete their clinical training, they feel less responsible for letting patients know that they are students, especially if they have the opportunity to perform invasive procedures.” That may be why medical students appear to have a “don’t ask, don’t tell” policy when seeking consent for pelvic exams on anesthetized patients. More than one-third of the 1,600 medical students surveyed nationwide strongly disagreed with the statement that “hospitals should obtain explicit permission to involve students in pelvic examinations,” as seen below and at 4:03 of my video, “Medical Student Performs Pelvic Examination on Woman Anesthetized Without Consent.”
After all, doctors “argue that performing a pelvic exam is no more intimate than reaching into the abdomen during a general surgery or attempting to intubate a patient,” and that sticking a finger into a woman’s vagina is “as intimate” as an ophthalmologist looking into the back of her eyes. Claims to the contrary are just “another attempt to justify our obsession with political correctness.” “Personally, I’d rather see a new generation of well-trained doctors than a nation of women whose vaginas are protected from battery by medical students,” said one medical school professor.
The national study concluded that “patients admitted to teaching hospitals do not relinquish their rights as human beings to have ultimate control over their own bodies and to be involved in decisions about their health care simply because they are admitted.”
Are women just indifferent? Studies have shown that up to 100% of women questioned said they wanted to know that vaginal exams were performed by medical students. If patients are so concerned about being asked, why can’t they at least ask for their permission? “You can’t ask a woman,” the medical school faculty member replied. “If you do that, they might say no.”
It’s amazing to me that people are still trying to expose this practice more than 20 years after I first wrote about it. What should I do? End the hidden practice of performing internal examinations on unconscious women without their consent.
