Most people are shocked to learn that it is common for medical students to learn how to do pelvic exams by "practicing" on anesthetized patients who have come in for surgical procedures, often without any prior consent. This practice has a long history and happens all over the U.S. and around the world in many medical institutions. The patients rarely know it has happened because they were unconscious. Pelvic exams can happen to anesthetized patients in other scenarios as well. This can happen to anyone with a vagina.
Both students and patients are traumatized by this long-standing practice. It is very hard for medical students to say "no" when they are asked to do something, and the psychological impact on them is yet undocumented. It was found in a 2003 peer-reviewed research study that 90% of students were learning in this manner. No new research has shown this number to have changed.
Institutions often defend and protect this practice, despite public outcry. We need to outlaw this practice in order to make it clear that this kind of betrayal of patient bodies is not okay. If medical institutions were going to change this themselves, they would have done it by now. It's time that we send a clear message that informed consent is critical for pelvic exams while under anesthesia.
There are currently only 20 states that outlaw this practice. Yes, that means it's legal everywhere else, including New Mexico. Our goal is to get laws passed in all 50 states. We are asking you to show our state legislators that we will not accept non-consensual exams on anesthetized patients in New Mexico. We, the undersigned, ask our New Mexico representatives to protect patient autonomy and informed consent by passing legislation banning this practice.
RESOURCES:
>> Here are a few places where this practice has been documented and a recent article on best legislative practices as we take action:
The 90% statistic is in this article, and it was found that students felt informed consent was less important after their OB/GYN clerkships (very problematic):
Ubel, P. A., Jepson, C., & Silver-Isenstadt, A. (2003). Don't ask, don't tell: A change in medical student attitudes after obstetrics/gynecology clerkships toward seeking consent for pelvic examinations on an anesthetized patient. American Journal of Obstetrics and Gynecology, 188(2), 575–579. https://doi.org/10.1067/mob.2003.85
Robin Fretwell-Wilson is the attorney who has worked on many of the state laws already in place. Let's make New Mexico next!
Wilson, R. F. (2005). Autonomy suspended: Using female patients to teach intimate exams without their knowledge or consent. Journal of Health Care Law & Policy, 8(2), 240-263. http://digitalcommons.law.umaryland.edu/jhclp/vol8/iss2/5
Shawn Barnes wrote this after performing over 100 exams as a medical student:
Barnes, S. S. (2012). Practicing pelvic examinations by medical students on women under anesthesia. Obstetrics & Gynecology, 120(4), 941–943. https://doi.org/10.1097/aog.0b013e3182677a28
A Bioethics perspective and more recent research:
Friesen, P. (2018). Educational pelvic exams on anesthetized women: Why consent matters. Bioethics, 32(5), 298–307. https://doi.org/10.1111/bioe.12441
Legislative Direction here:
Friesen, P., Wilson, R. F., Kim, S., & Goedken, J. (2022). Consent for Intimate Exams on Unconscious Patients: Sharpening Legislative Efforts. Hastings Center Report, 52(1), 28–31. https://doi.org/10.1002/hast.1337
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