I have a story. Let me tell you it.
A few years ago, my husband and I were having trouble conceiving a child. In Ontario, they have people who can help you with these sorts of things so after the requisite time, we toddled off to the fertility doctor in order to get checked out. For those of you who've never been down this route, first of all thank your lucky stars, but secondly, realize the tests they do are of the necessary but rather highly embarrassing kind: transvaginal ultrasound.. on the first day of your period. Sperm analysis. Invasive questions. It's the kind of thing these doctors see every day, so they are thankfully very professional about it. I, however, do not talk about these things every day, nor do I make a habit of showing up for vaginal exams just for fun. As a result, I was less comfortable than my doctor or the medical team that I worked with. It's embarrassing. It's your privates, you know. They're meant to be.. private. But this all had a purpose: To find out if our bodies were working properly, or not. So I gave myself a little "man up, nancy" talk and bravely forged ahead.
During one of these exams, my doctor discovered something odd. Something that would take a surgical investigation to resolve fully. The surgery was scheduled, and on the designated day I reported to the hospital, anxious and nervous. I knew this was a simple, routine procedure, but I was still feeling skittish. I would be going under a general anesthetic, and that fact combined with the private-parts nature of the work being done left me feeling vulnerable. My doctor, a kind, intelligent man about my age, spoke to me in reassuring, professional tones. He introduced everyone in the room and described their roles and the procedure. And when it was time to go under, seeing I was nervous, he stood by my side until they gave me the good stuff and my eyes slowly closed. When I woke up hours later in recovery, I went home feeling groggy, but relieved to find out the issue was, as expected, nothing. And ever since that day, I have been grateful to my doctor for being so professional, so compassionate; thankful that he was taking such care to make me feel reassured.
That was a while ago. I've since had a beautiful baby girl and I have long put the thought of that day behind me. Until today. When I read in the Globe and Mail that during
gynecological surgery, it's routine for a medical student to practice
giving pelvic exams to women while they're anesthetized, without seeking prior permission from the patient to do so.
I read the article, and I froze.
I realized in an instant that it is entirely possible that after my procedure was completed, when there was no need for me to still be receiving potentially dangerous anesthesia, when there was no reason for anyone to be putting a speculum within 15 feet of me, my unconscious body was then very possibly used as a lab rat for a med student - possibly students- to "practice" pelvic exams on me. Without my permission.
What?
What???
I feel nauseous. I feel horrified. I feel violated. I feel frightened.
From the article:
The long-standing argument in favour of allowing these exams to be
done on surgery patients is that it provides a unique opportunity for
students to practice the delicate, invasive examination without causing
the woman pain or embarrassment.
There is also an assumption
that women would never accept pelvic exams by students while conscious
so sneaking them in, while not ideal, is acceptable.
Let's let that sink in for a moment. So rather than cause me "pain or embarrassment", or give me the right to say "no", they instead simply can decide to do a painful and embarrassing (their words) examination on my unconscious body without my permission.
Can you believe this? Us ladies, us delicate dewdrops, (most of whom have had more pelvic exams than we can remember, for god's sake) are too fragile to be asked permission to let a student see our lady gardens! But don't worry about it, says the medical community, we'll get around it: WE JUST WON'T TELL THEM. Knock 'em out and stirrup 'em up, let's let the whole room see what's in there!
Think about this. Even dead bodies have to give their permission to let med students examine and practice on them. We are being given less respect than dead bodies.
But here's the kicker.
The concern among the medical community isn't whether it's ethical to carry out invasive examinations for 'practice' purposes without the patient first granting consent. The concern is how tough it would be to actually get that permission in the first place.
Talk about missing the point.
So, medical community, I have a few questions for you.
1. Does this practice actually occur? Do you allow medical students to carry out pelvic examinations on unconscious patients without informing them first?
2. If this practice does take place, are these examinations that are necessary as a routine course of the procedure being carried out and are simply being done by the student, or are these examinations that are being done outside of the required procedures (and thus exposing the patient to extra anasthesia and extra risk from having an extra invasive procedure)?
3. If this does take place.. have you never stopped to think whether or not it *should* happen without your patients' permission?
4....
And this is the most important point...
4. If this did take place in my OR that day, had I been asked to give consent, it's more than likely that I would have given it. But because you didn't ask, you took away my own power over my own body. You treated me like an object. You put your needs over my right to have sovereignty over my self. If you'd drugged me and let someone probe my vagina outside of an OR, it would have been called rape. And it's unforgivable.
This is an original post to Canada Moms Blog. Shannon blogs at ThreeSeven.ca and saves the world at ecochick.ca.
If you're outraged about this, and want to send a message to the
Canadian medical establishment and Canadian legislators that this is
NOT okay, please consider lending your signature to this open letter/petition. Thank you!
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