Due to outdated legislation, patients have woken up from surgery after unknowingly becoming victims of non-consensual pelvic exams. Pelvic exams are a critical part of gynecological care but are completely unethical when they are done in a manner that takes advantage of patients for educational purposes. It is essential that consent is given before proceeding with any medical treatment, and unconscious exams shouldn’t be done any differently.
In only 31 states, patients have to give consent to have a pelvic exam performed on them while under anesthesia. In comparison, the other 29 states still consider non-consensual pelvic exams legal. The variation in laws regarding consent highlights a desperate need for consistency to protect patients and their autonomy. It has become common practice in many states for medical students to perform intimate exams on unconscious individuals as a learning opportunity. After only becoming aware in the early 2000s, many states have begun the process of banning pelvic exams unless consent is explicitly given. The violation of autonomy and the patient’s trust is unethical and is beginning to normalize a harmful situation.
Involuntary pelvic exams were considered unacceptable by the American College of Obstetricians and Gynecologists and the Association of American Medical Colleges. Yet, many institutions maintain a position that they are necessary for education, and eliminating them would be detrimental to the success of future physicians, which prevents legislative action from taking place. Those with backgrounds of sexual abuse have found a distrust in the healthcare system due to the vulnerable position they are put in when unconscious in the operating room. Sexual assault survivors are already less likely to have medical exams performed because of the added stress and anxiety it causes, and non-consensual pelvic exams only exacerbate these concerns and put more patients at risk of feeling violated. Consent should be the minimum requirement, along with a supportive environment to make every patient as comfortable as possible.
Dr. Shawn Barnes, wrote about how he regretted performing practice pelvic exams on anesthetized women in 2012 after being told to do so by his superiors. Barnes’ testimony shed light on an unsettling issue occurring for many years and helped encourage doctors and legislators to speak out against the practice. A survey of over 100 medical students from varying schools concluded that 61 percent were told to perform the exam without consent. Another study conducted in 2005 found that 75 percent of medical students in Oklahoma reported that they completed the exam without consent. The alarming rate of misconduct in the medical community is appalling and must be addressed by more states.
Fortunately, many other states are now looking into the legality of informed consent in the medical community, and as of November 2023, Pennsylvania has just been added to the list. Their new law went into effect in January and will require a patient’s verbal and written consent before any medical student or professional can perform a pelvic or rectal exam on someone under anesthesia.
The movement towards informing individuals about the critical shift in healthcare shows a positive turn in advocating for patient autonomy. Legislative efforts are a necessary, significant step forward to advocating for patients’ rights and putting an end to the unethical practices performed in the operating room. The medical community must rebuild patient trust and ensure that every patient receives the treatment and care that they deserve by eliminating non-consensual pelvic exams.
