Friday, January 29, 2010

A Pelvic Exam Without Permission is Rape

According to The Globe and Mail, medical students are performing pelvic exams on unconscious women without consent.  It seems that this is a standard procedure in Canada.

Regardless of your feelings, you should be aware that this is standard procedure in many Canadian teaching hospitals.

Medical students routinely practice doing internal pelvic examinations while surgery patients are unconscious, and without getting specific consent, at least in Canada.

Guidelines in the United States and Britain say specific consent is required but, by contrast, Canadian guidelines state that pelvic examination by trainees is “implicit.”

It is essential for medical students to learn basic techniques, including pelvic examination, in well supervised settings.

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.

image See how this works,  because they think they will be denied consent they perform the procedure without asking.   This makes this practice highly unethical.  Women have written about medical rape in regards to labour and this practice absolutely falls within this category.  Simply because a doctor is performing this evasion, does not make it any different than if a stranger grabbed you off the street and penetrated you without permission.

They are not really worried about causing pain or embarrassment, this is about who has access to female bodies.  As far as I am aware, no such procedure is performed on men and when we consider that doctors act as gatekeepers, this practice is highly problematic.  The medical profession has a history of discounting women's bodies or pathologizing us at every turn.  Starting with hysteria, our bodies have always been viewed through the lens of patriarchy.

The absence of a no does not equal a yes and instead of focusing on whether or not the woman said no, the question really should be did she say yes and did she do this in full awareness of what she was giving consent to?   The mere fact that the medical establishment does not bother to seek consent means that they do not value women’s bodies.  It is standard operating procedure to view the patient as an object, to disconnect between the patient and the doctor but by doing so we completely remove the humanity of the patient, thus leading to atrocious violation of rights.  If a woman is just a pelvis, an object, a thing, then it is possible to view the examination as no different than checking to see if a piece of fruit is ripe.

 imageThe disconnect between patient and doctor is pushed my medical schools in order to assure scientific nature of their work, however the reality is no matter the mindset of the doctor, they are still dealing with living breathing human beings.  If this happened in any other circumstances, the person would be charged with a sexual assault.  The purpose of rape is not sexual gratification, rather it is to display power with impunity and by examining women without their consent, the medical establishment is asserting authority over women. It cannot be reasonably argued that this is not rape.  I can say without doubt that if this were to happen to me without my consent I would feel violated.

I am further curious to know what the ratio of these violations are between White women and women of colour.  The medical establishment has a history of sterilizing women of colour without proper informed consent and I highly doubt that the way that women of colour are viewed has changed dramatically, though we have been told that we are living in a post-racial world.  Another factor worth examining is how many times has this happened to disabled women versus able bodied women.  Women with disabilities can in these instances be particularly vulnerable and unfortunately the rate of assault is extremely high. 

There are far to many factors to allow this to continue to be standard operating procedure.  When a patient is interacting with a doctor, they are vulnerable and are turning themselves over to the expertise of another and therefore a violation of that trust can in many cases cause women to delay or ignore a need for medical treatment.  It seems that the Canadian Medical Board needs to re-examine the Hippocratic Oath because they are certainly doing harm in the name of good.