Informed consent and informed refusal are cornerstones of medical ethics. They’re also constitutional rights. A person can even refuse life-saving medical treatment. Doctors who ignore competent patients when they refuse medical treatment have committed a criminal assault.
But some doctors are ignoring this fundamental right when they treat women. According to several investigative reports, doctors are performing pelvic exams on women without their consent, and often against their will, when they go in for surgery. The practice doesn’t just apply to women who have gynecologic surgeries. A woman who goes in for a tonsillectomy or gallbladder removal might be subjected to a doctor probing around in her vagina, and never even know it.
Pelvic Exams Against a Patient’s Will or Without Her Consent
The New York Times details the story of an Arizona nurse who checked into a hospital for stomach surgery. She told her doctor she did not want students involved in her procedure. After she awoke, doctors told her she had gotten her period. They knew because they had performed an invasive pelvic exam without her permission. Another woman told a hospital that she did not consent to a pelvic exam during routine, non-gynecological surgery. The hospital told her she had to consent to the surgery, and that if she didn’t, she should seek care elsewhere.
These incidents are not anomalous. At teaching hospitals across the country, students practice pelvic exams by performing them on unconscious women, even when those women do not consent or specifically state that they do not want an exam. Most women never know that they have been violated. But some, like science teacher Sarah Wright, report complications such as pelvic pain.
These exams are not a secret. Unlike some other forms of medical abuse, doctors do not deny performing exams against their patients’ will. Instead, they insist that doing so is necessary, and that they should therefore be permitted to ignore informed consent law and assault their patients. In an interview with The New York Times, Dr. Jennifer Goedken, an Emory University physician, expressed concern about banning the exams, and emphasized the importance of a “good, comfortable exam.”
Even if we disregard more than 100 years of jurisprudence and revoke a woman’s right to informed consent and informed refusal, this defense doesn’t make sense.
An exam cannot be comfortable or uncomfortable when a patient is unconscious and anesthetized. Performing a pelvic exam demands more than just sticking a finger or an object in a woman’s vagina. It requires patience and empathy. Women are not objects. They are living, breathing people with emotions. These emotions are among the most important things a doctor must consider when performing a pelvic exam. Doctors who are good at the practice are gentle, sensitive to their patients’ needs, and communicative. Exams on unconscious patients teach none of these skills. Instead, they teach doctors to disregard the consent, the very humanity, of the patients they examine. That may make them worse, not better, at examining patients when they are awake.
How Doctors Escape Responsibility for Assaulting Patients
So how do doctors get away with this practice? Broad consent forms authorize medical providers to perform a number of procedures during surgery. Even when a patient refuses to sign these forms or crosses out the portion related to pelvic exams, doctors can still get away with assaulting patients. In most states, people who sue for medical malpractice must prove damages. Psychological harm is not enough. Medical boards are unlikely to discipline providers for doing something that is commonplace, even when it’s technically illegal.
This leaves women with no recourse. It emboldens providers to continue performing procedures they know their patients do not consent to. This, in turn, teaches providers that the desires of their patients are inconveniences. Trauma doesn’t matter. Bodily autonomy is irrelevant.
Reproductive justice is about more than just defending abortion clinics and preserving legal choice. A woman’s struggle for bodily autonomy begins at birth, and often comes to a head in medical clinics that would override her wishes.
We have a word for people who penetrate the vaginas of unconscious women against their will or without their permission. It’s not doctor. It’s rapist.