Some states are creating more laws to require consent before doctors can allow their medical students to perform pelvic exams on unconscious patients. Yes, you read that correctly, it is legal in MOST states for medical students to perform pelvic exams on unconscious patients without those patients’ consent or knowledge that it’s happening. Many medical institutions see this as the best way for students to learn how to properly perform a pelvic exam. It’s great that med schools want their students to know how to perform a pelvic exam correctly, but what would be even better is if the patient who is having the procedure done knew it was happening.
This horrendous practice actually came to light in the early 2000s following small scale studies on medical students, and, as you would expect for the USA, progress on this issue has been slow. While 21 states have completely banned the practice (with Colorado, Missouri, Michigan, and Massachusetts considering bans now), it is still perfectly legal for med students to do this in 29 states.
In an interview with PBS, McGill University Bioethicist Phoebe Friesen brought up an important point on ethically-incorrect practices such as these. Friesen stated, “I think that when we consider that in the history of medicine a lot of individuals we think about prisoners, slaves, sex workers, all of their bodies were utilized in medical research and medical practice without their consent.” It’s true, the US has a devastating history of using marginalized people as subjects of medical research and performing operations on their bodies without their consent. One example of this occurs at the US/Mexico border, where women and all people with uteruses entering the country have historically been subject to forced hysterectomies.
There is some hope for the future, though. Many medical students are fully aware of the abhorrent nature of practices like these, and in that same PBS interview, one of those medical students, Alexandra Fontaine of Ohio, is speaking out. Fontaine is currently advocating for a bill in Ohio that would require the patient to give explicit consent before a pelvic exam could be performed on them for educational purposes. Fontaine also expressed that she has hope for the future of more of these laws becoming a reality, and that medical systems will understand the importance of following them. She stated, “I think once health systems understand that they’re laws and they have to abide by them, that will trickle down through, you know, supervising physicians, attending residents, all the way down to med students. But I think it’s also going to take things to the other end where med students have to be empowered to push back and say, hey, we know that this is the law and we’re going to follow it.”
The Epstein Health Law and Policy Program has been doing critical work on this issue, and even created an Unauthorized Intimate Teaching Exams: Public Engagement Initiative in 2021. You can read more about their work to follow and increase legislative action on this issue here. The program has been doing critical work in tracking which states have banned the practice, which are considering a ban, and which still fully allow medical students to perform on-consensual pelvic exams. The program also sheds light on the fact that asking for consent should not only be mandatory for ethical and moral reasons, but centering consent as a crucial part of the learning process in medical school can help to teach fledgling doctors the importance of respect and good bedside manner.
Though it’s devastating to learn about, now it is as important as ever to start petitioning your local government for laws that protect bodily autonomy. With the recent fall of Roe, and new laws popping up around the country that attack the bodies of transgender people and young women, now is the time to not only start paying attention (if you haven’t been already) but to also take action. A good way to start is by checking the status of the legality of this practice in your state here, and contacting your state representative.
Top photo: Rockefeller Institute for Medical Research from Wikimedia Commons
