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Guest Post - Pelvic Exams without Consent
Posted by Heebie-Geebie on 02.21.20

Bostoniangirl writes: I find the practice of giving anesthetized women pelvic exams without their informed consent horrifying - and horrifyingly widespread.

Particularly viscerally terrifying to me was the story of the woman who was given phenergan to calm her nerves and awoke to find herself with a speculum inside her.

Physicians rely on the idea that there is implicit consent when a woman consents to certain surgeries. I vaguely recall that there was case law on a similar concept where surgeons who noticed serious issues that weren't the precise focus of a particular surgery went ahead and addressed them with a patient without having explicitly discussed them first. Certainly, if I was otherwise going to die on the table, I would want a surgeon to perform a procedure. Anyone willing to make the best case for when it might be acceptable and how best to improve the situation?

Heebie's take: (I haven't read the link b/c of the NYT paywall, so maybe they address this but) it seems like the fix for this is so easy that it's bizarre to me that it's not undertaken: when you explain to the patient about the procedure, you give a disclaimer that it's standard practice to do these ancillary pelvic exams for [X, Y, and Z] reason.

So what I'm inferring is that there must be occasions when there's no justifiable reason whatsoever?

Here's my best guess for the reasoning in those cases: "As long as we've got the car up on the lift, we'd be fools not to check all the obvious entry points for any unrelated issues." It's definitely a dehumanizing perspective, but maybe it just needs to be re-marketed?

(Am I being an ass? I have that vague sensation.)

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Posted by Heebie-Geebie on 02.20.20

Did he crash and burn last night? Did anyone watch? I'm super annoyed that he timed his ascent so well. Even my mom is musing about his electability and it made me irate. Yggles says that Bloomberg tanked last night. I hope so.

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