Dateline: November 16, 2023
Source: Pennlive
A ban on pelvic, prostate and similar exams on unconscious patients who haven’t given permission needs only the signature of Gov. Josh Shapiro to become law.
An official of the Rape, Abuse and Incest National Network said, “Unauthorized pelvic exams are a gross violation of the privacy and autonomy of patients … The solution is as simple as requiring a patient’s informed consent prior to the examination, which will prioritize the patient’s comfort, safety and autonomy.”
The law will require Pennsylvania health providers to receive verbal and written consent to conduct pelvic, rectal, or prostate exams while a patient is under anesthesia. If not followed, the health care provider would be fined $1,000, and the patient is allowed to seek outside monetary damages.
It ss not just Pennsylvania; more and more states are requiring patients to give consent for med students performing intimate exams.
I have always advocated that medical students should practice on each other (it used to be that way). They owe that respect to the patient, can empathize, and it will give them credibility to a patient. I can't tell you how many times providers have told me (and many others reported the same) that these exams are "no big deal."
No big deal? Then let me stick my finger in you first. All of a sudden that is a big deal. Patients are told such a response is inappropriate, they (martyr) provider is doing it for the patient, or some other gaslighting response.
It is all about perspective and empathy. One would think that one must have intelligence and critical thinking skills to become a doctor or a nurse. In fact, these people act like some of the dumbest people. Let me demonstrate perspective in the words of President Ronald Regan:
"Recession is when your neighbor loses his job. Depression is when you lose yours."
You lost your job, that is sad. I lost my job, it is the end of (MY) the world. I teach people to say in response to a provider saying in response to a patient's fear, concern, refusal of a procedure/exam something like "you don't have anything I have not seen before" or "we do this all the time (so many times a day)..." The patients response should be:
I feel so much better now. You are so intuitive. Most people accuse me of being selfish, but you see that I am concerned about how YOU (the provider) feel about seeing me naked/giving me a rectal exam/etc. As long as you are OK with it. Thank you for nullifying my feelings, marginalizing me as a patient, and dehumanizing me as a person.
Some other things for patients to protect themselves when they request to keep their underwear on for a procedure, same gender care, refusal of chaperones or other voyeurs, refusal of medical student participation, or ANY request to modify a procedure to make it acceptable to the patient:
Simply saying that under the Americans with Disabilities Act (ADA), I am requesting the accommodation of an all male care team (or whatever), and by federal law you MUST be accommodated. You also do NOT have to disclose what your disability is and you do NOT have to prove that you have a disability. Any reasons that providers give to refuse a patient request are either a policy of their facility or a state law. The ADA is a federal law and trumps all else...
Another reason to grant an accommodation is a religious conviction. What if you were muslim (or some other religion) and had deep held religious beliefs about who sees you naked, you would be accommodated.
Patients should also share their identity as a protected class (gender, orientation, religion, race, etc.), and simply ask for their accommodation based on that. The protected classes under federal law include:
- age
- ancestry
- color (of skin)
- disability
- ethnicity, gender
- gender identity or expression
- genetic information
- HIV/AIDS status
- military status
- national origin
- pregnancy
- race
- religion
- sex
- sexual orientation
- veteran status
A good tactic is to find out who the facility/provider has their liability/malpractice insurance with (this should be public record if required by the state to be licensed, check with state department of insurance). Then send a notice (letter) to the carrier of potentially filing a claim, complaint, and/or a lawsuit against the provider and institution. Immediately the carrier creates a claim, assigns an adjuster, and begins charging for handling the (potential) claim. This costs the provider and facility money whether or not you pursue a claim and regardless if it is determined by regulators that a violation occurred.
Read the facility's annual report to find who sits on the board of directors (and who their employers are) and what organizations are capital investors or donate money (endowments). Many of these organizations have Diversity, Equity, and Inclusion (DEI) and environmental, social and corporate governance (ESG) policies and rules in place.
If a facility has violated the rules by mistreating you as a member of a protected class (especially LGBT or minority), they will initiate an investigation if complaints are filed with them about the facility as a recipient of their benefit. The same with the employer of board members.
Some other sources to file complaints with are the Human Rights Campaign (HRC) if one is in the LGBT+ community, ACLU, and state professional licensing boards. Seek out political organizations. Especially if you are a member of the LGBT community or a racial minority. These organizations will hold protests on their front door for discrimination. Another good group are organizations that fight against sexual assault (women's centers).
Target these organizations with letters, social media post, online reviews (Yelp), etc. Get friends, family, and others to do the same. This creates a pattern which really throws a big red flag that something is wrong at the facility and with the providers.
