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Teaching hospitals hit over pelvic exam consent. (Anesthetized Patients).

OB GYN News

| July 01, 2003 | Silverman, Jennifer | COPYRIGHT 2003 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

Teaching hospitals are being called into question over their consent procedures to conduct pelvic exams on anesthetized patients.

But a new grassroots advocacy organization is contending that the preoperational consent forms given to patients in teaching hospitals don't explicitly state that a medical resident or student may conduct a pelvic exam while a patient is unconscious.

Instead, the forms use broader terms, such as "services will be performed by individuals selected," or "patients may be visited and attended by students or residents of various disciplines," Gabrielle Lichterman, executive director of the New York-based People Against Non-Consensual Pelvic Exams, or Non-Con, told this newspaper. Non-Con was formed this year to stop the practice of nonconsensual pelvic exams on anesthesized patients.

The wording does not make it clear that a student or resident may be conducting a pelvic exam, she said. Non-Con's research indicates that only a handful of the 400 teaching hospitals in the United States have banned what the organization calls nonconsensual pelvic exams.

The American College of Obstetricians and Gynecologists (ACOG) and other medical organizations for years have been urging that patients be informed and that. doctors obtain patient consent, Ms. Lichterman said. "The problem is the medical community is left to police itself. They're saying that something is wrong, but why hasn't it changed?"

For its part, ACOG's Committee on Ethics, in a statement issued in .April, said that a woman's informed consent is a "prerequisite" to medical treatment and participation in research. If a pelvic exam planned for an anesthetized woman offers her no personal benefit and is performed solely for teaching purposes, "it should be performed only with her specific informed consent, obtained when she has full decision-making capacity," the committee said.

Dr. Thomas Purdon, a former ACOG president, said he supports informed consent and the permission for exam under anesthesia to be included on every operative permit. He is concerned, however, that an important quality evaluation that's been a mainstay of evaluation in the operating room for more than 50 years is getting sensationalized.

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