During the early 2000s, studies regarding the practice of performing pelvic exams on anesthetized patients without prior consent emerged[1]. These reports showed that unconsented pelvic exams were commonly used as a teaching method for medical students while they made their rounds. In a brief, one-paragraph press release which has since been taken down, the American College of Obstetrics and Gynecology stated that if an exam provides “no personal benefit and is performed solely for teaching purposes, it should be performed only with her specific informed consent[2]…” While there was a brief uproar of public disgust towards this practice, very little action has been taken to outlaw unconsented pelvic exams. At this time, due to such inaction an anesthetized patient may unknowingly be subjected to an unconsented pelvic exam during a procedure.
Fortunately for the citizens of Utah, an amendment to Senate Bill 188 entitled “Consent for Medical Procedures” will pass state legislation this year. During day 43 of the 2019 Utah General Session, floor sponsor of the amended bill Representative Kim Coleman stated:
“…in the journal ‘Healthcare Law and Policy’, one physician described the practice of giving a pelvic exam to a woman under anesthesia without consent as a practice that is age-old and universally performed. This is not okay.”
This newly amended bill will require physicians to obtain expressed consent prior to performing these pelvic exams. Previously, this teaching practice was performed under general consent forms, which are signed before undergoing anesthesia[3]. As Representative Coleman put it, women have given consent “unwillingly” for “something that’s not even connected with” the current procedure that they are undergoing. Senate Bill 188 will require a separate form of consent, labeled in 18-point font, to perform an educational pelvic exam during an anesthetized procedure. Physicians not fully adhering to the new law will put their medical professional license at risk.
The amendments to Senate Bill 188 represent a massive accomplishment and a major step forward for Utah. Utah will only be the fifth state in the U.S. to make this practice illegal, joining Hawaii, California, Illinois, Virginia, and Oregon[4]. People in the remaining 44 states are still at risk of experiencing this backwards practice of unconsented pelvic exams in order to teach medical students. While the victims of this practice are primarily women, men should also be concerned because they are at risk of receiving unconsented prostate exams. This raises a big question: if the majority of the U.S. population is currently at risk of being degraded during anesthetized medical procedures, why is this not a main point of conversation?
[1] Peter A. Ubel et al., Don ‘t Ask, Don’t Tell: A Change in Medical Student Attitudes After Obstetrics/Gynecology Clerkships Toward Seeking Consent for Pelvic Examinations on an Anesthetized Patient,188 AM,J. OBSTETRICS & GYNECOLOGY 575,577 (2003).
[2] Robin F. Wilson, Autonomy Suspended: Using Female Patients to Teach Intimate Exams Without Their Knowledge or Consent, 8 J. Health Care L. & Pol’y 240 (2005)
[3] Utah State Legislature. Day 43 of the 2019 General Session. S.B. 188 Consent for Medical Procedure Amendments. 12 March 2019
[4] Phoebe Friesen. Bioethics. 2018; 32: 298-307