Sexual Assault Claims | Non-Consensual Pelvic Exams
A pelvic exam is “a physical exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum.” The procedure is quite invasive: “First, the area outside the vagina is checked for signs of disease. A speculum is then inserted into the vagina to widen it so the vagina and cervix can be checked for signs of disease. Cell samples may be taken for a Pap test, or to test for sexually transmitted diseases or other infections. The doctor or nurse then inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand to feel for lumps and check the size, shape, and position of the uterus and ovaries. The rectum may also be checked for lumps or abnormal areas.”
The exam is usually conducted during a visit to gynecologist, while the patient is awake. However, in many states, doctors and medical students are not required to obtain explicit consent to perform a pelvic exam while the patient is unconscious. According to Emma Goldberg’s New York Times article, “She Didn’t Want a Pelvic Exam. She Received One Anyway,” published February 2020:
Sometimes the exams are conducted — by doctors or doctors-in-training — while women are under anesthesia for gynecological and other operations. Often the exams are deemed medically necessary, but in some cases they are done solely for the educational benefit of medical trainees. At some hospitals, physicians discuss the procedure with patients beforehand or detail its specifics in consent forms, but at others the women are left unaware.
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Sexual Assault | Pelvic Exam While Unconscious
It is not uncommon for patients under anesthesia to have an unauthorized pelvic exam. In fact, the practice has been going on for more than 30 years:
Nearly three decades ago, Dr. Ari Silver-Isenstadt was a medical student at the University of Pennsylvania. Just before his gynecological clerkship, a friend cautioned him that he would probably be asked to perform pelvic exams on unconscious female patients. […] As Dr. Silver-Isenstadt tried to sound the alarm on the practice, he learned that medical faculty members tended to accept it as a necessary component of a physician’s training. Although the practice has broadly persisted, a number of states passed laws banning it.
In 2019, the Association of Professors of Gynecology and Obstetrics published an article titled “Consent for the Pelvic Examination Under Anesthesia by Medical Students”. In it, the authors list standard procedures “to ensure that consent for examination under anesthesia is obtained and documented.” They include:
- Supplemental consents for student examination under anesthesia (similar to refusal of blood products consent forms).
- Stickers on the main consent form attesting that discussion of examination under anesthesia was done and consent obtained (similar to “time out” documentation stickers).
- Including the term “exam under anesthesia” preceding the surgical procedure on consent forms (eg, “exam under anesthesia, laparoscopic salpingectomy” on the procedure line of a consent form rather than simply “laparoscopic salpingectomy”) to complement language already common to surgical consent forms regarding student involvement.
- Examination under anesthesia within the surgical consent form.
- Inclusion of an item on pre-induction checklists confirming whether the patient consented to examination under anesthesia by learners.
However, these are only recommendations. In the United States, it is illegal to perform an unauthorized pelvic exam on patients under anesthesia in only 10 states:
- California
- Delaware
- Hawaii
- Illinois
- Iowa
- Maryland
- New York
- Oregon
- Utah
- Virginia
Other states considering the same ban include Arizona and Florida.
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Peiffer Wolf Carr Kane & Conway is a nationally recognized law firm. Our team of attorneys is fully prepared to assist our clients, protect their privacy, and guide them through the entire process. If doctors or medical students have performed a non-consensual pelvic exam while you were unconscious, you should Contact Us immediately. You can fill out an online contact form or call 504-523-2434 for a FREE Consultation.
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