Way of learning intimate examination for medical students

I read this article, it's instructive at least, not obligatory right

https://everydayfeminism.com/2016/10/unethical-pelvic-exams/

What do you think about it, ladies and gentlemen?

I found the article biased and one- sided. Med students do need to learn via hands on exams/procedures, but (IMHO) it is done with full patient consent, not underhanded as the article implies. What happened in the past doesn’t mean it’s happening today, even if more “discreetly”.

Even cadavers have given implied consent by donating their bodies - prior to death. 😄

As an adjunct, we have had extensive experience in teaching hospitals (UTSW and Colorado) and we were alway informed about medical student/intern involvement and provided options.

Yes, these types of articles are often partial, I'm just surprised that nurses are sollicited sometimes to be medical model..

I'm not a medical ethicist, but I believe any contact in a medical context without informed consent is wrong. This discussion and other threads here led me to check the policies of the medical schools and teaching hospitals in my state. Each one has a code of medical ethics that forbids the abuses of unconsenting patients described in these threads.

My research also led me to other places that allow these abuses and fight attempts by government to rein them in. I can not understand how any medical ethicist justifies some of these practices, especially when easy alternatives exist such as volunteers/standardized patients. The best rationalization I can come up with is that a patient is just a piece of meat and we don't really need to have any regard for them beyond that. It goes downhill rapidly from there (power and sexual jollies, rape culture, whatever you want to call it).

On to coerced informed consent in the case of students being asked to practice on each other. Would I want my female classmates practicing very intimate exams or invasive procedures like cystoscopy on me? Probably not, but I would let them. However, as a male I have far more sexual agency. If I had a vagina I would feel a lot differently about the situation. I might feel that it would be ok for other females to practice on me because it eventually leads to more empowerment for females in general.

When I was in my early twenties, my girlfriend's best friend was in a long since shuttered private hospital system's residential nursing school. She and her roommates and classmates practiced intimate area skills like enema administration and bladder catheterization on each other. They were obviously all female in those days and I'm pretty sure they knew what they were getting into. I know we have some members here that are nurses from that era. It would be interesting to know their thoughts on the ethics of that.

But I think in the modern era, its incredibly sexist to have the attitude “oh so you girls want to be doctors now and not just nurses… well, you have to spread your legs for your male classmates… its for science”. I'm really kind of surprised that still flies these days.

I didn't read it thoroughly but the writer seems to have made a lot of assumptions and certainly has opinions with which I don't agree.

I expected that med students must either use each other or volunteers for practice. The complaints about girls privacy not being respected ring hollow to me when I think of the complete disrespect for a boys privacy. Girls can do things to boys such as touching all their parts while bathing them “because they are going to have a baby when they grow up”. Boys are expected to be paraded naked in front of any females who may be present for the same reason. Boys are not allowed to bathe girls or see them naked in the majority of homes.

I recently spent a night in the hospital some female came in to apply the pad to my backside that I guess is to prevent bed sores. I don't know if she was a nurse, nurses assistant, admissions clerk, janitor or someone who happened to be walking by in the corridor. She told me to loosen my pants so she could put on the pad then said I might as well drop them to the floor anyway along with my underpants because she had to do a skin check before they would let me get in the bed. I stood there naked with several other females wandering in and out of the room through the door which was left open to the corridor. This took about 10 minutes before I was allowed to get in the bed. My feelings were that we were all adults and should know what another human body, male or female, looks like anyway so what's the big deal?

At the dermatologist recently she sent her assistant out to get what she needed to work on me. Of course I'm sitting on the exam table naked and she returns with another female in tow who just seemed to be observing. When the derm asked me to retract my foreskin to show her the road rash I had mentioned on the intake form they all moved in close to see that, so what? If the third girl had never seen a penis or retracted foreskin before it was time she did. That just didn't bother me. I came there for the derm to look over my naked body, if she brought the whole office staff in with her I didn't care. As I said, we're all adults and it's just a human body.

But I think in the modern era, its incredibly sexist to have the attitude “oh so you girls want to be doctors now and not just nurses… well, you have to spread your legs for your male classmates… its for science”. I'm really kind of surprised that still flies these days.

This is another instance of (in this case medical training) notions becoming more prudish compared to the past.

I would also look at it as the culture of military officer training ideally does: never ask the troops to do anything that you as an officer wouldn't do. Or inverted; be prepared to undergo whatever those under you are expected to undergo.

If you want the responsibility of being a doctor, then you have to be prepared to experience, what you, as a doctor, will perform on others.

Naturally this doesn't go as far as performing surgical or other potentially harmful procedures on one another. But other more routine examinations? If you want to be top of the line in the medical profession as a doctor, then get the experience hands-on by undergoing it yourself.

Nor would it be sexist to require the corollary: you boys want to be doctors? Drop those briefs and bend over for your colleague students … fair is only fair.

If you want the responsibility of being a doctor, then you have to be prepared to experience, what you, as a doctor, will perform on others.

Naturally this doesn't go as far as performing surgical or other potentially harmful procedures on one another. But other more routine examinations? If you want to be top of the line in the medical profession as a doctor, then get the experience hands-on by undergoing it yourself.

We had an experience where my wife had to have the back of her throat checked by an ENT doc. He had to snake a small tube with a camera on the end of it up her nose, through her sinuses, to get some images of the back of her throat. He used a spray to slightly numb and he assured it it wasn't as bad as it looked and that he knew that first hand as he had it done to himself several times in medical school.

While it may not be mandatory to experience a lot of these and other examination procedures, I suspect most docs have done so during their training to better hone their skills.

It was established that some teaching hospitals in France used to advise students to conduct pelvic and rectal exams on anesthetized patients, without any medical necessity. This most likely violated medical ethics and some laws. Students used to be told e.g. “come on, if you don't do it how will you learn”.