Hey! Get that finger outta there!
June 10, 2003 2:01 PM   Subscribe

Imagine drifting off to dreamy anaesthesia -induced sleep for some such surgery and having some medical student cram a digit up one of your holes. Apparently, it happens all the time in the name of "learning".
posted by vito90 (27 comments total)
Similar discussion here.
posted by willnot at 2:06 PM on June 10, 2003

Why is learning in quotes vito90? It's being done to educate medical students. It's not done for entertainment, humiliation or sexual gratification. Whether consent should be required is a separate issue.
posted by substrate at 2:11 PM on June 10, 2003

promises, promises.
posted by quonsar at 2:14 PM on June 10, 2003

"Medical students routinely perform pelvic exams on anesthetized women, and activists want to enlarge the small print on consent forms"

Read everything before you sign. Just jotting off a signature, legally, allows the person to do whatever you might have just agreed to. This isn't a rental agreement, it's your body...otherwise it's going to be a learning tool.
posted by mkelley at 2:26 PM on June 10, 2003

Let 'em practice on each other.
posted by trondant at 2:27 PM on June 10, 2003

Fucking ridiculous. How anyone could think that it's OK to perform pelvic exams without consent is beyond me. I refuse to believe that there is no other way for medical students to learn about this.
posted by widdershins at 2:29 PM on June 10, 2003

Or what trondant said.
posted by widdershins at 2:29 PM on June 10, 2003

Fucking ridiculous. How anyone could think that it's OK to perform pelvic exams without consent is beyond me. I refuse to believe that there is no other way for medical students to learn about this.

Maybe someone with more medical experience can enlighten me, but isn't this generally how teaching hospitals work?

You sign a form saying that medical students are going to shadow a doctor and be around or whatever doing exams, and that's it.

I mean, if I was having heart surgery, the medical students would be doing exams there too maybe, right? It does seem a bit silly to call a pelvic exam more of a "violation" (see, putting quotes around words is fun!) than reaching into your chest cavity and grasping your heart.

Should they be doing that on each other too, rather than patients already needing the surgery? Or are pelvic exams a special exception? Or would you prefer doctors to treat their first patient never having done it before under guidance?
posted by malphigian at 2:35 PM on June 10, 2003

Yeah, the scarequotes around learning are pretty damn ridiculous. It is in fact actual learning so uh that part isn't in question.

There's a legitimate issue here in re: consent, so it would be a shame to obscure it with allegations that medical students are getting off on illicit probing of geriatric rectums.

Personally, I'd say an explicit request for consent made orally is both reasonable and necessary. A fair number of doctors seem to have this feeling that they are above the common man, and thus needn't ask for consent. Not cool.
posted by kavasa at 2:44 PM on June 10, 2003

There are a number of medical schools that employ people who allow medical students to practice the trade in their orifices. They are quite used to having their holes probed and provide excellent feedback (as in "oh, no, don't do that"). PS. These people (especially the men) are -well- paid.
posted by jmgorman at 2:48 PM on June 10, 2003

The tone of this post is grossly misleading.

Receiving treatment at a teaching hospital implies an implied consent. Still, patients should be well informed. Clearly, they should not be subject to any examiniations or procedures with which they are uncomfortable.

However, as mentioned in the linked article, it's essential that future physicians gain experience while under the supervision of an accredited PhD. Far from "fucking ridiculous" This is what teaching hospitals are for; it's an absolutely essential part of medicine.
posted by aladfar at 2:53 PM on June 10, 2003

Sigh . . . remove 'an implied' from my previous post.

Regarding alternatives: There's an enormous difference between practicing an exam on a healthy volunteer, and doing the same on someone with an illness.

How is a doctor supposed to detect an abnormality if she's never encountered one before?
posted by aladfar at 2:56 PM on June 10, 2003

Point taken regarding "learning". Was trying to be super clever. The point of the post was the other discussion re: consent, not that this is done in the name of titillation. My bad.
posted by vito90 at 4:17 PM on June 10, 2003

They are quite used to having their holes probed and provide excellent feedback (as in "oh, no, don't do that"). PS. These people (especially the men) are -well- paid

how well is well? i've been looking into a career change that would be spiritually sastifying and also make for great small talk with the ladies.
posted by fishfucker at 5:36 PM on June 10, 2003

i dont know if a 'teaching hospital' implies a university or something, but i work in a cardio hospital and we have students from local schools here all the time, usually scrubbed down and in with the surgery teams.

Not sure how widespread this practice is... very odd, and i'm shocked it goes on
posted by shadow45 at 6:37 PM on June 10, 2003

For one thing, doing an exam on an anesthetized person doesn't do anything for the student learning how to do it with the least amount of discomfort to the patient. Isn't that how they should be done, and thus a useful skill?
posted by beth at 6:53 PM on June 10, 2003

If the woman is out cold, how can she say "ow, that hurts, stop touching right there"? How are the students supposed to learn to be gentle enough, if the patient can't respond?

If this was done to me without my knowledge, I would be absolutely infuriated.
posted by mabelcolby at 6:59 PM on June 10, 2003

beth has a good point. I hadn't thought of it from that perspective. I've had the doc trot in a herd of students on me before and it wasn't a problem, but I also understood I (purposely) went to a teaching clinic.
posted by substrate at 7:17 PM on June 10, 2003

I won't register with the first link, and the second link leads me to believe that exams only occur in the context of an appropriate surgery. I am wondering if the following scenario is at all possible: What about the idea that a person going in for a thyroidectomy gets a pelvic/rectal exam just because they are out cold and the student is in need of a check off on their list of physical exams performed?
posted by oflinkey at 7:25 PM on June 10, 2003

I say let's stop all this "learning" nonsense right now.

After all, it's not like we actually need new doctors, is it?
posted by spazzm at 9:41 PM on June 10, 2003

c'mon people... It's an issue because, if asked, the majority of people would probably say "gee thanks but no thanks, I'm exactly up for a pelvic examination from Johnny Wannabe Doctor just at the moment". So they get around this by not even asking, brilliant! Sure, when thought about rationally, its not a big deal that it happened, but it is a big deal that it happened and they didn't think it would.
posted by cohappy at 11:09 PM on June 10, 2003

Eat lots of flatulogenic foods before going in, that's what I say. That way even if you're unconscious when they start poking, you'll be able to tell them what you think of them.
posted by George_Spiggott at 1:05 AM on June 11, 2003

whoha, well over here they do ask. The only time I nix a student to poke at me is when I'm awake and in pain, they're welcome to hang around and watch the good Doctor. Three out of four of my operations there was either a surgeon student or a sedation student there.

"students" make them sound like totally unexperienced teenagers. They're young doctors-to-be, and if they are going to be good ones they need to see and act under supervision on real cases. I don't mind, as long as am not awake and in pain.

I think it's far far worse when the doctor brings a *group* of students in to look at the special case, it makes me feel like the elephant man. I don't tolerate it.
posted by dabitch at 4:04 AM on June 11, 2003

I say let's stop all this "learning" nonsense right now.

Nice side step, but that's not the issue. No one is saying student doctors shouldn't work with patients under supervision. The issue is whether consent should be required, and the answer to that is a resounding yes.

Unfortunately, it will probably require a visit from Mr Class Action before hospitals figure this out.
posted by Beholder at 4:39 AM on June 11, 2003

Good point, mabelcolby. How can a student learn to be gentle and do it correctly if the woman is out cold and can't respond to discomfort or pain?

Personally, I would probably give consent to one student if I were having gynocological surgery, but more than one is just creepy. Pelvic exams aren't exactly "comfortable", no matter who does it (or the circumstances), but I would definitely want to be asked for consent before it is done. To do it without my explicit consent to me would be a violation. Period.
posted by greengrl at 5:33 AM on June 11, 2003

And if a tumor was found during one of these teaching methods, and subsequently your life was saved because of early detection, how many of you would be objecting then?

Also, what mkelly said. Didn't your momma tell you never to sign anything without reading it?
posted by archimago at 6:07 AM on June 11, 2003

No, kidding. Read what you sign. But even if you consented without knowing, remember, the practice is done ultimately for everyone's benefit not for some sick gratification. If hospitals are less than forthcoming it is because it can be very difficult to find people willing to let medical students be involved with any part of their care. I'm a man, but if I was having surgery and found out that a med student had done a colonoscopy while I was out I think I'd just say, "whatever".

Of course, being married to a medical student probably makes me totally biased.
posted by McBain at 10:23 AM on June 11, 2003

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