Guidelines in the United States and Britain say specific consent is required but, by contrast, Canadian guidelines state that pelvic examination by trainees is “implicit.”
The practice – one of those dirty little secrets of medicine – has been exposed in a thoughtful, professional manner by a young doctor.
The story goes back to 2007 when Sara Wainberg was a medical student at McMaster University. Her younger brother Daniel, also studying to be a doctor, phoned for advice: As part of his rotation in obstetrics and gynecology, he had been asked to perform a pelvic exam on a woman who was under anesthetic. He refused, saying doing so without consent would be unethical.
“It got me thinking,” Sara Wainberg said. “I had done this numerous times in my training and it had never occurred to me that it might be unethical.”
She polled her fellow students and found 72 per cent had also done exams on unconscious patients, without consent, confirming that it is routine.