Sunday, January 30, 2011

Medical students are performing intrusive exams on unconscious patients

Australian medical students are carrying out intrusive procedures on unconscious and anaesthetised patients without gaining the patient's consent. The unauthorised examinations include genital, rectal and breast exams, and raise serious questions about the ethics of up-and-coming doctors. The research, soon to be published in international medical journal, Medical Education, describes - among others - a student with "no qualms" about performing an anal examination on a female patient because she didn't think the woman's consent was relevant.

Another case outlined in the research describes a man who was subjected to rectal examinations from a "queue" of medical students after he was anaesthetised for surgery. “I was in theatre, the patient was under a spinal (anaesthetic) as well and there was a screen up and they just had a queue of medical students doing a rectal examination,” a student confessed. “[H]e wasn’t consented but because ... you’re in that situation, you don’t have the confidence to say 'no' you just do it.”



The author of the study, Professor Charlotte Rees, voiced concerns about senior medical staff ordering students to perform unauthorised procedures, leaving the students torn between the strong ethics of consent in society and the weak ethics of medical staff. Of students who were put in this position during the research, 82 per cent obeyed orders. “We think that it is weakness in the ethical climate of the clinical workplace that ultimately serves to legitimise and reinforce unethical practices in the context of students learning intimate examinations,” writes Prof Rees. The study consists of 200 students across three unnamed medical schools in Britain and Australia. Not all participants agreed to carry out the intimate examinations without permission from the patient.

One student refused to take part in an examination of a woman who was “part spread-eagled on the bed and the nurse is (sic) pulling down her jeans at the same time and it was all very complicated and you could see her, she was about seventeen”. Carol Bennett, the CEO of the Consumer Health Forum, said the report was a "poor reflection on these medical schools that they are setting these examples. Most people would not be pleased about having medical procedures performed on them without it even being mentioned to them," she said. "Patients should never be examined without consent, particularly by a third party."

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