HHS to Hospitals: Stop Pelvic Exams Without Patient Consent

The Department of Health and Human Services has come out firing against a practice it says violates the privacy and dignity of patients in health care settings across America. The New York Times reports that on Monday, the federal agency sent out a letter to the nation's med schools and teaching hospitals blasting the practice of pelvic exams, prostate exams, and other sensitive procedures done without the explicit consent of patients, especially those who are anesthetized.

• Investigation: The Times cites its own 2020 review that found doctors, residents, and hospitals sometimes carry out such exams when a patient is under and when the exam isn't medically required. Some of those exams seemed to be "only for the educational benefit of medical trainees."

• The numbers: NBC News noted in September that a study found that 3.6 million patients may have received an "unconsented intimate exam" over the past five years.
• In defense of consent: In a 2022 paper in the journal Bioethics, Samantha Seybold asserts that patients are "not just 'bodies with vaginas'" and lays out the "morally significant" reasoning on why exams like this without consent should be stopped. "Every woman should be able to refuse having her sexual organs appropriated as teaching tools during surgery," Seybold writes.
• Progress: As of last August, fewer than half the states in the US banned pelvic exams without consent, per Rewire, but more states have come forward recently to do just that. Reproductive justice advocates say that exams without consent are closely tied to "obstetric violence" (reprimands, threats, ignoring asks for help, etc.), in that both result in a loss of bodily autonomy.
• Guidelines: HHS' Monday letter lays out clarification on a long-time requirement that hospitals must get a patient's sign-off on such exams if the hospitals want to continue to participate in Medicare and Medicaid programs.
• Reaction: "Patients who are participating in future clinicians' education should be aware, should have the opportunity to consent, should be given the same opportunity to participate in that education that they would be given if they were awake and fully clothed," one patient who underwent a pelvic exam she didn't OK while under sedation in the ER tells the Times.

(More pelvic exam stories.)