Australian doctors anally probe unconscious patients

[aerius]

From news.com.au

Medical students are performing intrusive exams on unconscious patients

* By Helen Davidson
* From: news.com.au
* January 28, 2011 3:21PM

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, Madison reports.

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 told news.com.au.

"Patients should never be examined without consent, particularly by a third party."

Comment is being sought from the Australian Medical Association.

Remind me to be extra careful if I'm in Australia so I don't end up in a hospital and get anally violated while I'm unconscious.

[Todeswind]

What exams did the women in question already consent to that put them under anesthesia? If memory serves the wavers they have you sign before you go under are very extensive.

[weemadando]

What exams did the women in question already consent to that put them under anesthesia? If memory serves the wavers they have you sign before you go under are very extensive.

Having had to deal with surgeries for family members repeatedly in the past few years the waivers are extensive, but also VERY explicit. Each component of the procedure is usually described in detail and subject to it's own waiver. The surgeons, anaesthetists and other practitioners involved all have to interview with the patient/responsible party prior to the procedure to ensure that every step is understood so that there cannot be a defence of "the legal document was not explained to us" should something happen.

Hell, when there have been med students present during GP appointments I've had, I have to consent to them being present, then should they wish to duplicate a test (even if it's just using a stethoscope), they have to again seek explicit consent from me for each instance.

I really doubt that someone would say in the pre-op briefing/legal bit "sure, I consent to having a half dozen med students perform rectal exams while I'm out". At the very least, I'm sure they'd at least remember being asked the question.

[mr friendly guy]

Remind me to be extra careful if I'm in Australia so I don't end up in a hospital and get anally violated while I'm unconscious.

Well unless being NOT careful leads to you having an enlarged prostate, or some other mass which can be felt on a digital rectal exam, I doubt students would be clamouring to examine a "normal" person. It doesn't take much time in doing a DRE vs say a cardiovascular exam (which requires doing things in a certain order, in a limited time frame, so there is benefit to practicing on a normal person). The only reason they would do a DRE is if there is a physical sign to be elicited. Or those medical students were really Grey aliens on a budget and couldn't afford the proper anal probe device.

What exams did the women in question already consent to that put them under anesthesia? If memory serves the wavers they have you sign before you go under are very extensive.

The way you phrase it sounds like the women consented to an exam which required them to be anaesthetised. More likely the women were undergoing surgical procedures and then the students examined them while they were out.

[Todeswind]

What exams did the women in question already consent to that put them under anesthesia? If memory serves the wavers they have you sign before you go under are very extensive.

The way you phrase it sounds like the women consented to an exam which required them to be anaesthetised. More likely the women were undergoing surgical procedures and then the students examined them while they were out.

I can't imagine a situation in which a "line" of med students probing someone would be necessarily ok without expressed consent or in which someone might give "implied" consent but that's not to say such situations don't medically exist.

[General Zod]

Is there a more reputable source for this article? Everything I can dig up so far tracks back to a few nutter fringe sites, some articles from 2003 and my bullshit meter is going off.

[Sea Skimmer]

Yeah, this reads like something generated to covertly work against health care reform in the US. Some fucked up shit takes place in the world certainly and hospitals are no exception, but if a story like this was real it would surely have been picked up by others sources.

[weemadando]

Pro Tip - if the Murdoch dominated Aussie media hasn't picked up on an anti government Aussie news story I think its safe to call bullshit.

..wait that is where its from. And given that Fairfax and ABC haven't picked it up my bullshit meter remains in the red.

[Knife]

I can't imagine a situation in which a "line" of med students probing someone would be necessarily ok without expressed consent or in which someone might give "implied" consent but that's not to say such situations don't medically exist.

Implied consent is tricky, usually means that the patient is unable to vocalize or communicate a 'yes' but in the health care workers best judgment, if the patient was able to, they'd say yes. I have a hard time; however, believing that anyone would give consent to let a line of med students give them a digital exam of their anus.

That said,t the article is weird. Nothing but a 'student questionnaire' with nothing mentioned as a verification of the information given. While I wouldn't be surprised if questionable shit happened all the time in Med School, something of this magnitudes seems unlikely.

[Jawawithagun]

A quick googling of the name of the researcher turns up a list of publications from her time at the University of Sydney: http://sydney.edu.au/medicine/people/ac ... /crees.php
And also her list of publications at the University of Dundee: http://www.dundee.ac.uk/meded/courses/c ... p?ID=24850

The study talked about is the latest one listed.

Looking at the article listings for the journal it is said the study is to be published in, it's neither in the January nor the February issue.

[Alyrium Denryle]

A quick googling of the name of the researcher turns up a list of publications from her time at the University of Sydney: http://sydney.edu.au/medicine/people/ac ... /crees.php
And also her list of publications at the University of Dundee: http://www.dundee.ac.uk/meded/courses/c ... p?ID=24850

The study talked about is the latest one listed.

Looking at the article listings for the journal it is said the study is to be published in, it's neither in the January nor the February issue.

It is in press, meaning it has been accepted for publication, and will be published... but it could take a while to actually hit paper.