The Health Reporter Is In, Dec. 13, 2018

The Health Reporter Is In, Dec. 13, 2018

Q: What's the possibility that women under anesthesia at local hospitals could be getting unauthorized pelvic exams by medical students and not know it?

A: Illinois law requires any medical provider — doctor, medical student, resident, nurse, advanced practice nurse or physician assistant — to inform a patient of his or her profession upon providing the care "which includes but is not limited to any physical examination, such as a pelvic examination."

In the case of an unconscious patient, state law requires any care or treatment administered to be related to the patient's illness, condition or disease.

Carle Foundation Hospital and OSF HealthCare emailed statements to News-Gazette Media about their positions on this issue, but declined to be interviewed.

"At OSF HealthCare, the privacy and dignity of our patients is of utmost importance," said DR. JOHN KRECKMAN, chief medical officer and VP of medical affairs. "OSF HealthCare providers do not perform exams or procedures without a patient's consent."

Carle said health and safety of its patients is its top priority, and it helps patients understand their rights in many situations, including while they're under anesthesia.

The statement goes on to say, "Carle care teams do not perform additional procedures or tests other than what the patient agrees to for teaching or any other reasons. With the exception of dealing with an unexpected medical situation the care team can address while working through the original need or needs, the patient is aware ahead of time what the care team will do."

UI law Professor ROBIN FRETWELL WILSON said Illinois is one of six states that forbid unauthorized medical exams. But she doesn't see Illinois' law alone providing adequate protection against this practice.

For one thing, she said, laws don't necessarily equal a social movement.

And in the absence of a disclosure, unconscious patients aren't in a position to know when they're being examined by doctors-in-training and/or for something unrelated to their conditions, unless a friend or family member actually observes it, she said.

Patients also don't always know when they're in a teaching hospital, Wilson said. And medical students aren't necessarily motivated to disclose they've done exams to which patients didn't consent, she said.

Plus, Wilson said, when patients do find out they were examined without their knowledge or consent, it's difficult for them to bring a lawsuit over it.

This doesn't always just happen to women, Wilson said. She recalled one man's experience in which he was going to a doctor for a prostate exam.

"The physician just very quickly said, 'I'm sure it's fine with you that my student does this,' and it was after the physician had already done that."

Wilson contended health care accrediting bodies need to be looking over hospitals' shoulders on their practices with respect to unauthorized exams.

"It's one of these places where we are discounting women's bodies, and we feel there is an entitlement," she said. "This has been a persistent practice, and we know it happens."