A bill introduced this month in the New York state assembly and senate hopes to halt the practice of performing nonconsensual pelvic examinations on unconscious patients. As it stands, 45 states, New York included, allow medical students to conduct the tests on people who have been anesthetized for other procedures, who may be unaware that at some point they might be checked for anomalies in their reproductive system.
Nassau County assemblymember Michaelle Solages and Brooklyn state senator Roxanne Persaud introduced the bill, which would also require hospitals, most of them teaching hospitals, to disclose the number of exams that they perform on people who have been put under, as Politico reports. The bill is a response to media reports revealing more about the nonconsensual practice in 2018, and the ultimate goal of the legislation to eliminate it entirely. "Non-consensual pelvic exams are — shockingly — common practice nationwide; it is unethical and unacceptable," NYS Senator Roxanne J. Persaud said in a statement to Gothamist. "In New York, we have empowered women with rights over their bodies and this issue is no different. Hospitals must not be permitted to administer pelvic exams on unconscious or anesthetized women without their prior consent. We must also educate women of these issues."
"Number one, that doesn’t build trust for people going to teaching hospitals," Solages tells Gothamist, adding that it might also dissuade people from receiving care at those institutions around the state. "Number two, it’s also a violation with the patient, it doesn’t build trust with healthcare professionals and we already have an issue with that, especially with communities of color."
Solages adds that when she gave birth at a teaching hospital recently, she had a problem with her arm. "The residents would come in...and asked me to consent: 'Can we look at your arm?'" she says. "We want that established when it comes to a pelvic exam. First of all, we want there to be consent between the patient and the healthcare provider."
Many people were unaware that nonconsensual pelvic exams were a practice until recent media reports. Public response has been quick and horrified.
OMG. That's a thing? This is LEGAL in most states?!?! I feel so sick. So so sick.
— Sally Rutter (@SallyRutter) March 14, 2019
These are NOT "exams". These are acts of RAPE. This behavior is the actual legal definition of RAPE. So if this is true, you better be right. Snopes says it's legal in 45 states. Can someone verify this, please? This is outrageous.
— Lady Jayne (@666k9s) March 16, 2019
"I had several women reach out to me and ask, 'Did this happen to me?'" Solages says.
It's unclear how many teaching hospitals in the city perform the exams. An NYU Langone spokesperson tells Gothamist that they do the exam on patients undergoing gynecological procedures, and ensure that surgeons include "exam under anesthesia" in their consent forms. Additionally, they say, doctors explain to patients in the consenting process that they do this the exam before the surgery, and under anesthesia, "to make sure we understand the specifics of the patient’s anatomy before starting the invasive part of the procedure."
A NewYork-Presbyterian spokesperson told Gothamist in an email statement that the hospital "does not perform nonconsensual pelvic exams" and that it is their "priority to protect all of our patients and we will be reviewing the bill." Mount Sinai did not immediately respond to Gothamist's request for comment.
As Phoebe Friesen, a researcher at the University of Oxford, wrote in a Bioethics journal article last year, four states abolished nonconsensual pelvic exams after a public backlash in the 1990s. In 2012, then-medical student Shawn Barnes wrote in the journal Obstetrics & Gynecology about the ethical concerns of students being asked to repeatedly perform the act —which continues to be seen as standard educational practice.
Recent research has also revealed how widespread this practice continues to be, as Friesen notes in her paper: In 2003, one study found that 90 percent of 400 medical students across several schools in Philadelphia had performed the nonconsensual tests as part of their studies. And medical students at the University of Oklahoma confirmed that 75 percent of patients that had had pelvic exams performed on them had no knowledge that it would be happening during their medical procedure.
For many people in the medical community, pelvic exams have historically been seen as a preventative measure for patients, as well as instructive for students. But in recent years, medical professionals have debated whether or not they even help to curb disease and other disorders, partially because there's little research surrounding the exams as a whole. The likes of the American College of Physicians have denounced the routine examinations, unless someone is pregnant or exhibiting symptoms of disease or infection, saying that they're more likely to cause anxiety and discomfort instead. The fact that the exams are continuing to be done without women's explicit consent—and often not during a gynecological procedure—is even more questionable.
"At the end of the day, there’s no medical benefit when it comes to nonconsensual pelvic exams," Solages says, noting advances in technology that could make for less invasive measures. "The response from women reaching out to me is proof positive that we need to get rid of this antiquated practice."