The ethics of intimate examinations—teaching tomorrow's doctorsCommentary: Respecting the patient's integrity is the keyCommentary: Teaching pelvic examination—putting the patient first
In the early 70's 'World Medicine' (of blessed memory) published a
letter from me in which I expressed my puzzlement at the variety of
apparent sentiment amongst women on the subject of vaginal examination. I
am not much less puzzled now. Perhaps if I had one, I would understand
better.
Like many male medical students I am sure that I owe a far greater
debt of gratitude to my wife than to any teacher.
The nearest I am ever likley to come, however, is a rectal
examination and with the strangury advancing I am conscious that my
appointment with the fickle finger of fate cannot be very far off. Am I
concerned? Not in the slightest. Short of appreciable discomfort I would
not hesitate to contribute to the education of as many students as were
interested but then, to me, it is a trivial and comprehensible procedure
having no more consequence than, say, abdominal examination.
The morbidly delicate metropolitan sensitivities that inform so much
debate in the ethical area are running amok in the practice of medicine
and threaten to so mire it that ere long it will become frozen by
regulation and diktat.
The majority of women convey to me the impression of impassive
neutrality about vaginal examination, only rarely is there a noticeable
apprehension. Terror and enthusiasm are both extraordinarily rare.
Are we quite sure that the majority of women are not perfectly
sensible thoughful creatures who are quite capable of expressing
themselves, when conscious at least? Examination under anaesthetic without
valid consent ought to be consigned to history but then I have always
thought it an effete teaching exercise on practical grounds - let alone
ethical ones.
Emphasising the routine, stigma-free, health affirming nature of
examination (of any part) to the public at large and educating them about
the nature and purpose of examination could be so valuable. Channel 4 -
are you listening - I am free for a screen test any time...
We urgently need a vigourous reassertion of the utilitarian ethos.
The BMJ should always include a balancing view when the distinction is
drawn between two opposing camps.
Rapid Response:
Kant rules - Not OK!
Sir
In the early 70's 'World Medicine' (of blessed memory) published a
letter from me in which I expressed my puzzlement at the variety of
apparent sentiment amongst women on the subject of vaginal examination. I
am not much less puzzled now. Perhaps if I had one, I would understand
better.
Like many male medical students I am sure that I owe a far greater
debt of gratitude to my wife than to any teacher.
The nearest I am ever likley to come, however, is a rectal
examination and with the strangury advancing I am conscious that my
appointment with the fickle finger of fate cannot be very far off. Am I
concerned? Not in the slightest. Short of appreciable discomfort I would
not hesitate to contribute to the education of as many students as were
interested but then, to me, it is a trivial and comprehensible procedure
having no more consequence than, say, abdominal examination.
The morbidly delicate metropolitan sensitivities that inform so much
debate in the ethical area are running amok in the practice of medicine
and threaten to so mire it that ere long it will become frozen by
regulation and diktat.
The majority of women convey to me the impression of impassive
neutrality about vaginal examination, only rarely is there a noticeable
apprehension. Terror and enthusiasm are both extraordinarily rare.
Are we quite sure that the majority of women are not perfectly
sensible thoughful creatures who are quite capable of expressing
themselves, when conscious at least? Examination under anaesthetic without
valid consent ought to be consigned to history but then I have always
thought it an effete teaching exercise on practical grounds - let alone
ethical ones.
Emphasising the routine, stigma-free, health affirming nature of
examination (of any part) to the public at large and educating them about
the nature and purpose of examination could be so valuable. Channel 4 -
are you listening - I am free for a screen test any time...
We urgently need a vigourous reassertion of the utilitarian ethos.
The BMJ should always include a balancing view when the distinction is
drawn between two opposing camps.
Yours, with a nervously pouting sphincter
Steven Ford
Competing interests:
None declared
Competing interests: No competing interests