We’re Fighting for Safe and Dignified Healthcare in CT — and You Can Help! | by Livia Fry | Oct, 2021

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Livia Fry
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Petition linked here.

Please note this story contains clarifications to the original text*

Imagine needing surgery. You would worry about a lot of things. Finding the best doctor. Finding the best hospital. Having a complication. Not waking up from the anesthesia. The pain you will experience afterwards. The list goes on. Now imagine having one more worry. But this one isn’t to do with your health. Rather, it is to do with protecting yourself. Protecting yourself from the possibility of forced vaginal or rectal penetration for the purpose of practice/education while you are unconscious and unable to give — or withhold — consent. Would you have the surgery? Would you take that risk? Now you may have a choice to make. Do you protect your health, and indeed, your own life by undergoing the surgery? Or do you protect your body from the potential of an unwanted and unwarranted invasion by not having the surgery, but in doing so risk your health, and maybe even your life?

The situation above probably sounds ridiculous to you. It probably sounds like something out of a dystopian novel. But the reality is, this is the situation facing the people of Connecticut right now.

Because of language commonly found in medical consent forms, teaching hospitals can have a lot of leeway in the way they use their patients in their teaching practices. Language in consent forms is often written to be broad, particularly surrounding the role of students and trainees in the provision of healthcare, which in many cases consists of only one or two lines, and follows the following formula: “I understand that students and trainees may be involved in my care and consent to treatment by providers in the event of unforeseen events or complications.” Those one or two lines are typically buried in the middle or at the end of a form, which patients often report being rushed to sign by providers or administrators as they are “standard.”

Most patients assume “student involvement” — unless otherwise specified — is limited to observation. Unfortunately in Connecticut, it is not illegal for medical students to practice pelvic and prostate examinations on anesthetized patients without their direct and informed consent.

There is a bill before the Connecticut state legislature right now — HB-5067 — that would ban the use of non-consensual pelvic and prostate examinations as a part of the medical education process. It will still allow students to practice their clinical skills — it poses no threat to their education or to their ability and opportunity to one day become competent, confident, and experienced clinicians. It simply prohibits students from practicing these invasive examinations on patients who have not given their specific consent.

HB-5067 is the latest iteration of this legislation, which was first introduced in the Connecticut state legislature in 2019 as SB 16. Unfortunately, while other states have acted quickly to enact similar laws, Connecticut’s bill did not even get a hearing during the 2021 legislative session.

The Yale University School of Medicine came out in opposition to the original iteration of this legislation (SB 16 — An Act Prohibiting an Unauthorized Pelvic Exam on a Woman Who is Under Deep Sedation or Anesthesia) in 2019, submitting public testimony to the state legislature stating, in part, that “all consent forms contain specific language explaining the involvement of trainees in the decision making and procedural process.” (This testimony is available online and is a matter of public record.) Please take a moment to judge that for yourself. Sample consent form language — in this case Yale’s — reads as follows:

“I understand that some of the system hospitals are teaching hospitals. Doctors or other health practitioners who are members of the care team and are in training may help my practitioner with the procedure. I understand the purpose and potential benefits of the procedure in relation to my goals. I give permission to my responsible practitioner to do whatever may be necessary if there is a complication or unforeseen condition during my procedure.”

*Disclaimer — Yale’s consent form language is quoted as an example here as they refer to consent forms in their 2019 public testimony in opposition to SB 16 — An Act Prohibiting an Unauthorized Pelvic Exam on a Woman Who is Under Deep Sedation or Anesthesia cited in the above paragraph.*

Tell me — would you define a student or trainee as a “responsible practitioner” in the event of a complication or unforeseen condition? Would any reasonable person? And how does a student’s need for practice — which is in no way unforeseen and can be established ahead of time — fall under that category? And when you sign any consent form, at any medical institution or provider, stating you understand the benefits of a procedure to your goals, would you even begin to imagine that an intimate examination by a student who is unlicensed conducted for the purpose of them practicing their clinical skills could possibly be covered under that language?

Interestingly enough, medical students from various states have expressed discomfort conducting intimate examinations on patients for the purpose of practice without knowing whether that patient has given direct and informed consent, but did not feel at liberty to voice their discomfort or opt out.

We aren’t asking for much. We aren’t asking teaching institutions to sacrifice the educational opportunities they offer their students, or to take opportunities away from students. We are simply insisting that those opportunities only be offered with the consent of the patients whose bodies they are using. We are insisting that exploitation and abuse no longer play a role in the medical education of our state’s future doctors, and that they are taught the importance of consent early on. And we are insisting that our laws protect us from the dehumanization and indignity of being turned into living teaching tools without our consent. Hospitals exist to serve their patients — patients do not exist to serve hospitals, and we do not owe hospitals the use of our bodies in exchange for necessary healthcare.

*Disclaimer — Yale is referred to in this text due to their 2019 public testimony in opposition to SB 16. It is not the intent of this petition to accuse or in any way allege that the Yale School of Medicine or any of its affiliates or students have ever participated in or are currently participating in these practices.*

If you are a Connecticut resident just becoming aware of this practice, please join us in standing up and saying enough by signing this petition and contacting your state representative and senator. If you live outside of Connecticut, please stand in solidarity with our state’s residents and in demanding justice and protection for us when we are at our most vulnerable.

In addition to signing our petition, please consider reaching out to the Public Health Committee at (phtestimony@cga.ct.gov or by phone at (860) 240‑0560. If you are a Connecticut resident, please consider reaching out to your state representative (if you unsure of who yours is, you can find out https://www.cga.ct.gov/asp/menu/cgafindleg.asp

If you would like to learn more about this issue, please have a look at the following articles:

Explicit Consent for Pelvic and Prostate Exams: A Case for CT House Bill 5067
https://ctexaminer.com/2021/03/20/explicit-consent-for-pelvic-and-prostate-exams-a-case-for-ct-house-bill-5067/

Providers Are Sexually Assaulting Patients — and It’s Legal
https://www.healthline.com/health/nonconsensual-internal-exams-sexual-assault#1

Medical Students Regularly Practice Pelvic Exams On Unconscious Patients.
https://www.elle.com/life-love/a28125604/nonconsensual-pelvic-exams-teaching-hospitals/

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