Generalized Consent

[Pure]

Is Generalized Consent valid for specific acts?

Washington Post, May 10.
www.washingtonpost.com
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Practice vs. Privacy on Pelvic Exams
Med Students' Training Intrusive and Needs Patient Consent, Activists Say
By Avram Goldstein
Washington Post Staff Writer
Saturday, May 10, 2003; Page A01

When Zahara Heckscher went to George Washington University Hospital last month to have an ovarian cyst removed, she asked her surgeon if medical students would be practicing pelvic exams on her while she was unconscious. She was shocked that the answer was yes.

Medical students, interns and residents at teaching hospitals across the nation routinely learn how to perform such examinations by practicing on patients under anesthesia, medical educators say, and GWU Hospital officials say their program is no exception.

"Everyone I spoke with there acknowledged they normally do that," Heckscher said. "I think it's just such a violation."

So the 38-year-old District woman wrote a note on her consent form forbidding anyone other than her attending physician to perform a pelvic exam on her while she was under anesthesia. [...]
Heckscher and a growing number of activists say they think women should be advised routinely about the pelvic exam lessons and be given the opportunity to refuse. Gabrielle Lichterman, who recently launched a New York-based group called People Against Non-Consensual Pelvic Exams, says that an overwhelming majority of the nation's 400 teaching hospitals use the generalized consent form as permission to perform the exams, and her group wants federal legislation to ban the practice.
[...]
Michael Greger, a doctor from Boston who has lectured to medical students across the nation on the issue, said the voluntary guideline of having one or two students perform the exam is widely ignored."If they have five medical students on an OB-GYN rotation, they aren't going to let one do it and not the other four," Greger said. "I never heard of anyone out of some kind of respect for the patient just limiting it to a few."
[end excerpt]

 

[Netzach]

I don't know what this has to do with SM, but I appreciate the PSA, and if I need a cyst removed I'll be writing a little bit down the night before.

I'd even let people stick their hands in me in the name of science while I'm AWAKE thankyouverymuch. Jeez.

 

[Johnny Mayberry]

I see the purpose of this...if someone consents to play with you, including being bound and gagged, they are not necesarily consenting to being used by seven of your friends as well. Consent in general does not give someone consent to every specific act, and if there is a question, you should either stop and ask, or wait until another time to try something new.

 

[lark sparrow]

Interesting, Pure. I find the advantage taken of an unconscious person who has not even been given the opportunity to consent somewhat troubling. Is there any benefit to her in being checked several times by medical students? It is in the name of science and further development of students, but were an unconscious patient at a dentist or plastic surgeon office to be fingered by several passerbys from the office it would be highly unlawful obviously. While I know it is not the same thing, I can also understand a similar sense of violation. Some women might object if given the opportunity but the thought seems to be what you don't know won't hurt you. Does anyone know if this happens in other ways any time a patient is unconscious at the hospital? I suppose if a person is having surgery to the colon, we should also allow general consent lines to include a host of student doctors to perform anal exams as well without specific consent while the person is out. I could go on, but I'm going to stop there. Thanks for the heads up.

In BDSM, I think this is where hard limits, and discussion of any known touchy areas comes up before play - not to mention safe words during play. When Mistress and I scene not knowing exactly what is going to happen is part of the power exchange, with the grounding trust that none of it will willfully cross boundaries with intent to harm me.

That's well and good with Mistress within the boundaries we have set up mutually - having an unconscious "power exchange" with my doctor does not sit well with me. I give you money, you focus your skill on me, for me exclusively - anything other than that is a violation of the professional trust I have extended. It's not so much that I would be unwilling to "donate" to science - just ask me. I have even been asked if a swab from my nose, which was entirely unrelated to the treatment I was receiving was okay, as a sample for a study in which my personal info would be anonymous and I agreed. Monetary "donations" taken without knowledge or consent is usual called robbery. Anything as intimate and personal as your "person" seems worthy of similar consideration.

 

[MissTaken]

Nice post, as usual, lark sparrow.

To take the discussion one step further, I do believe that consent becomes more "generalized" as trust goes and the relationship evolves. At some point, one may lay their bound, blindfolded and gagged and not care what is done to him or her as long as it is the will of the Dominant. I have felt this way when deep into subspace, which is why the Dominant needs to be trusted and trustworthy. At that point of seeming unconciousness, he must know what is best for me when I don't.

To parellel this to the article, I don't believe I have ever trusted a physician to the degree to which being anesthisize (or whatever) didn't cause some anxiety for me.

So, I wouldn't be surprised to see this general consent thing changing very soon. Already, the issue of consent to release information is tightening up and becoming far more specific, so it seems the medical world is looking at some issues related to patient's rights.

 

[catalina_francisco]

Definately a disturbing practice in an environment where one already feels vulnerable. My experience in Australia ( where I lived until recently) was my doctor always asked before hand if I would consent to being subject to any training of medical students, and even consulted me before calling in other doctors for second opinions etc. Perhaps this was part of him being a private doctor instead of public system, or maybe just his personal manner as he was very mindful of not abusing or embarrassing women under his care to the point of openly correcting, in a less than friendly way, any hospital staff he found abusing this trust.

Is a massive betrayal of trust to do otherwise, and as a feminist I can't help wondering if part of the practice noted on this post is related to attitudes towards women in general. Medical science has not enjoyed a healthy history toward women in many ways, including the lesser publicised possible presenting illnesses as a warning sign of HIV infection of women, and the testing of breast cancer treatments on males, ignoring the fact there is a physiological and biological difference between the genders. Hopefully this post will alert women to the ways they need to be aware, and the need to protect themselves from non-consensual abuse.