Public Health Committee
March 9, 2022
Presented By: Kathleen Callahan, MSW
Dear Honorable Chairpersons Abrams and Steinberg, Ranking Members Hwang , Somers, and Petit, Vice Chairs Anwar, Kushner, and Gilchrest, and all other Members of the Public Health Committee of the Connecticut General Assembly:
My name is Kathleen Callahan, a resident of Stratford, and the chair of the National Association of Social Workers Connecticut Chapter’s Education and Legislative Action Network (NASW/CT ELAN). I am testifying on behalf of the chapter which represents almost 2,400 members. We call upon the Public Health Committee to vote favorably on HB-5278.
NASW/CT supports patient-centered, trauma-informed health care and while some view this issue of intimate examinations strictly through a medical lens, we also apply a behavioral health perspective. We recognize that an intimate examination, such as pelvic, prostate, or rectal, without consent – or authorization from a legal representative – is not only a violation of trust but a traumatic experience for the patient.
Trauma-informed environments are safe, trustworthy, and collaborative. This invasion of privacy is a clear breach of these principles, treating a patient’s body as a test subject in an experiment. While medical teaching informs the wellness of all, patients should have full body autonomy and consent is not optional.
Back in 2003, the Association of American Medical Colleges shared our concerns, stating that performing pelvic examinations on women who are under anesthesia without informed consent as “unethical and unacceptable” and that treating patients with dignity and respect is imperative.[1] The American College of Obstetrics and Gynecology has also denounced this practice, stating pelvic exams performed for teaching purposes occur only with explicit consent, must be related to the planned procedure, must be performed under direct supervision, and only if the student is recognized as part of the care team by the patient.[2]
This practice does not only impact the individual involved. As awareness spreads through news reports, shock and disapproval will have an adverse effect on the position of the medical community in the eyes of those for whom they care. In a recent paper by the Associate Director of Interdisciplinary Center for Bioethics at Yale University, without consent these intimate exams can add to “moral erosion and moral distress of medical students and compromise the sacred trust between the medical community and the general public.”[3] The most common response I have heard when someone first learned of this practice was “Why not just ask first?”
Trust is an essential component in the relationship between caregiver and patient and in closing, NASW/CT urges you to vote in favor of HB-5278: An Act Prohibiting an Unauthorized Intimate Examination on a Patient Who is under Deep Sedation or Anesthesia or Unconscious.
With respect and gratitude for your service and consideration,
Kathleen Callahan
NASW/CT ELAN Chair
Stratford, CT
[1] Wilson, R. F. (2005). Autonomy Suspended: Using Female Patients to Teach Intimate Exams Without Their Knowledge or Consent. Journal of Health Care Law & Policy, 8(2) 240-263. Retrieved from https://ssrn.com/abstract=880120.
[2] Cleveland Clinic. (2019, November 20). Pelvic Exams Under Anesthesia Are Only for Clinical Indications, According to Cleveland Clinic Care Path. Retrieved from https://consultqd.clevelandclinic.org/pelvic-exams-under-anesthesia-are-only-for-clinical-indications-according-to-cleveland-clinic-care-path/.
[3] Bruce L. (2020). A Pot Ignored Boils On: Sustained Calls for Explicit Consent of Intimate Medical Exams. HEC Forum, 32(2) 125-145. doi:10.1007/s10730-020-09399-4.
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