Patient Modesty

Patient Modesty

"We all see you naked, but we don’t care" (but does the patient care?)

From a doctor:

"during the first operation that I witnessed as a medical student, I immediately realized that no one in there cares. We’ve all seen it a million times, and trust me, despite what you may believe, yours is no different than anyone else’s. I’ve had many patients who have been apprehensive about disrobing before surgery, but there is nothing remotely titillating in the operating room. Nothing."link

I've heard similar responses like this so many times.  It is such a big lie. It just makes me sick. First off, he says "the first operation that I witnessed."  There is a first time for EVERYONE.  There is no med student or nurse that was born with having "seen it a million times".  And keep in mind not only doctors are in the operating rooms.  A nurse, scrub tech, other techs, trainee, visitor, auditor, management all could be there watching.  I've read where a guy boasts that his friend that worked in the O.R. took him in to see a woman being prepped for a GYN surgery.  Woman totally exposed to a stranger off the street.  Without her knowledge at all.


Second " there is nothing remotely titillating in the operating room. Nothing." heard that from medical professionals all the time too.  Is that for real?  Let's look at some real world examples:

Examples:
 "New Orleans breast surgeon sent himself 'surreptitious' photos of naked patients during surgery"
"A noted New Orleans breast surgeon “surreptitiously” took nude photographs of patients during surgery, emailing himself pictures showing the patients’ “faces, breasts and vaginas,”

Seems this doctor didn't get the message.  Maybe he hasn't seen enough yet?  And notice he took pictures of their "vaginas"  His purpose is to work on their breasts.  But he takes advantage of the fact that the hospital doesn't allow patients to cover themselves.  Have to wonder what kind of person is making the rules.

For some practical tips and suggestions for maintaining modesty, check out our post on maintaining modesty.

"Doctor accused of taking photo of unconscious patient's private area"
How could she notice the tattoo and be interested enough to take a photo.  I thought they had seen it all a million times. Apparently sometimes it is interesting enough to warrant taking a personal photo.


Doctor taking photos of Sedated patient
Tell me again doctor that patients are all the same and the medical staff doesn't notice anything?

Doctor sexually assaults patient while unconscious
He also performed genital exams on a female despite being an Ear Nose and Throat specialist.  But they have seen it all, "yours is no different than anyone else’s". Apparently not all Doctors feel that way.


Prominent Emergency Room Doctor accused of four sexual assaults
This doctor seems to have made a habit of preying on young adult women who happened into his emergency room-- yet they "all look the same"...


Cardiologist snapping nude pictures of a girl in the bathroom.
If he's seen it all a million times why is he trying to sneak a pic?

And it is not just a problem with male health care workers. Female workers notice and respond to their patients' bodies as well.
Nurse texts photo of unconscious patient's penis

Female ENT doctor accused of routinely giving genital exams to male patients while they were sedated. 

Here's a whole article on protecting patients from sexual predators in the OR.

Why do these things happen?

The above are just a few examples of countless cases of criminal sexual misconduct in a medical setting. Cases where someone actually got caught.  Which you know that most of the time they aren't caught. Since they've "seen it all" and there is "nothing stimulating," why do these things happen? Why do we pretend that professionals aren't human and don't even see their patients? That is simply unrealistic and not accurate.

A medical training document published by the government of the United Kingdom states:

"Students must be taught that there is nothing unusual or abnormal about having sexualised feelings towards certain patients, but that failing to identify these feelings and acting on them is and likely to result in serious consequences for their patients and themselves."

"If a healthcare professional is sexually attracted to a patient and is concerned that it may affect their professional relationship with them, they should ask for help and advice from a colleague or appropriate body in order to decide on the most professional course of action to take. If, having sought advice, the healthcare professional does not believe they can remain objective and professional, they must:
• find alternative care for the patient
• ensure a proper handover to another healthcare professional takes place
• hand over care in a way that does not make the patient feel that they have done anything wrong."
link

"There is nothing unusual or abnormal about having sexualized feelings towards certain patients." It is biology. It is going to happen. So rather than pretending that doctors can turn off their sexuality like a switch, which they can't.  Why isn't the topic dealt with realistically so that proper protections for patient and doctor can be provided for?

What about chaperones in the room during exams? This article talks about how seldom chaperones are used and how often patients are more uncomfortable when one is used. I can understand this since the general approach to chaperones is to grab some other employee (so generally a stranger to the patient), so now the patient has two strangers ogling them instead of one. And sometimes that extra has little medical training. Plus, if there is an environment of inappropriate behavior at a medical facility, it often involves more than one employee or else other employees are quiet out of fear of employment repercussions. This case, where a surgical tech was both sexually assaulted and witnessed inappropriate behavior towards patients, is an example. Bringing in a coworker does little to encourage patient trust. In fact, when chaperones are used, it is generally to protect the doctor (from accusations and lawsuits) rather than the patient. This article  explains how and why chaperones are typically used and how they aren't much help to the patient. It also includes this great reminder that doctors are human and aren't magically blind to their patient's appearance:
"A third reason respondents said they used chaperones was protection from their own sexual feelings. One male doctor talked about a female patient of his who he considered “gorgeous.” He had a difficult time examining her. “…I needed to use a chaperone." he admitted. "A chaperone not for her comfort but for mine.”

Wouldn't increased modesty for patients make the situation more comfortable for both the patient and for the doctor and other medical staff who may be sexually aroused, in spite of his/her best intentions? The less they can see, the less likely they will be notice something they wish they hadn't. You can read more on this topic here.

Isn't there also a very logical argument for using doctors and nursers of the patient's gender for intimate procedures and exams? This article shows that patients would prefer it, but are often too embarrassed to request it, in part because of the derision with which medical personnel tend to respond to these requests.

For some practical tips and suggestions, check out our post on maintaining modesty.

Take it all off

 What ever happened to Patient modesty?

Take it all off?  Why?

 This phrase is said to patients in medical facilities all over.  In many (perhaps most) cases it isn't even necessary.  But somehow the medical "professionals" have forgotten that stressed and uncomfortable patients do not heal as fast as ones that aren't stressed.  And stressed patients say and and do stupid things.  It's not in the patients' best interest.  And this is another thing doctors won't generally tell you.

Here is a nice article "Keep Your Pants, and Your Dignity, at the Hospital" Seems like something a service industry (medical) should strive for.

"Dr. Harlan Krumholz, a professor of medicine and public health at Yale School of Medicine, has suggested patients may suffer from a period of vulnerability, which he called the "post-hospital syndrome." The combination of a recovering body and a stressful hospital experience could make people less able to fend off new diseases,"

And beyond contracting new diseases it can make patients not seek medical treatment. And once sedated most hospitals treat every person like a piece of meat and do nothing to protect their dignity.  They do not ask the patient if it ok to expose their privates or remove their gown prior to sedating them and doing just that.  They don't because they don't have to.  Sedated and anesthetized patients aren't able to speak for themselves.  And if the hospital doesn't tell the patient details of what they did to them in surgery how will they will ever know.  The hospitals ensure that no family or advocate is around to know either.  And what the patient doesn't know won't hurt them, right?  So the medical staff can do as they please.

Much of this nudity is totally unnecessary.  I can hear you now.  What's the big deal.  They are "out" so it's not hurting the patient.  They can't be embarrassed.  Well some people have religious beliefs that go beyond if they are embarrassed or not.  And some have personal beliefs.  Is it ok for a hospital to give a sedated vegetarian meat?  They won't know they ate it.  Or a Jew pork?  But somehow it's ok to strip them of their clothes and dignity regardless of what the patient believes and regardless of their desires. There are also people who have had terrifying sexual assaults in their past.

So many times "take it all off" is said when it is completely unnecessary.  Remember the anesthesiologist that got a big fine for making fun of a patients genitals while getting a colonoscopy? Article  Should have never happened.  But you say you have to be naked for a colonoscopy.  Um... no.  Ever hear of Colonoscopy pants? See some here Your doctor didn't mention that?  Yes they only need access to the anus.  Not the genitals.  The rest of you could still be covered and the pants allow access to the part that is needed.  I am betting that anesthesiologist, Tiffany M. Ingham, is wishing now that her hospital had used colonoscopy pants.  If the hospital had used them they would have avoided traumatizing a patient, a lawsuit, bad press, loss of a employee, etc.  All for a few $ in clothing?  Was that bad situation caused by the negligence of the hospital?  Hummm...

Another good article  "The dreaded hospital gown, described as health care's prison jumpsuit, often imposed on patients needlessly"

"Researchers in Montreal and Toronto surveyed patients at five hospitals, finding that almost 60% could have worn clothes that covered their whole bodies, but that barely one in 10 had on more than a gown."

So many surgeries are done where they remove part or all of the patient's gown and leave them totally naked.  A helpless, unconscious person laying totally naked in a room full of people.  What does this sound like?  And there are so many times when this is not necessary.  Heck many states require strippers to cover their nipples.  Patients don't even get as much dignity as a stripper

Here is another time that "take it all off" really hurt the hospital.  In trying to catch an employee stealing drugs, the hospital videotaped the operating room.  In doing so captured the patients that had, out of routine, been stripped totally naked by the medical staff.  Eventually the videos got out and were viewed by many people that were not even medical personnel.  And now the hospital has a big lawsuit.  Read more details article.  If the patients even had even the most minimal covering there would have been NO lawsuit.  None.  When will hospitals learn?  Protecting patients protects the hospital, too.

.... Come home from the hospital with something "fixed" only to suffer from emotional trauma from being put on display naked for a crowd in the surgery.  Seriously, when did this start being ok to everyone?  It is not ok to me.

 Apparently I'm not the only one:


 Medical Patient Modesty
Read the comments section

Another article: "What Your Doctor Won’t Tell You About Surgery"
written by a doctor where he states "We all see you naked".  He admits

"When I had my appendectomy in college, I was absolutely mortified when I discovered the next day that the surgeon, residents, nurses, assistants, techs, aides, and probably several dozen other people all saw me au naturel".

Now that he's a Doctor and is the one with his clothes on his story changes....... :-(  Apparently his own experience with his appendectomy taught him nothing!  What's so hard about letting people stay modest.  When going for a surgery on a limb (not the torso) there is NO reason to have ones' genitals exposed.  None.  Period.  Medical professionals when will you get a clue?

Even very simple changes would greatly improve patient comfort. Nurses at LDS hospital fought to make some changes to their outpatient surgery procedures. One of these, was to allow patients to wear underwear.

"SOME PATIENTS were especially bothered to spend half the day without underwear -- for shoulder surgery, say. Ms. Lelis was convinced this longstanding practice was meaningless as a guard against infection, persisting only as the legacy of a culture that deprived patients of control. "If you're practically naked on a stretcher on your back," she says, "you're pretty subservient." The nurses persuaded an infection-control committee to scrap the no-underwear policy unless the data exposed a problem; they have not. " source

And there we have a key problem, most of the time there isn't a medical need for the patient to be naked. It is just "how it's always been done" or it is more convenient for the medical staff. Patient dignity should be more important than the staffs convenience. Patients should not be put unnecessarily in a degrading and demoralizing situation that leaves them feeling vulnerable and powerless.

I think this blogger says it well (and the rest of his article is good too),

I have always stated: "Medical treatments and procedures would be radically different if the providers had to be in the same state of exposure as the patients."

More on this topic:
Patient Modesty
How to Protect Your Modesty in a Medical Setting
We All See You Naked, But We Don't Care

Preventive Medicine: Overdiagnosis

 

Over-diagnosis

 from the blog "Why is American health care so expensive" the post Preventive Medicine: is a great article that everyone should read.  It is wonderful to see a Doctor that can think and make recommendations based on the individual not just follow blanket recommendations based on averages or propaganda.