Many women say it should go without saying: Your doctor should not be able to give you a pelvic exam without first getting your permission.
That’s the law in Illinois. Yet in many states — including Missouri — physicians aren’t required to ask first. And some doctors say the practice of giving women such exams while under anesthesia has long been commonplace, as a way to train medical residents. Explicit consent has not always been part of the equation.
For two years running, Missouri Rep. Shamed Dogan (R-Ballwin) has introduced a bill to bar physicians from giving unconscious women pelvic exams without first getting their express consent. On Friday’s St. Louis on the Air, Dogan explained that he was inspired by national media coverage of the issue. (Most recently, the New York Times looked into the practice.)
But, he noted, the speaker of the House has so far failed to assign his bill to a committee. With that inaction, Speaker Elijah Haahr, R-Springfield, has in effect single-handedly blocked the legislation from ever getting a hearing, much less proceeding to a vote.
Dogan said he welcomed the back-and-forth that could take place in committee.
“When you have a hearing on a bill, that’s when you get an opportunity to hear from members of the public, from the associations, from medical students, from doctors, from everybody who has a stake in this issue, about what the reality is,” he said. “And we didn’t have that opportunity.”
Still, he noted that he’d based his bill on current guidelines for obstetricians and gynecologists.
“I see no reason why anybody should object to putting into legislation what’s already in their professional guidelines,” Dogan said.
Both St. Louis University and Washington University medical schools said they do not perform such examinations without meeting a strict set of guidelines, including full consent. That is also true of BJC Healthcare, the hospital chain where Wash U’s residents practice. (SSM Health, which employs St. Louis University medical students, did not answer our question by press time.)
But Jill Delston, a philosophy professor at the University of Missouri-St. Louis, said she believes the practice continues today. Delston explored the practice in her new book, “Medical Sexism.” And in addition to what she’s read in national media coverage of the issue, she’s gotten feedback that makes her fear that residents continue to perform such exams while their patients are anesthetized.
“Anecdotally, after my talks, I do have medical professionals come up to me and say, ‘Yes, this is something I’ve experienced or I have done,’” Delston said. “So yes, I think it’s still occuring.”
If Dogan’s effort fails to gain traction again this session, he said he’d like to introduce the bill a third time but isn’t sure.
“I’m in a little bit of an uncomfortable position, honestly, as a man sponsoring this legislation,” he said. “I’d like to have one of my female colleagues take the lead on it next year. So, I hope some of them might be listening [today].”
“St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is hosted by Sarah Fenske and produced by Alex Heuer, Emily Woodbury, Evie Hemphill, Lara Hamdan and Joshua Phelps. The engineer is Aaron Doerr, and production assistance is provided by Charlie McDonald.
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