Educational pelvic exams on anesthetized women: Why consent matters

Bioethics. 2018 Jun;32(5):298-307. doi: 10.1111/bioe.12441. Epub 2018 Apr 23.


It is argued here that the practice of medical students performing pelvic exams on women who are under anesthetic and have not consented is immoral and indefensible. This argument begins by laying out the ethical justification for the practice of informed consent, which can be found in autonomy and basic rights. Foregoing the process of consent within medicine can result in violations of both autonomy and basic rights, as well as trust, forming the basis of the wrong of unauthorized pelvic examinations. Several objections to this argument are considered, all of which stem from the idea that this practice constitutes an exception to the general requirement of informed consent. These objections suggest that nonconsensual pelvic examinations on women under anesthetic are ethically acceptable on utilitarian grounds, in that they offer benefits either to the patient or to society, or on the grounds of triviality, in that consent is already presumed, or the practice is insignificant. Each of these objections is rejected and the practice is deemed indefensible.

Keywords: autonomy; informed consent; medical education; trust.

MeSH terms

  • Anesthesia, General
  • Education, Medical, Undergraduate / ethics*
  • Female
  • Gynecological Examination / ethics*
  • Gynecology / education*
  • Gynecology / ethics
  • Humans
  • Informed Consent / ethics
  • Personal Autonomy
  • Physical Examination / ethics*
  • Physician-Patient Relations / ethics*
  • Students, Medical / statistics & numerical data