As a patient, you put a lot of faith into doctors. That’s why it’s particularly distressing to hear about them acting in a way that flies directly in the face of the Hippocratic Oath they take promising to follow certain ethical guidelines. Such is the case with a new anonymous essay published in the journal Annals, in which the author explains two instances of sexual harassment doctors have performed on out-of-it patients.
The author recalls how one of his medical students, David, revealed what happened when his attending physician was prepping a patient for a vaginal hysterectomy: “While he was cleansing and scrubbing her labia and inner thighs, he looked at me and said, ‘I bet she's enjoying this.' My attending winked at me and laughed.” David admitted to laughing along because he simply didn’t know what else to do.
Then the anonymous author offers up a stomach-churning example from his or her own past, when a resident danced around singing “La Cucaracha” with his hand inside the vagina of a woman the essay calls “Mrs. Lopez.” "He keeps dancing," says the essay writer, who explained that it was his or her job to hold the woman's knee while the resident performed an internal bimanual uterine massage. "And then he looks at me. I begin to sway to his beat. My feet shuffle. I hum and laugh along with him." Moments later, says the author, the anesthesiologist tells the two to knock it off and they stop. These ethical transgressions are shocking, perhaps because people are often so anxious about health issues that callous reactions to their unaware bodies are particularly distasteful. But the problem goes deeper than that.
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Although any assault is awful, these stories are particularly rattling because your natural instinct is to trust doctors. “Medical providers hold tremendous power over their patients, says Nancy Hensler, Ph.D., a psychologist in private practice in Washington, D.C. “It is supposed to be their sacred duty to heal. As these clinical stories show, that power also can be greatly abused.”
If you’re a victim, in addition to potentially losing trust in an industry that is ultimately supposed to keep you safe, the implicit level of helplessness when you’re under anesthesia makes the situation worse. “To be violated while in a vulnerable state is highly traumatic, whether registered consciously by a person or unconsciously at the level of procedural memory,” says Hensler. Yes, it’s true: Your body can remember things that happen to it while unconscious, she says. “Such traumas can be stored in the body for many years and are now known to be correlated with long-term physical and mental health problems, including anxiety disorders, post-traumatic stress disorder, and sexual dysfunction,” she says.
There’s a chilling parallel between this kind of medical abuse and the type of drug-based rape you might find on a university campus. “These medical incidents are not that different from reports of bystanders at college parties who have witnessed similar physical violations of and crude jokes about drunken or drugged women,” says Hensler. She credits society’s blasé attitude toward women’s bodies and agency as individuals as the culprit. “One pernicious reality at play in these clinical stories is the pervasiveness of violence against women,” says Hensler. “There’s an acceptance of a culture that encourages, or silently consents to, women’s bodies being objectified, mocked, and violated, whether they're conscious or unconscious.”
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That objectification plays into a dynamic that’s at the heart of various iterations of sexism, including this one. “This type of action uses patients as a means to a bizarre end, whether it’s for sexual gratification or exercising power over somebody,” says Lawrence Nelson, Ph.D., a lawyer, a bioethicist, and an associate professor of philosophy at Santa Clara University. “It’s a terrible breach of ethics of the profession to be doing something that is not for the patient’s medical benefit but instead is for some power trip.”
First things first: In an ideal world, it wouldn’t be on you to prevent misconduct from happening. “The burden should be on the medical community to create a zero-tolerance policy for such disrespectful behavior,” says Hensler. With that said, it’s always smart to take safety precautions with your health, especially in a situation where you’ll be knocked out. “Do your research,” says Hensler. “You can investigate potential doctors by looking them up on their state’s board of physicians website to see if there are any complaints against them.” You can also do some general Web research on review sites like Yelp or ZocDoc to see what previous patients have to say.
Once you’ve decided on a doctor, ask him or her which safeguards are in place to prevent this kind of abuse from happening. “The way the doctor responds will tell you a lot,” says Hensler. “Is he dismissive or prepared to address the issue?” It will also let him know you take an empowered approach to your health, which is a good preventative measure.
Finally, listen to your gut, says Hensler. If your intuition pings and you feel iffy about him, even without hard evidence that you should, consider seeing someone else.
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You can go down a few avenues if you think you’re in this situation. First, you should contact the police, says Paul Saputo, lawyer, of Saputo Law Firm. “The law is going to vary from state to state, so whether or not it qualifies as assault would depend on the specific circumstances.” Your options include filing a lawsuit based on assault or filing a claim for medical malpractice says Saputo.
Nelson recommends considering taking up with the institution instead of going through the law. “Most institutions don’t want it known to the public that their physicians are violating patients’ bodily integrity,” he says. “You could try to get a settlement out of that without involving a lawyer because the litigation system is expensive and slow to move.” If others come forward about the same thing happening, that could spur the institution into punishing the doctor at fault.
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