Friesen P, et al. Is Specific Consent for Educational Sensitive Exams on Anesthetized Patients Necessary? Arguments for and Against From Canadian Medical Students. J Surg Educ. Epub January 9, 2025.
Keywords: ethics; informed consent; medical education; pelvic examination; rectal examination.
Abstract
Objective: Discussions related to the importance of seeking specific consent for sensitive (e.g., pelvic, rectal) exams performed on anesthetized patients by medical students have been growing. The perspectives of Canadian medical students on this topic have never been sought.
Design: An anonymous questionnaire related to experiences and beliefs regarding consent and sensitive exams under anesthesia (EUAs) within medical training was distributed to medical students across Canada.
Setting: Of 17 medical schools in Canada, 6 confirmed distribution, 8 schools expressed an intention to distribute but did not confirm whether distribution had occurred, and 3 did not share the questionnaire.
Participants: 134 respondents answered at least 1 question. Canadian medical students who had begun clerkship or previous students enrolled within the last 5 years were eligible.
Results: Our data indicates that, of Canadian medical students surveyed, the majority (72%) believe that specific consent for educational sensitive EUAs is a moral requirement, while 20% are unsure, and 8% do not share this belief. Respondents offered a variety of reasons why specific consent is necessary, including patient rights, autonomy, respect, and integrity, as well as concerns related to nonconsensual exams being abusive or constituting assault. Some respondents noted that consent is already implied, is unnecessary because of clinical benefit, or requiring it could lead to missed educational opportunities, especially for male and/or racialized medical students.
Conclusion: These results indicate that while most respondents support specific consent for educational EUAs, confusion regarding the purpose of these exams and the moral basis of specific consent exists in training.