The various aspects pertaining to the issue of medical modesty can be daunting. While investigating the black and white of it one can trip over an array of gray stumbling blocks. So much so that advocates prefer to keep the subject within one hue, and simply color it “Modesty”. While that is an excellent stand with which to advocate the general subject, many people/patients/clients find that it does not truly express their views. The word ‘modesty’ may not fully convey their needs and struggles for acceptance or understanding regarding respectful care. For them, it really is a moral choice. These decisions need not be faith-based, but are still fully and ethically who and what people choose to be. Or, perhaps these convictions are based on religious edicts, and people have spent their lives protecting that “eternal” path from being carelessly shattered.Here lies the dilemma of ‘medical modesty’. Have we condensed the modesty issue to such a degree that the significant messages of moral convictions are not being heard? If we insist that modesty be the issue’s main thrust, are caregivers given the opportunity to see the passionate side of morality and damages caused by disregarding it?
The truth is that the medical arena will not respect or defend the decisions of your body the same as you would. Most do not even feel the need to protect your ethical standards unless backed by protocols to avoid legal issues. Instead, they assume the role of psychologist stating that any mental harm while within their walls can be easily discarded. Or perhaps the role of medical pope, absolving you of any actions you deem immoral that they may inflict on you. And marriage councilor, finding any marital damage that stems from their actions to be petty and unwarranted jealousy. Their beliefs become your prison, and this self-serving attitude inflicts damage. So they send broken people home after promising “no harm”, never accepting responsibility for the tornado of emotional or spiritual damage that is now your life.
Caregivers may state that they simply do not have time to consider all of these harms. It certainly seems that if they have time to discount them then they have already found time to consider them. So let’s try to put accountability in their ethics. Let’s let them know the full range of damage that occurs while on their watch. Only when all possibilities are exposed and out of the closet will caregivers ever understand the full ramifications of their actions. Then we can truly and simply color the picture as ‘Modesty’ with full and honest understanding of all the grays.
Suzy Furno-Maricle (aka swf) blogs at Patient Modesty Solutions
44 comments:
Thanks Suzy. Modesty is such an individual emotion that no one else can ever know what one person is feeling or how they are affected. Clearly many institutions and providers ignore the issue because it's in their interest and that they have no plan for accommodating patients.
I can't recall the source right now -- I'll look it up -- but I recall reading recently about a movement to include in the patient history process a "spiritual" history.
This would go a long way toward learning more about patient attitudes toward their bodies, modesty and gender preference.
Doug Capra
I received this e-mail with permission to anonymously post here.
"Feb 07" said:
Part 1
Beyond the whole issue of cross-gender care is what's behind it.
Very often, medical "professionals" seem to feel that their patients are no more
than pieces of meat - whose thoughts, feelings, and values don't matter.
Informed consent is viewed as just a nuisance to get around somehow - and they
view pressured or coerced consent as if it were "informed" consent. Even if we
DO come in knowing the risks and benefits of some procedure or some course of
treatment, it's STILL brushed off, and, if they can enforce it, we are given no
more choice in treatment than our pet is when taken to the vet.
So, we've still got people, especially women, who go in very afraid of getting a
rare cancer, which she is less likely to get than she is to get serious
complications from the further testing required after a false positive.
Because of this fear of cervical cancer, with which according to the
CDC in 2007 (the last year for which there are statistics), 12,280 women were
diagnosed with cervical cancer out of a population of approximately 150,000,000
women in the US. They report that 4,021 died of cervical cancer. Thus, 'the
number needed to treat' - to detect a single cancer, is approximately 10,000,
far exceeding any guidelines for an effective test or treatment. The
pressure (often leading to bruising) plus the ionizing radiation increases the
risk for getting breast cancer, and mammograms too have both false positives
(leading to more risky procedures increasing one's chance of dying), as well as
false negatives (the whole mammogram procedure gave no benefit). It's not really
informed consent unless this information is present.
Part 2
Feb 07 said:
If you read Dr. Sharon Orrange's blog at
http://www.dailystrength.org/health_blogs/dr-orrange/article/the-10-real-reasons\
-men-don-t-go-to-the-doctor for "the real 10 reasons men don't go to the
doctor", she is extremely condescending toward men and their unwillingness to
undergo some tests that have nothing to do with the complaint, and moreover, she
doesn't even seem to have the notion that any sort of consent is required before
she can do intimate care on a man or boy. There are some intimate procedures
that she says she WILL DO. If you read the blog, don't miss the discussion.
There seem to be a lot of people who agree with the whole matter of cross-gender
care and informed consent which is lacking, as well as her nonprofessionalism.
The right to consent implies the right to refuse.
If we don't have rights to our own bodies, and who does what to or with them, we
really have NO rights.
Suzy, I am an example of someone who is still trying to get over the negative impact of having been treated insensitively and disrespectfully almost a year ago. I did write a lengthy letter which I hand delivered to a top hospital administrator and I also sent it to the CEO of the hospital. I could do this because my husband has been a respected physician at said hospital for 25 years and I have credibility as well as friendships there. I don't know if anything has been done and even now I wish I had said more as I thought this would help me get over my treatment but I am not there yet.
I personally like emphasizing human "dignity" concerning the modesty issue as I think people just think we are overreacting when we are being modest.
I believe these are important discussions; we are in an age of very little privacy and the ways of treating patients in high-tech and impersonal environments can be truly traumatizing if we are also humiliated.
Charlotte:
You are a femme-extraordinaire.
So few patients demand any sort of recourse. Instead, for years they replay the scenario in their heads and the damage is grossly compounded.This is why caregivers often get away with disrespectful treatment....because they can. Or at least, they have.
Obviously your letters achieve three things: Shines a light on their actions, puts the responcibility of accountability in their corner, and (hopefully) puts you on the road to a degree of healing by taking your power back.
Will you will keep us updated on any actions your letters could have set in motion?
I hope others will read your post and choose the power of speaking up as opposed to the harmful inaction of silence.
Well done Charlotte.
Suzy
Suzy,
I just tried to read Dr, Orrange's article titled "The ten reasons why men to go to the doctor".
She has apparently seen fit to have the article removed from her blog. Hmmm....isn't that a coincidence!
It would appear she is quite sensitive to any negative perceptions regarding her chauvinistic and insensitive attitude towards men when it comes to modesty and care in the medical field.
I have the sense that she is probably the type of female doctor that when it comes to her care, and especially when intimate care or procedures are involved, that she would seek out and demand female health provides.
jonathan
The '10 reasons men don't go to the doctor' article is still up. Here's the correct link.
Thanx 'jonathon' for pointing out the link error. When I copied the ANON'S post from her e-mail I failed to check the link.
And thanx Joel as well for correcting it.
I did send a request for Dr. Orrange to consider commenting on her perspective and what seems to be a lack of consideration for Male Modesty issues. I included my personal e-mail as well. I will post the responce if I receive one.
Perhaps someone else has had any luck getting her to respond?
Suzy, thanks for the complimentary comments. I did receive perfunctory and (for me) inadequate letters from the administrators to whom I sent the letter as well as from the other parties involved. I don't think I will ever know if anything was done or changed but I do think my letter created a "furor" of sorts. As I said, I have credibility AND I have some skills as a writer having recently completed a masters degree which required many lengthy theological and philosophical term papers. I spent a lot of time on my 13 page recommendation letter. I think it is important for me to move on now but the damage to one's psyche can be huge not only concerning the modesty/dignity aspect but also, for me, a feeling of intense "hurt" that my fellow human beings and colleagues of my husband (who has been a highly respected doctor in our community for 25 years) would treat me in such an insensitive and monstrous manner.
~Charlotte
In short, I see the problem only partly at the level of individual doctors and nurses. The real culprit is the ubiquitous infestation of people's, mainly of powerful men's brains with promiscuity as a social norm.
Men, who are not only desensitized but just void of any experience of having monogamy as a part of their personality, are decapacitated to comprehend the agony of the women experiencing as a sexual assault, what they consider as acceptable based upon the value system of promiscuity.
Maruli
Part 1
Why do institutions ruthlessly force treatment and nursing by doctors and nurses of the opposite gender upon patients, even though they protest and resist?
This concerns institutions like hospitals, nursing homes, rehabilitation centers, forensic and psychiatric wards, in short all institutions, where people enter, because they have no choice to stay out, either by health issues or by being admitted by law.
The principle of medical treatment is supposed to be: primum non nocere. That means, first of all, do no harm.
It is by now general accepted science, that psychological factors have a very important part in helping or impeding the healing of any health issue.
When a woman experiences the handling of her body by a male doctor or nurse as a sexual assault and she is powerless to refuse it and to protect herself, this does serious harm to her. This may well make her more sick and impede her healing. It is a violation of the primum non nocere rule.
There are several factors to consider:
1. Who has the power to decide the job organization, the institution governance, the rules, the choice to employ male or female nurses?
Who is responsible and accountable, when a male nurse washes a woman in spite of her protest?
Has he decided this himself, is the distribution of the work load decided by the workgroup or by the management and by dominating bosses?
Are there any rules to protect the women, but the staff ignores the rules and nobody enforces them?
Does a male nurse risk his job, if he refuses to wash a non-consenting woman?
2. For what reasons do people choose to become nurses, doctors, massagers and other jobs of directly handling human bodies?
How much maturity and emotional intelligence was in that choice?
Average: It is just a well paid and secure job, there has been a role model in the family, or there is any other haphazard but neutral reason.
Dangerously immature and lacking emotional intelligence: Some men are driven by their subconscious sexual wishes to choose a job, which gets their hands on women's bodies.
Maturity and emotional intelligence: They are caring persons with a lot of altruism and maybe political motivation. They want a job, where they feel to do something good and not just be part of the capitalistic rat race.
3. Has the institution of their training and the institution of employing them screened for their motivation to keep the dangerous and immature men out?
Maruli
Part2
Assuming for the following considerations, that the male nurse is a person with the motivation to give good care to the patients. He sincerely wants to avoid harming. What are the reasons, that he in spite of this does wash the woman, who experiences this as a sexual assault?
1. The woman suffers but nobody knows it.
1.1. The woman has been so brainwashed, that she is has begun to belief herself to be a ridiculous prude, whose feeling uncomfortable in this situation were her own flaw, and she does not dare to protest.
1.2. She is scared to be punished as a trouble maker.
1.3.. She has been declared as seriously mentally disturbed, and her protest against being washed by a man is mistaken by insensitive promiscuous men as a part of her mental condition. In the worst case, if she has the courage to struggle against the sexual assault, they may even force psychopharmaceuticals into her.
2. The nurse is promiscuous with extrinsic morals only. For a promiscuous person, sexuality between bodies is principally permissible and acceptable, no matter if it goes as far as copulating like alley dogs or if indulging in any form of allowing or enjoying sexual stimulation. For a promiscuous male nurse, it is just of no importance, how much or how little washing a woman's body is a sexual activity.
If he is not only promiscuous, but also immature, he projects his own promiscuity upon all other people. He has no clue, that a woman, for whom monogamy is a core part of her personality, perceives any sexuality without a committed relationship as a harmful assault. He is ignorant, how much he is harming her.
He may well have the morals not to cheat and to respect other people's relationship, and such. He may well consider himself as a moral man, but based on the assumption of universal promiscuity. If he is part of a social group, where promiscuity, desensitization, oversexation have become the norm, he may never have a chance to learn, that a woman has her own dignity and that her basic human rights include her right to keep unrelated men away from her intimate space.
Such a nurse may take the alleged sanity of promiscuity so much for granted, that he may indeed sincerely belief, that a woman's wish for modesty is a sign of mental disturbance.
Only a male nurse, who is monogamy and whose promiscuity-inhibition has never been destroyed, can have the intrinsic moral based upon his own values, that enables him to know the limits of morally justifiable intrusion into a woman's intimate space.
There is the problem: The woman in the situation of experiencing the male intrusion into her intimate space directly suffers harm from that nurse, but the true cause of the harm is the social norm of widespread promiscuity and oversexation in mainstream society, and the desensitization of those, who have the power to inflict harm on the minority of the sensitive and monogamous people.
Promiscuity is a scourge of humanity, and the harm of promsicuous male nurses is just one more indication of this.
Maruli
Maruli:
Before venturing any more comments, I would wonder if your veiw of your country in general is that men receive greater regard for modesty in medical scenarios than women?
Otherwise, I would wonder if we could apply the same aspects of desexualization to female healthcare providers, or rather: female healthcare providers (in your opinion)have different latent motives as seen as less preditory?
Maruli --
Based upon your theory, which I disagree with at its foundation, if I read it right -- based upon your theory -- all men are potential abusers because, as you suggest, promiscuity is embedded in maleness. This, does this promiscuity always manifest itself in sexual abuse? So,those few male nurses who may not be promiscuous, are forcing themselves upon female patients. How about gay males? How do they fit into your formula?
Let's not forget. People are different. Some women accept male nurses for all kinds of care, and male doctors. Some men accept female nurses. It's more about how we're raised than about any embedded genes.
I am not for strict separation of genders in medicine. But I am for patient choice. If, as you suggest, all males have the promiscuous gene, then we should outlaw male doctors and nurses, or at least prevent them for working with women -- a suggestion I can't agree with.
If I'm not interpreting your comments correctly, let me know.
Doug Capra
Per Maruli:
These comments were actually meant to be read as a progressive thought process that Maruli spent years of consideration with. Any questions regarding the post can be answered by reading the work in it's entirety at http://egalitarianrationalcommitmentparadigm.blogspot.com/2011/02/243-patients-cross-gender-choice-of.html
starting with her purpose and goals.
Thank you.
Suzy
Suzy: That link puts the remarks into more context. I still have some issues with the position. Potential abuse isn't just about access to bodies for sexual pleasure. It's about power. Men and women are different in how they may abuse. Men tend to be more physical. Women tend to be more psychological. But both have the potential to abuse. The physical is, of course, more blatant and obvious, to both the abused and the abuser. The psychological can be more subtle and, though recognizable to the abused, may be subconscious to the abuser. Just some thoughts.
Doug
I appreciate the post by Suzy. Many people indeed care about their modesty in all settings including medical due to moral convictions.
I am a Christian lady who made a commitment to True Love Waits (to wait until marriage to have sex) when I was a teenager. At the same time, I thought about how I was never going to let a man except for my future husband to see and touch certain parts of my body. I feel that doctors and nurses are not morally above others. I would only have a female doctor/nurse for certain procedures that are intimate. I don't care to see a male doctor for non-intimate things such as strep throat, ear infection, knee problem, etc as long as I am able to remain clothed.
Some doctors and nurses are sensitive to patients' moral convictions. But many of them are not. I think that the medical community needs to be trained to become more sensitive to patient modesty. Patient's wishes should be the 1st priority and then his/her family's wishes should be second. Doctors and nurses should never focus on what is more convenient for them.
I personally think medical professionals should respect patients' wishes for modesty and same gender doctors/nurses regardless of reasons.
There are a number of reasons people prefer same gender doctors/nurses for intimate procedures. Some of the reasons are moral and religious convictions of course.
Look at one husband's story about how upset he was that his wife went to a male gynecologist one time at http://patientmodesty.org/modestycomments.aspx?ID=2.
To Doug Capra and all:
I just found this by googling, so now I can speak for myself. Suzy copied here my blog entry 243, stripping it of cross-references to previous postings. She later added the link, which is only the link back to the post, that she had copied.
My text is out of context, when read without having read a lot more of my previous postings.
What she copied is a continuation of the same topic in postings 241 and 242.
This is the link to my entire blog: http://egalitarianrationalcommitmentparadigm.blogspot.com/
My blog is not impartially scientific. The purpose of my blog is to find a partner and I am explaining my own world view subjectively from the perspective of a woman. The trigger to write about the subject of modesty was, that on a dating site I was matched with a massage therapist, who considers it as absolutely normal to massage women. As much as he seems a nice guy, it disturbed me enough to be a dealbreaker, so I wrote blog entries about my reasons.
My blog is very subjective about what I like and dislike in men, explaining this on the background of evolutionary psychology and biology. I see many male traits distributed along bell curves, seeing the decent ones at one end and the jerks at the other. So my blog is not implying, that all men and maleness are bad, but making the point, what kind of men are bad and I want to avoid them, and whom I consider as decent.
Thanx ANON 2/12.
There is no doubt after researching this subject that many find modesty embedded in a moral code. Statistically what percent we will not know until we can find an adequate way to gather valid information.
Certainly enough of a populace to ask caregivers to consider the repercussions of not respecting the issue.
I believe in the end we are all working with three issues:
Modesty/Morals/Entitlements
and all three have possible mitigating factors.
Modesty is really how one views their own body. Entitlement is how one feels others view their body. Morals sort of encompass both.
Regardless of which issue one faces, people/patients/clients need a firm foundation of rights and support.
Dr. Sherman and Doug Capra have written much to support the need for communication to achieve that foundation of strength. It really is a wealth of information contained here...
Continued luck with the website...
Suzy
Maruli said -- "I see many male traits distributed along bell curves, seeing the decent ones at one end and the jerks at the other. So my blog is not implying, that all men and maleness are bad, but making the point, what kind of men are bad and I want to avoid them, and whom I consider as decent."
Maruli: I suppose we could say the same about female traits, based upon evolutionary psychology and biology. The questions arise -- to what extent are we programmed, how much is genetic and how much environmental, how much determinism is involved?
Your massage therapist example is interesting. What if he's gay? Would that make a difference? How about female massage therapist who think it's perfectly fine to massage men? No danger there? Where do they fit along that bell curve?
I do understand the evolutionary biology, psychology and anthropology theories you're talking about regarding men. I don't reject them out of hand. But, if you believe them to be 100% true, there are serious political, economic, and social consequences associated with that belief -- perhaps decisions about what gender may be fit for certain jobs, for example. Of course, that could go for women as well as men.
I wonder, as a woman, if you would comment on that bell curve as it relates to female traits, and how, if at all, that affects what we're talking about on this blog -- patient modesty.
I'd also like your response to this article: "Is There Anything Good About Men"
http://www.psy.fsu.edu/~baumeistertice/goodaboutmen.htm
Doug Capra
Doug Capra:
"to what extent are we programmed, how much is genetic and how much environmental, how much determinism is involved?"
I do not know, if you have had a look at my blog or not. That is one major question behind my ponderings there. It is difficult for me to answer to feedback concerning my blog entry 243 and put the entire historry of my thinking of the previous 242 blog entries into a few short sentences.
"I wonder, as a woman, if you would comment on that bell curve as it relates to female traits, and how, if at all, that affects what we're talking about on this blog -- patient modesty."
"I suppose we could say the same about female traits, based upon evolutionary psychology and biology. "
Of course, and I have written blog entries about the myth of motherliness and even about the stupidity of women. I am childfree to the extent, that I cannot even imagine, what could attract a woman to a screaming and stinking bundle called baby. (Sorry, I am blunt, no provocation meant) One of the starting points of my own blog was pondering about the question, why there are so many childfree people like me in spite of being a defiance to the survival of the species.
The predominant bell curve in women (it exists also in men) is the one between breeders and non-breeders, between the dedicated mothers, who sacrifice their life for their offspring and between those women, for whom neonaticide is self-defense.
I even see women's protest or compliance with modesty violations in connection with this scale. If a woman submits and represses her discomfort with a male doctor/nurse/midwife, she may well do this as a part of her sacrifice directy in favor of her child and indirectly in favor of the survival of her genes.
" Your massage therapist example is interesting. What if he's gay? Would that make a difference? "
My text is a follow up to my blog entry 241, where I was explicitly making my point, that in Germany in hospitals and nursing homes, the treatment and nursing by men is forced upon women, who explicitly do not want this, and I consider this a form of sexual assault. It violates the basic human right to be free and protected from unwanted sexuality.
People's choice (entry 242 of my blog) is a different matter. In the case of any sexual assault as in any other violation of human rights, what matters, is the experience of the victim, not the intention of the perpetrator. Else we would get dangerously near to nazi times, where raping a woman to produce arians for Hitler was considered as more acceptable than an abortion.
I will go later and look at the other site.
Suzy:
"I would wonder if your veiw of your country in general is that men receive greater regard for modesty in medical scenarios than women? "
I just wrote entry 244 in my blog, it is a lengthy comparison of the cultural difference of the modesty problem between the USA, Germany and the netherlands.
In short: Modesty is no issue in both ways of cross gender treatments in Germany. I think that even 66 years later, the authoritarian and mysogynic mentality of the nazi times influences on a subtle level the German delusion of male doctors being saints. Their high social status impedes people to doubt their ethics. The rejection of the islamic subcultures misleads the rejection of protecting women from male doctors as religious instead of being a question of dignity and choice.
Maruli
http://egalitarianrationalcommitmentparadigm.blogspot.com/
Maruli -- Thank you for your honest answers. I appreciate that. Your position is certainly provocative. It makes for a more interesting discussion.
Doug
Doug:
I have just read that very interesting article "Is There Anything Good About Men", that you suggested to me. But as always, there is one fundamental difference between men and women, that is omitted:
Men have the choice to either be egalitarians, or to use their greater physical strength to enforce domination over women by violence, coercion and intimidation.
Women have less choices. If their are not enough egalitarian man available, then they have only the choice to suffer or to run, if possible.
I know, that at least 95% of adult men are physically so much stronger than I am, that they are able to kill me with their bare hands and to force any atrocity of their choice upon me. I know, that by instinct and by social norms, some men are driven and feel entitled to use womens' bodies ruthlessly and by the delusion of entitlement.
Therefore I think that there is fear in the subconscious mind of many women, and it is behind a lot of gender differences. Desensitization, denial, submission, religious acceptance of being rewarded in heaven for suffering on earth are all just female strategies to deal with that fear.
And womens' acquiescence to be exposed and handled by male doctors is just one expression of this.
The more elaborate version of these thoughts are in my blog entry 245.
Maruli
http://egalitarianrationalcommitmentparadigm.blogspot.com/
Good points, maruli. But let me suggest this. To a significant degree, technology has changed things. Yes, men are physically stronger than women and in strictly physical encounters can most often force their will upon women.
But with guns and other weapons, women can equalize the situation. Women can and do perform many feats that used to be for men because physical strength isn't an issue anymore -- flying jets, drop bombs, push buttons to launch missiles, etc. Now, whether women take advantage of these technological advances has more to do with culture than with their ability to do this. In cultures that don't support women's rights, you wont' find women in general using these advantages. Some women go along with the discrimination, agree with it. The follow the cultural mores about their role.I still say that culture is a significant force that uses both men and women to their advantage.
Doug/MER
Doug, it seems that I did not express well, what I meant when writing about fear. This has inspired me to write entry 246 in my blog about the conscious and subconscious fears of women. The following is a short version of it.
Even the most women friendly men are oblivious for the fact, that on the individual level of every day life, no technology has changed anything since the age of the cave men. In any isolated one to one situation, women are as vulnerable and at the man's mercy as ever.
In every situation, when a women has a chance encounter with a stranger or a man, whom she does not know enough to trust, she is in real danger, if they are at a place, where there are no other people around.
The statistical chance of being attacked may be low. But every time a man expresses his instinctive inclinations towards a woman's body in a noticeable way, and that happens very often, the woman cannot know, if he has the self-control to stop short of an attack. She experiences herself at the mercy of a potentially dangerous animal.
When a man hikes to some deserted and remote ruins of an old castle, he can sit there, relax and enjoy his picnic. In the same situation, I as a woman alone can never really be relaxed, and when a man appears nearby, I am on red alert and I start to get scared.
When I miss the last bus and have to walk home from the railway station at midnight, I am scared too.
Weapons are not an answer. They would make life only more risky. Here in Germany, luckily enough, weapons are strictly controlled. Most of the average cultivated and decent people have never in their life even had a gun in their hands, except those, who had been soldiers.
I am very glad, that normal people in Germany do not have guns, not even at home.
Men have often no clue, what it means to experience the threat of a life of being a potential prey to predators all the time. There is a widespread denial of the danger for women, and many women are very naive themselves.
In the western world, a woman is like an antelope in the savanna, where there are lions, who are allegedly tamed, but not all are.
In the islamic world, there is much more awareness for the women's danger, but the prey is punished by being locked away and made walk under a tent, while the predators are allowed the freedom.
They put the antelopes in the cages, while the lions are free.
In the USA, there are those ghettos, where sometimes only people of one skin color do live. Any person looking differently is in real danger to be attacked by just entering the ghetto. But they have the choice to keep out of the ghetto.
For a woman, the entire world is a men dominated ghetto.
The lucky women find a partner, who protects them against other men, and the unlucky ones, who are alone, live a life of permanent danger, that is stressful and depleting.
Therefore at this point, I dare to ask a very personal question:
If any of the people reading this knows a single man around 60, who is looking for a woman like me, please tell him to read my blog. Thanks.
Maruli
http://egalitarianrationalcommitmentparadigm.blogspot.com/
Maruli said
"Therefore I think that there is fear in the subconscious mind of many women, and it is behind a lot of gender differences. Desensitization, denial, submission, religious acceptance of being rewarded in heaven for suffering on earth are all just female strategies to deal with that fear.
And womens' acquiescence to be exposed and handled by male doctors is just one expression of this."
It's important to keep in mind that men also acquiesce to being exposed and handled by female doctors and nurses. There may be another entire set of psychological reasons for men as opposed to women, but regardless of these conditionings, we have this common ground that is often simply intimidation.
Men and women need to work together to identify the concerns of modern patients, then help each other rise above them.
Suzy:
I admit, my view is somehow biased from the perspective of a woman.
There are two kinds of intimidation, the purely psychological intimidation of fearing real or believed consequences of any kind, from ridicule to being deprived of kindness or financial risks, and the physical intimidation of being under the threat of violence.
Men and women may both be prone equally to the psychological intimidation, but the physical intimidation is an addtional plight only for women.
This and your blog are focusing upon the problem of patients modesty, I see this problem as one facet of the bigger problem of the general dominance of men over women.
Maruli
Maruli
I think we've gotten way off the modesty topic -- but your philosophical point of view is so foundational that I think it's worth discussing. Let me address of a few of your comments:
1. "no technology has changed anything since the age of the cave men."
1. Untrue. In fact, I would suggest that in the 20th century, especially the last 30-40 years, technology to a significant degree has helped with the rise of women's rights and the whole egalitarian movement. Technology has allowed women to move into jobs that had been based more on the kind of physical strength many women didn't have.
2. I do agree that most men don't know what it's like to be a woman alone in a vulnerable situation. On the other hand, there just as many things women don't know from the male perspective.
3. You come from a culture that has certain attitude toward personal weapons. Fine. That's your culture directing your attitude. There's nothing wrong with people protecting themselves from violence, and if takes a weapon to do that, than so be it. But I don't think we'll ever agree on that, so let's agree to disagree.
4. "Men have often no clue, what it means to experience the threat of a life of being a potential prey to predators all the time."
Try war. Even today in the USA, the best stats show women as only 17 percent of some of our armed forces. Historically, men have fought the wars. Of course, the civilians have always suffered -- the aged, women and children. Also, there are small men, weak men, men who don't For a woman, the entire world is a men dominated ghetto. know how to defend themselves. It's not so simple as you suggest.
5. "For a woman, the entire world is a men dominated ghetto."
This represents a very extreme point of view. In no way am I diminishing the violence committed against women by men in today's world. I abhor it. But how much of that is "maleness" and how much is "cultural," is up to debate. And although you say that not all men are like the bad ones, the practical result of your attitude is, for the protection of women, to treat all men like they are potential abusers.
Doug/MER
"This and your blog are focusing upon the problem of patients modesty, I see this problem as one facet of the bigger problem of the general dominance of men over women."
Maruli:
That is part of the problem here. It is not one facet of the general dominance of men over women. In this situation, men suffer as well as women, therefore I have never reduced the issue to one gender over the other.
In the medical scenario it is many times dominance, perceived or otherwise, by the controlling power of healthcare. Imagine a man so helpless and ill that he feels he must submit to the women controlling his situation to get critical care. It is life and death...and he has indeed lost his power and control. Do we reduce that to the power of women over men? Or rather, admit that the medical arena is unfair to both.
Being a woman, I am well aware of gender disparities. Many of us have several tragedies under our belt. This issue is not as simplistic as it seems: many come to it after hardship of sorts. But I refuse to lead my life simply as prey always running from a hunter.And I also refuse to only advocate for my own gender, knowing that men need help as well.
I think I made my point, that I think that man's physical strength causes women's vulnarability, fear and intimidation, and that the violation of women's modesty is a consequence of male dominance and female desensitization, denial and naivité.
Whatever more I would add, it would be redundancy, as I would start to repeat myself. Therefore I should not continue to derail this discussion from its real topic.
Maruli,
I think your worldview is actally very narrow, and it does not represent me either. Imagine what would happen if a male caregiver has a very active sex life outside the medical arena and he's even fairly promiscuous, but really declined to see or examine me intimately, (something that because of general entitlement in the medical culture, as Suzy says, will almost never happen). I, for one, would be very touched.
TThe roblem is that female doctors and caregivers have become just as stupid.
I would really like to make a question to Suzy: how would you feel about being Dr. Orange's patient, for instance? I find her attitude to women really ofensive. The "they need to get their pelvic and Paps thing". I, for one, wouldn't let her touch me with a pole!!!
I think there's an issue we ignore here, and which Suze should develop, which is the class issue. Doctors and other caregivers have done horrific things to men, women and children, but because of their high status and earning power, nobody has ever even doubted their morals....
That said, Maruli has some point, if a girl of woman (I, for instance, am really under five feet)is alone one-on-one with a mele, the physically stronger person has all the advantadge.
But then again, if we said to mother they shoudn't leave small children alone with caregiers of any gender, they have such blind trust they would even insult us for even suggesting such things might, just might happen!!!
To ANON 03/08:
First regarding Dr. Orrange..
What I look for in a provider is mutual respect. A provider must understand patients needs for respectful care. We may differ as to what that dignity and respect actually entails, but we need to have that foundation for trust.
Dr. Orrange may be a perfectly capable doctor, but she has displayed a fundamental lack of either concern for this issue, or care about it's importance. So, no: she would not be a good choice for me OR my family.
As to: " the class issue. Doctors and other caregivers have done horrific things to men, women and children, but because of their high status and earning power, nobody has ever even doubted their morals"
I see merit in this point. Jan Henderson, PhD touched on this in her firt article on this blog. The need to convince women (and men!) that there was such a chasm of social integrety and status between doctors and patients began the distancing of patients as modest human beings. It worked so well that female caregivers were able to later use those same arguements with male patients. We see how well this conditioning worked for decades.
We have begun the age of savvy patients: who have been able not to look at providers with disrespect but however: see them as the human beings that they are.Acknowledging that human-ness allows us the freedom of insisting on choices. Information, education, and the sheer numbers of those in the medical arena now preclude most people from believing caregivers are hatched from Faberge eggs on divine wings (No offense Dr. Sherman)but are instead just mortal creatures like us.
Once you strip away mystery and mystique, we can see clearly those who act with respect and a persons best interest, as opposed to those who are so swept up in the game of their own motives that they will perpetrate any illusion and gender theory to suit their own needs.
You are right: perhaps this needs an unbiased second look....
Excellent post Suzy.
PT
Morals and modesty are basically the same thing for me. Undressing in front of people of the same gender is OK (if not sexual) in locker-rooms, public restrooms and in hospitals & doctor's offices. Doing so in front of the opposite gender is immoral except for your spouse. Period.
With this belief I have to determine which is more important to me, morality or my health.
Anon Jan. 16:
"With this belief I have to determine which is more important to me, morality or my health".
With these beliefs in mind,I would ask you: Do you actively seek out same gender intimate care, or rather; avoid care because you can not find care that suits those needs?
It would be great for us to know if those who feel as you do are getting much resolution to this dilema.
"...same gender intimate care..." Suzy, you may need to be more specific. Personally I am a male who has several female physicians including general practitioners and dermatologists (plural because they are all-female clinics and I see different ones) who perform intimate care on me. I have no problem with intimate care by a female physician. However, I dislike intensely having to discuss my problems with their female receptionists.
Jay
to the women who say they have been abused my men. it goes both ways. I was abused until I was 13yrs old by female family members. I am a modest guy, very embarrest person. I just want equal rights wht women to choose my male providers and caregivers the same as girls and women do. not all of us guys are permiscuiose. please excuse spelling?
I hope this thread is not dead!
I just came across a very interesting article on male gynecology that is well-written and dignified. I would like to hear what some of you, especially Dr. Sherman, think of the arguments. It seems persuasive and I have seen it on several websites, but!!! www.modestyxxx.com is the website.
Very briefly, the article is interesting but doesn't quote any studies of any kind. The author's description of male sexual physiology is very incomplete. The male sex drive is not only under involuntary sympathetic control. For both men and women the major sex organ is the brain. In other words the setting has to be right. This is likely more true for women than men, but holds for both. Yes a young physician may be distracted by opposite sex exposure and it's true for both sexes but they soon learn how to control it and function appropriately. As a medical student, learning genital exams can be very stressful and high pressure. Not an atmosphere conducive to arousal. I only did pelvic exams early in my career and training. The way pelvics are done are purposely very clinical in nature with the patient all draped and a nurse near by. I never found them arousing, sometimes the opposite depending on the patient. It is absurd for anyone to think that a male gynecologist is sexually stimulated all the time. It's not even physiologically possible. My wife has seen many male gynecologists over the years. I never had the slightest concern over their propriety.
There are of course doctors who are deviant as in any field. And that is true of woman doctors too. Reportedly female psychiatrists have a high incidence of sexual trysts with their male patients for instance. They rarely get reported as assaults though.
In short, the problem is uncommon. The relatively few doctors who can't control themselves tend not to last long in practice without complaints nowadays.
"The truth is that the medical arena will not respect or defend the decisions of your body the same as you would. "
That's part of the truth but not the whole truth. Your right in that patients need to be alert and take more responsibility for their healthcare. But too often, it seems to me, your argument moves toward the extreme in stereotyping men and male physicians and nurses. In fairness, Suzy, you do a wonderful job in advocating for both men and women in this area, and I respect that.
Dr. Sherman you are incorrect in saying that the author of the article "Gentlemen Don't Look Up Ladies' Skirts" (www.modestyxxx.com) doesn't quote any studies.
A document from a British NHS study is quoted, saying there is "Nothing unusual about sexualized feelings towards certain patients." And there is a textbook published by the AMA - Sexual Problems in Medical Practice (Lief, ed. p 20, 1981)- quoted saying that doctors who have erotic responses to patients should consider this "neither unusual or abnormal." The author excerpts the "infamous" article published by the AMA called "Time and Tide," the reminiscence of a young doctor who has sexual fantasies while performing a pelvic exam. These are all available to check on the Internet - I have found them and so could you and others.
The article's final section "Not A Sex-Free Zone - What Doctors Do" is filled with citations from medical researchers who have studied the sexual relations of doctor and patient and found a surprising amount of sex taking place. These are also readily available on the Internet.
Your assertion that you have never found pelvic exams to be erotic is typical of doctor defense and hardly believable. First of all, very few physician would make such a confession and secondly, the matter of a male having an erotic episode is scientifically measurable. Have you ever had your erotic responses measured while performing a pelvic exam? NO! Well that is truly the test. Your own testimony is hardly persuasive. Medical researchers frequently find male subject deny erotic responses, but the scientific instruments say otherwise. See Deborah Blum's book as cited.
Dr. Sherman your website has provided a valuable service on medial modesty, but you have not done justice to this article. I hope your readers will take a look and see for themselves.
Believe what you want. Doctors can be attracted to patients of course, both male and female physicians. But they're not attracted by doing pelvic or prostate exams which are very clinical and often unappetizing.
I think it is a valid point to recognize that many pelvic exams are not sexually appealing, some even being disgusting. I wonder how the author of "Gentlemen Don't Look Up Ladies' Skirts" at www.modestyxxx.com would deal with that obvious fact?
But what of those women - like my wife and many others - who are fit, healthy, and attractive? If my wife is sexually appealing to me, why not to her doctor? If the male human is sexually aroused by sight, based on genetic commands, why should I believe the male doctor can override those commands? Simply asserting and denying is not very persuasive.
The male doctors I have heard refuse to admit to any sexual attraction under any circumstances - "It means no more than examining an ear or a knee," I have heard it said. It seems to me that the medical physician is overstating the case in order to close the door on the issue, with no scientific evidence to support.
Evidence from documents of medical associations in the US, Canada, the Britain admit that doctor-patient relationships can be erotic, even publishing an extremely candid scenario of a doctor becoming entranced with a young patient while doing a pelvic exam. Most research into erotic doctor-patient relations indicates that male gynecologists are more inclined to engage in such behavior than other specialties. Does this not point to the intimate nature of the male gynecologists daily work?
This article is perhaps the first serious intellectual attempt to address the question of male gynecology, eroticism, and the pelvic exam. I would have preferred a shorter version, with several areas left out, but I do think it deserves a thorough and honest debate. The medical profession until now has been dismissive of this issue, for example, never offering any evidence to explain what happens to a 20 year old male who has raging hormones and is busy for years "conquering" every female possible in today's "hook-up" society. But then suddenly when pursuing his residency in gynecology because something of a saint. Exactly how does that work? In reading the research in sexual psychology, I find evidence that when males are shown mere photos of the female genitals, the arousal system immediately fires off, although some deny the response.
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