Sunday, April 15, 2012

Modesty: Medical vs Societal Standards
Guest post by Carolyn Knight

Medical Carte Blanche

If you go through security at an airport and are selected for a pat down, they will make sure that a TSA agent that shares your gender pats you down.  If you get arrested and receive a pat down before entering a squad car and an officer of your gender is not present, one will be called to the scene.  But, if you are in need of a urinary catheter at a hospital, you get no say in the matter whatsoever.  Oftentimes they are not even going to perform the insertion behind closed doors. 
Awaiting a prostate procedure
In today’s medical facilities, statistically speaking, catheter insertion is more likely to be performed by a female nurse. In fact, according to the U.S. Department of Health and Human Services, only around 6% of the nurses in the U.S. are men. Since some patients do not wish to be examined by a medical practitioner of the opposite sex due to cultural, moral, and modesty standards, this is a problem.

Some people believe that there is a general attitude in the medical profession that what gets in the way of a medical objective must be crushed and swept out of the way.  When it is cancer, then by all means, crush it and sweep it out of the way, but when it is human dignity people must advocate their rights. 

Dying female patients that are admitted to the emergency room that must have their clothes cut off and their breasts exposed for a chest tube or worse might not be too concerned about their modesty, but sometimes modesty is violated over matters of convenience and not collapsing lungs. 

People that enter the medical profession may not have the inherent tendencies to violate patient privacy. However, a total lack of modesty in training in school from LPN programs all the way to medical school and you have many practitioners that no longer have any boundaries. 

According to ABC news, men are less likely to visit the doctor than women because of factors such as modesty and a desire to not appear helpless. The price men pay for not seeking medical attention is tremendous. If those in the medical profession work to respect the privacy and modesty of their male patients, they would likely see a spike in men seeking help for their medical conditions. Men should, at the very least, be able to choose the gender of their doctors and nurses in the emergency room when they are seeking help for conditions that require extensive physical examination.

Of course, modesty and privacy concerns don’t just affect men. According to the American Medical Association, only around 40% of practicing OB/GYNs are women. And, according to the Canadian Medical Association Journal, around 50% of women prefer to seek help from a female doctor when it comes to childbirth and gynecological issues. So, women who desire to see a female gynecologist in the emergency room have less than a 50% chance of being able to do so. Women can, of course, choose the doctor that gives them a pap smear. However, they rarely have a say when it comes to which doctor sees them in an emergency room.

Male patients have a right to a male medical professional whenever exposure or contact with genitalia is a factor as much as female patients have the same right to be treated or handled by a female.  The lack of consideration for this right to privacy is not healthy for the trust of the patient in the practitioner, or for the aspects of truth, compliancy and giving forth of information and compliancy that is necessary for optimal treatment. 

As the accused have fought for the rights to be searched by the same gender, shouldn’t the same level of courtesy be given to those made vulnerable by their need for medical attention?

Author’s Bio: Carolyn is a guest blogger who writes about career advancement, LPN programs, and higher education.


Anonymous said...

I have to say : I like this article. It's simplistic and matter-of-fact tone echoes what we have said all along, and that is that people deserve and should expect choices in dignity and respect in all aspects of life.
I would only ask two questions..

1) Has this article been published in any other public arena that might call attention to this subject.

2) If Carolyn might expound on this thought."People that enter the medical profession may not have the inherent tendencies to violate patient privacy. However, a total lack of modesty in training in school from LPN programs all the way to medical school and you have many practitioners that no longer have any boundaries." I am curious as to the transformation from a person who holds thier own dignity and respect in high regard, and a patient's digity as disposable.
Perhaps Carolyn could shed some light on this often wrestled with and seemingly never answered question.



Joel Sherman MD said...

I too like the article. It's main point is clear, that unlike every other situation in society, patients are given little choice when it comes to modesty. Obviously medical situations differ from others, but that should not be used to deprive patients of all choices.

Anonymous said...

Dr. Sherman:
Where can I find a doctor like you who understands this issue??? I also would like to know, like Suzy, if this article has been published in any other arena. I think that would be a big step in getting this issue out in the open, discussed and evaluated as to it's importance to a large segment of patients. It needs a much wider forum. Jean

Joel Sherman MD said...

Jean, there's no magic way to find a doctor who's sensitive to these issues. The best you can do presently is to ask ahead of time when making the appointment. Make it known to the receptionist that this is a major concern to you, and see what response you get. It won't always be helpful but it is at least a place to start.
I'm not aware that this article will be published elsewhere. Maybe Carolyn will comment. Publishing here is a start. The blog certainly does not have a mass following, but interested people do find it.

Anonymous said...

Dr. Sherman:

I often run into emailers who read this blog. They may be too 'intimidated' to comment on such personal views...but they certainly chat among themselves. The info here is extremely important to opening avenues of thought and empowerment!
I did not mean to give the impression that this article needs to be global to have importance. I was more curious as to whether we could find her work in other places. If I gave any other impression I do apologize.


Anonymous said...

The only problem I have with this article is the paragraph
regarding a dying female patient that has her clothes
cut off for a chest tube insertion.

I personally have been involved in thousands of level
1 trauma patients. Most patients that are brought to
the trauma room are not dying. In fact, many are
convinced by the ems service to be brought in as trauma by mechanism. That is due to the damage to the car. More often than not, the patient is unharmed.

In regards to the article I will attest to the fact that
female nurses in the trauma room will always cover
up their female patients, whereas male patients are
left uncovered long after the trauma team has completed the assessment.


Eddie said...

PT... I have a question for you then.

If they come in as a level 1 Trama but clearly they are not. Do the nurses/medical team re-evaluate the situation before actually cutting of the persons clothes and having them embarrassed or mortified? I know if that was me, I would be scared for life.

Why is it that female nurses disregard male modesty after the assessment? Have you ever asked?

Eddie said...

PT- Since you work in a trauma center and i'm curious to your post.

1. If they come in as a Level 1, but clearly its not, do you re-evaluate the situation before cutting the clothes off the patient or do you do it for all traumas regardless of the injury? I feel that would be very embarrassing or humiliating for someone who wasn't seriously injured.

2. Why is it that female nurses wont cover up males after the evaluation, do they not think they guy is going to care. Also don't they want to keep them warm so they don't go into shock.