Preserving Patient Dignity (Formerly Patient Modesty) Volume 127
A Worthy Posting today on Volume 126 to set off a discussion of "Preserving Patient Dignity"which should be more acknowledgment that there has been, within the past, some ignorance by the medical profession that the concept of the dignity of the patient exists and should not be attacked and injured.
Here is the last posting of our contributor Reginald:
Hello,
As I pondered why dignity is such a hard concept for healthcare, I mused regarding what has changed – realizing that what happened in the past was not always something better.
Thirty years ago I had a cardiologist as a GP. Yes, a cardiologist as a GP. That this was possible was astounding, even at that time. I visited him once a year and, the visit lasted for almost an hour. The session started in his office. Yes, in his office, not an exam room. His first statement was, “Tell me what has happened in the past year?” He’d then listen, respond, and ask further probing questions. After at least 30 minutes he’d invite you to the exam room while he followed with his black bag. (One would think that he was a doc out of the 1800’s.) The exam was complete – nothing missed – no rush. Bowel issues might be addressed in the exam room via a sigmoidoscopy, a modified colonoscopy without anesthesia. There was no need for another office or hospital visit. The exam might be interrupted as he was called out to answer a patient’s phone call. He could be heard saying, “No, Mr. Smith. You must take that medication for the rest of your life.” He’d return to the exam, apologize, and continue. His wife was his assistant and his receptionist. This was in Santa Ana, CA not in rural America. Sadly, when he heard that the insurance companies were limiting payments to 15 min. visits, he retired. He was too professional to be directed by non-medical entities.
What’s changed? Aside from the fact that a cardiologist could also be your GP, your visit took some time and the doctor LISTENED. An hour-long visit will not return but, LISTENING doesn’t really require much time.
Today, few in health really listen, nor do they ponder what they’ve heard. A quick diagnosis is made and you’re on your way. In a hospital setting, no one will listen to you AT ALL. For any procedure there’s a protocol and the protocol comes before the patient. Dignity issues are not addressed because they are not part of the protocol or, because they interrupt the procedure. No time is given for consideration of the patient’s requests for dignified care.
I do believe that this is at the heart of our responses (real or perceived) to what we consider breaches or dignity. Yes, there are bad actors; but, overall health care personnel don’t plan to harm. They don’t listen and, they are unwilling to spend the time to consider how protocols might be revised to accommodate INDIVIDUAL dignity. Group “dignity” is attended to via politeness and courteous; however, individual dignity is never addressed. This would require time and, getting to know the patient as a person and not a procedure. Is there any hope that this will change? What can we, realistically, do to affect change? Maybe, more importantly, the question is Would anyone in healthcare even consider the above explication of individual vs group dignity?
Reginald
posted by Maurice Bernstein, M.D. @ 2:13:00 PM
186 comments
186 Comments:
Welcome to Volume 127. You should be able to post now your comments here. ..Maurice.
Forget insurance, I would pay out of pocket for a doctor like that. It doesn't matter anymore whether you are willing to pony up or not, doctors like that don't exist anymore.
The nurses forum is back up. I lost the link but a couple of weeks ago a nurse was complaining about a patient's dignity. Apparently an gentleman in his 70s soiled himself and then tried to get up to go to the restroom and subsequently fell. The nurse was trying to clean him up on the floor while a doctor assessed his injuries. She said ten or fifteen people were gawking at the situation and not necessary or helping in any way. The poor guy tried to cover himself unsuccessfully and crying from embarrassment too I think. The nurse was outraged and I was too after reading the story.
I had a real good laugh today at the hospital's expense. They sent my insurance company a ridiculous bill for $90K+. The insurance company knocked it all the way down to $9600. That's harsh, lol. It wasn't that great of an experience but hahahaha the hospital's billing department is even more incompetent than their endo department. Can't buy too many fancy cars for that. Revenge is sweet.
"Revenge is sweet": Is "revenge" a word or really an act for consideration by a patient or patient's family to think about and plan toward the physician, nurse or other medical folks who ignore that patient's dignity during their interaction with the patient or patient's family? Is revenge, those appropriate to its expression, worthy of consideration? Would revenge be legal or ethical? Is revenge a productive act or will its expression only further diminish the relationship with patient and family and cause only harm to the patient? Is revenge only sweet or can it turn sour? ..Maurice.
Dr. B,
Revenge probably is too strong a word. If I get horrible service at a restaurant does not leaving a tip make the experience any less unpalatable? Both parties are diminished. However paying a premium price for an inferior product makes me the victim twice so not doing so is a relief mentally in some way wouldn't you say?
For what it is worth I think the service they provided was worth more than what they got paid. However, that is their doing, not mine. I would be curious what people think. If a patient is injured either mentally or physically by a callous or incompetent medical provider and the patient later learns said provider is struck off, loses their license, successfully sued, stiffed on a bill, goes bankrupt, gets treated shabbily by the medical profession themselves, or whatever, is it unethical to take some small bit of satisfaction from that? Are we not human?
Who was that horrible cluster of people standing around watching that poor patient? And how was it that they even had TIME to cluster around? JF
For a bit of further education about the action and reaction of revenge, reach this analysis:
https://www.psychologicalscience.org/observer/the-complicated-psychology-of-revenge
JF, I was thinking the same as you. Hospitals do have portable screens readily available.
..Maurice.
Several things come to mind on this. 1) i thought the staff were to busy to just stand around. 2) the rooms are too small for spouses/SO to be in while they are doing intimate procedures ( such as bed baths or whathaveyou) but not 10-15 gawkers, finally and the most important.... WHY THE HELL DIDNT SHE TELL THEM TO LEAVE? I thought if anyone saw anything inappropriate they speak up? Shes mad enough to post to a blog but not mad enough to tell them to get out while its happening? Cat
Hello.
Revenge is NEVER appropriate! Everyone is diminished. Let the individual, and any appropriate others, know how you feel. Report to authorities or the media. Suggest or demand remedies for improvement. Try to have the situation amended so that others don't endure your trials. Then, let it go. Move on as best you can so that the incident doesn't occupy your every moment. (This doesn't mean that you won't be affected for the rest of your life; nevertheless, keeping the incident at arm's length might be possible.) Basically, don't let others drag you down to their level. Demonstrate your dignity.
Reginald
Come now. Let it go? Rise above it? I have read many comments here referring to karma? Did not many here cheer when this guy:
https://abc13.com/doctors-malpractice-surgery-patient/802568/
Won his lawsuit? JF I have read some older posts where you describe the heinous abuse you suffered at the hands of medical staff just for standing up for your modesty. I do not advocate violence but you-all please don't try to tell me that you don't harbor resentment on some level, sometimes for years, as do I. Not just for myself but for others too.
Greetings All
I thought I would provide an update on my non-sedated colonoscopy at a local center. It went off without a problem and was only mildly uncomfortable for a few moments. I liked being awake and in charge and also liked that there was no recovery time.
There were a couple of odd things for the procedure. The first occurred when the anesthesiologist introduced himself and said he would be taking care of me during the procedure. I explained that I was doing a no-sedation colonoscopy. He acted surprised and said that in that case, he could take a break. He then said, I will wait in the next room so I don't hear your screams. I took it as a joke, but it was probably not the best thing to say to a potentially nervous patient.
I was wheeled into the procedure room where the equipment was on the back wall and a large monitor was on the wall adjacent to the door. They had me lie on my left side with my butt facing the back wall. The nurse arranged the gown so my backside was completely exposed and the material rested on my side and outer thigh. It would have been very easy for the gown to fall to the other side potentially causing genital exposure, particularly when she reached under the gown to apply some very firm pressure to my abdomen during one of the turns. Of course, being awake I was ready for the potential exposure and would have covered myself.
The really strange thing is that the door to the room was left open and I watched other patients being wheeled to other procedure rooms as well as other nurses walking about. Good thing the monitor and my butt was facing away from the door!
I retained my blanket as I was wheeled to the recovery area but I saw them wheel an elderly woman to recovery with just the gown. On a tall person, the gown could easily ridden up and exposed private parts.
I left comments on their survey about the open door and reiterated the suggestion that they use colonoscopy shorts to eliminate possible exposure of patients.
On a separate issue, I was like to know if anyone has experienced something similar or thinks it was slightly odd. I went in for an ultrasound to diagnose pain behind my knee. I was told to remove pants and given a paper sheet to cover myself with. The nurse left the room for me to change and knocked before she re-entered. So far, so good. I asked if I had the sheet adjusted correctly so she could access my knee and she said its okay, I will adjust it. I didn't realize my doctor wanted to scan the veins from my groin to just below my knee as well as behind my knee. The nurse proceeded to tuck the paper sheet underneath the leg opening of my underwear. She got very close to making genital contact but not quite. Thinking of it afterwards it seems strange that I wasn't simply told to tuck it into my underwear myself. Very trivial compared to what others have experience but still felt odd. Not sure what she would have done it I was wearing boxer briefs as usual.
Still haven't screwed up the courage to visit the urologist for some issues.
EM
Hey EM I'm sorry they had the door open for your procedure. That is odd and uncomfortable - the door should have been closed. I'm the type of person who thinks that during sensitive/potentially exposing procedures that the doors should also have reminder signs to knock before entering or to not enter at all.
I'm also sensitive to these near-exposure/loss of dignity situations like yours and the lady in the gown on the hospital bed. I had a non-sedated colonoscopy once and was met with a lot of reservation about the no sedation, but they ultimately let me go through with it and was allowed to keep my clothing on (I just lowered my pants after they were set up and ready to go) and they met my request of only women in the room. Just putting this out there so others can see it as options to request (i.e. keeping clothes on until just before the procedure then rolling down your pants/shorts). For someone with sexual trauma this was quite a positive healthcare experience.
At my medical school we are taught to not move patients clothing or their gown if they can do it themselves or if they grant you permission. We're taught to also ask the patient to tuck the drape into their clothing if needed. This is not universal though, my significant other is a medical student in the USA and he had ZERO instructions on patient draping. It wasn't until he told me an unfortunate story of how he exposed a male patient's genitals (when it wasn't needed_ that I realized. I then shared with him what I learned about draping and the resources that were provided to me by my school. He felt bad for what he did.
I also hate it when medical professionals manage my clothing/gown/drapes and I WILL speak up about it.
Also to Cat and Reginald - I saw your comment on the previous thread. I really appreciate your suggestions and encouragement. I have actually had a number of positive comments from standardized patients, real patients, and physician tutors for my own approach to patient physical exams that is different from what they teach (because I focus on reducing unnecessary exposure and patient comfort, autonomy and informed consent). I love your new ideas and I will check back here to remind myself of ways I can advocate while I'm lowest on the totem pole (medicine has a bit of a hierarchy). I'm not going to hold back and will set an example for others - no one can reprimand me for simply caring a lot about a patient in mind, body and spirit. And Cat, I'm actually living in the US at the moment with my significant other who studies medicine here.
Lately I have been having arguments with my significant other on whether or not medical students should ask patient permission before observing/participating in their care (especially for specialties like surgery and OBGYN). I strongly believe that we should always be asking for permission, simply because of fundamental bioethics (informed consent, patient autonomy, transparency). Students are also just extra bodies and are not absolutely needed during healthcare visits/procedures/surgeries. In my eyes, it is a PRIVILEGE not a RIGHT to learn on other people, and that the patient is the most important person in the room - they are the ones who might be sick and are in the inherent, more vulnerable position. People could also come in with previous trauma (eg. sexual, medical) and this way we won't accidentally worsen or create trauma.
From my partners perspective (who is further along in his training than me), medical students shouldn't need to ask because: 1. how else would we train new doctors? 2. patients are aware they are at a teaching hospital and know that learners will likely be involved in all aspects of their care. 3. Most people on a surgical team don't introduce themselves to the patient or ask permission, so why should I try to always do it? 4. I should introduce myself as a medical student on their care team, but not ASK the patient for permission. Its a teaching hospital. plus things can get awkward if I ask to observe then the attending physician has me participate.
I have very good counter arguments to each of his points (1. asking permission doesn't mean you will automatically get declined (most people say yes and appreciate you asking); 2. Not all patients know it is a teaching hospital, know exact what that entails, and they might not even have a choice); 3. In my opinion, and in an ideal world, everyone should be introducing themselves to the patient as part of informed consent and transparency; 4. Again, should always ask for permission, and the attending doctor should ask again if your responsibilities increase from observation to participation). It is SO disheartening to witness how rampant the lack of care is for the patient as a person, not just their physical body/medical problem. It is especially disheartening to hear it from my partner. I also think many medical students tend to care a lot about patient comfort and dignity, but that this gets 'hammered' out of them over time as part of a strange acculturation process.
Edgar 61.
Yes. I have often talked about revenge fantasies. And shouldn't be thinking that way. But I STILL think there needs to be a countability.. The more abuse is tolerated, the more it will continue. There is no quick easy way out of it. JF
EM, I'm glad your colonoscopy w/o sedation went well. I have had four w/o sedation. My discomfort was very minimal; a little mild pressure feeling on occasion is all. No one ever pressed upon my abdomen, but I suspect had you been sedated she would have just pulled your gown away. I say that based on questions posed on Quora about patient exposure during colonoscopies never seeming to be answered. That and why would a doctor have invented colonoscopy shorts if patients were never exposed.
On your vein scan, it sounds like just more of the same casualness and lack of concern for what they patient might be thinking. At a minimum she should have said what needed to be done before doing it.
Oh Alicia... please do not take this personally but ( always a but) it sickens me to hear of the arrogance of your SO. It DOES NOT MATTER, if its a teaching hospital or not. Patients consent can be withdrawn AT ANY GIVEN TIME. I must say, they would be kicked out of my room/care so fast with that attitude. Your 1st paragraph, i thought we might get somewhere, with you teaching your SO about dignity. Then you go on to say, they just dont care about patient wellbeing and its only about them. It is not their body, it is mine. Im sure they would NOT appreciate you or anyone else telling/demanding them to do something. Tell them they are no longer allowed to watch porn and see the reaction. Or go out to bars with friends. I pray you choose to stay in the states to work. So many i believe go in with your intentions, but then other nurses beat them down until they dont care. Desensitized gets thrown around A LOT. Is it really a good thing to be Desensitized over seeing someones genitals? Desensitized to a human beings comfort? If more would stay sensitive there would be a lot less unnecessary exposure. Keep doing you and teach others, there is way more to caring for people then just clinical. WE NEED YOU...Cat
Alicia, as I have previously written here, when I was teaching "Introduction to Clinical Medicine" to first and second year medical students, I, from the onset of my teaching, told my students that they should progress their physical exam exercises with the patient's knowledge that this was a teaching exercise and the patient was free to refuse full or any segments of the examination. No "iffs ands or buts". Patients, for the most part, appeared satisfied with the teaching experience they provided to the student. ..Maurice.
Yes. I have often talked about revenge fantasies...
JF I do not blame you one bit. I am angry for you. Sometimes when I hear about incidents of violence in medical settings I wonder what the reason was and if it was anything like what you encountered. I suspect at least some of it is related to abusive or incompetent or callous "care". I know of a straight up sadist urologist who is still practicing today without a single blemish on his state license. I know, because I looked. There were lots of complaints in his online reviews but so far nothing has gotten past the board officially. I sincerely wish that hadn't happened to you.
Edgar61 are you sure you’re thinking of the right person
Edgar61,
Interesting that you and JF have talked about this. Cindy and I are doing our next show on the difference that is being made between patients who harm medical providers and medical providers who harm patients. The media and government is complicit in gaslighting, making light of, etc. of patient harm but jumps all over when a medical provider is harmed.
First, let me say that violence is not the answer. However, most harmed patients understand the trauma and despair when you have been harmed and you cannot get help or justice. I think about the man in Tulsa who killed a doctor, another medical person and a patient who was protecting the doctor. At least we know part of his motive and that was he was in pain from a procedure that apparently made him feel worse. In Memphis, we know nothing except that doctor was thought to have god-like status. However, he may have been a nice guy and most of the patients were satisfied but like with everything rarely is there perfection. We have yet to found out what the shooter's motive was. The media has gone all out in these crimes because the patients used a gun to harm/kill which medical providers have harmed more but do it without the use of a gun. Victim counts for medical harmers are much higher than the patient who harms medical providers but yet no real numbers exist on this rather there are numerous articles about how medical provider are being physically assaulted/abused by patients. Because of this gaslighting, I believe it drives some patients over the edge because really there are few if any real support groups or legal avenues for harmed patients.
There is a nurse in England who has been alleged of killing babies. She even made a confession but most likely she will get out of the charges. It happens time and time again. Those who intentionally harmed my husband get away with it. They medical system over the years have had many serial killers/harmers. Probably more than other professions. We are told we are protected but when we harmed we come face to face with the fact the system only protects the harmer. Stories of harm are kept silenced so it is easy to understand why a harmed patient might snap. Again, it is wrong but...
Yes, we would enjoy for those who intentionally harmed my husband to face what we call Karma. However, we will not allow them to further destroy our lives by actively harming them. But it does make me smile when I think of them or even their loved one(s) being harmed in the same manner. IMO, since Stephen King writes such sick, twisted stories that glorify violence maybe I should write one abt this subject too? At the very least, I believe anyone who has suffered medical harm should write about and this should be a joint publication kind of like Reader's Digest. It would be volumes and volumes. I would also encourage medical providers to add stories of harm they have knowledge about like the routine disrespect of patient's bodily dignity.
Jeff it could have been you I was referring to my mind gets muddled sometimes and your sigs are similar.
JR.. an interesting point is if a nurse feels threatened by a patient or the family member THEY can call security and without questions asked escort either one out, then call the local police. Patients CAN NOT call security on the staff. Cat
JR maybe you could call it readers, undigestible or tales from the OR crypt
You write it and I’ll read it and promote it
JR thank you for that Tulsa story. This is why I have always had a distrust toward medical people. Because I know that whatever they do I will have to live with for the rest of my life. If I die of colon cancer or heart attack that's my bad luck but I won't willingly let them do stuff that could harm me. Animals in the wild don't go to doctors. It is natural.
I’m transferring care from my present therapist to one that specializes in EMDR with all the hopes that I can get relief from the PTSD that I suffer. I just attempted ketamine infusion with negative outcomes.
Sometimes ketamine is used in surgery as a replacement to versed as a sedative which may explain why I had such a negative reaction to the versed I was given for my heart surgery. I came out of the heart surgery with unbelievable damages to my body that was clearly from a struggle that ensued in the or but of course no one would discuss the damages or even acknowledge, they existed and of course no mention in my medical records .
The amount of suffering that I endure at their hands is is impossible for me to put into words. What is truly sad is there maybe someone at this very moment getting ready to endure what I went through and they care as much now as they did the day they basically ruined my life. I would give them grace if they had no idea what the potential consequences could be but the reality is they are fully aware and that is what makes it criminal
Jeff,
You might want to talk with Cindy as she became very agitated with versed. She had told them she didn't want it bc of the adverse side effects it had but they did it anyhow. She said she became somewhat aggressive with it which is known to be one of the adverse side effects. With my husband, versed makes him feel like he the audience watching a horror show of what is happening to him and making matter worse, it remembers it. Of course, it along with fentanyl has other physical adverse side effects. Ketamine is used less often because of the fear of hallucinations and agitation especially during the recovery phase. I am so sorry for all the suffering you are experiencing. Few understand how much trauma harmed patients suffer and endure. You are in my thoughts. Reach out to me if you want. Also, Archie Banterings is real good resource about PTSD. He is the one who helped my husband and I understand what we were suffering from.
Wonderful! Do you all realize that this blog and blog thread can but also IS providing psychotherapy from one writer to another? And from a $$$ point of view: the therapy is FREE! One could not expect more as a function and result of a blog. ..Maurice.
JR it is a great comfort to know that you and others sympathize and understand the devastation that can occur at their hands.
When you consider a hand written note from the anesthesiologist to the ICU nurse that patient flipped out when genitals were shaved in pre op . Knowing that the patient was already in an agitated state she chose to inject me with a full dose of versed in pre op against the dosing advice of the American anesthesiologist federation for patients over 60 . I was then injected with another full dose of Versed 7 minutes later in the OR obviously in an attempt to subdue me which was followed by fentanyl and propofol This could have caused respiratory failure but I guess they didn’t care because they could just shove a breathing tube down my throat .
I emailed her in regards to the flipped out comment and never received a response she merely turned me over to patient relations which went nowhere
SHE WAS A REAL PEACH
Dr. B This blog site has been a wonderful source of comfort to me because all of my experiences have been so isolating but here you find your not alone
Jeff,
I would believe it as they dosed my husband the same way. With versed and then the addition of fentanyl, he doesn't get agitated but becomes very alert and scared but is in a zombie state. His blood pressures will go up and down as well as his breathing rate. In fact, he had a vagal response to all the versed and fentanyl. He had 4 mgs of morphine, 200 mcg fentanyl and 3 mgs of versed all within an hour's time. It almost killed him but they didn't care. They labeled it as shock from having a heart attack but he was stable for hours until all the drugs. His respiration was very low as well as his BP. Yes, for older patients there is a different dosing recommendation as well if they are also sick. They pay no attention to these recommendation as they want their patients drugged to the max. They simply don't want to deal with you.
As for revenge, for us they personally aren't worth it because we consider them to garbage but we do hope they will get the Karma they deserve and I firmly believe they will. I have known stories of some very bad people eventually getting the Karma they deserved. Some say they wouldn't wish this on their worst enemy but we certainly wish it on them as they earned it. Mary Queen of Scots once said she "would forgive but not forget" what her husband Darnley did to her secretary but we will neither forgive or forget. You don't forget or forgive such vile betrayals that rock your very soul. However, you must not allow it to destroy you.
From Archie, we learned all about what we were experiencing and that we weren't alone. That meant a lot. We have researched medical PTSD so we can deal with it. We can't always avoid all triggers. Sometimes they have to play out but to a certain degree we have found ways to rein it in. Music is one of our first lines of defense. We have certain songs that bring peace. Our animals bring much peace and comfort as well as hobbies. We avoid being where scrubs are as we are aware of shift changes but bleached blonde nurses are a trigger as well as anyone who looks like the others and of course, the hospital systems. My middle finger has stood up a lot in the past years when I have to pass their signs. We haven't seen one hospital since the day he escaped. My husband remains mostly silent but for me talking about it helps. It just depends. We have accepted we will never know why they decided to victimize him rather than someone else. Letting go of that was huge. I do plan to write a Stephen King type story about them using as the background what they did to him.
JR thank you so much for your encouragement and insight
For me to stay in this state of mind and the constant rumination only allows them to continue their damaging effects
Bless you and Cindy for what you do
Possibly you might have been mixing me and Jeff up. My real name is Judy. But I go by JF here.
I'm so worried they're going to give me Versed or Propofol against my will if I ever have to go to the hospital or have a procedure done. I'm especially worried about Versed - I've read horror stories online of immediate and lingering side effects. I can get through a lot with no sedation and just pain meds or local anesthetic.
What can I do to ensure I'm not given these amnesic medications unnecessarily? Do I tell them I have had an anaphylactic reaction before?
Alicia I have it listed in my medical records that I am allergic to versed after the experiences that I had . It states that it may cause mental changes and that I may become combative. That’s enough to scare them off.The part I don’t know is if they may try using an alternative to achieve the same affects? They have a lot of tools in their toolbox. Their goal is complete compliance ,submission and no memory
How do the Amish
stay healthy? They even have their babies at home and have lots of kids. Has anybody in this group tried home remedies and can tell us whether they work or not? JF
JF there are a lot of home remedies that are very effective the problem is the issues that have driven me into the loving arms of the medical world was spinal surgery ,multiple cardiac catheters, colon resection aortic valve replacement, pacemaker. For these there are no home remedies. At this point for me I either have to receive gender concordant care for anything that requires removal of underwear or I refuse treatment. The medical world would be more than glad to let me pass because they have created a different world than I was taught to abide by and have very strong convictions about. They changed the moral precepts to their advantage because of their own disadvantage in gender balance. They have done a good job so far. Indoctrination,deception,drugs to name a few
Alicia,
Make what I call a very advanced Advanced Directive. This version goes well beyond just the normal areas associated with a directive. In there state what you will and will not allow. For instance, list you refuse certain meds. List in there what you expect from care such as bodily dignity respect and all medical providers (drs., nurses, techs, etc) must follow Trauma Informed Care Protocol. In my husband's, we even list the people by name that he will not accept as being part of his care team. He doesn't say why but he wants to make sure they are never near him again. He also lists that once he has been given any type of sedative or painkiller, they must seek verifiable consent from me for all care. Have this notarized or have a lawyer be involved. You may send copies to whoever you feel needs them but always carry a copy with you. Make sure in your MRs, you have listed versed, etc. as meds you refuse. Give a reason such as you have had an adverse side effect and know what the side effect was. Once you have done this, go back a few weeks later to see if your refusal actually made into your MRs. The other thing we do is carry an audio recorder so we have proof of verbal refusal. We live in a state where only one party has to know they are being recorded. Having said all this, there is no guarantee they will cooperate as my husband refused versed and fentanyl so they merely injected it into an IV without his knowledge which amounts to medical assault. CMS appears to support the medical assault of patients by verbally telling me that a doctor has the right to inject any drug into a patient that the doctor deems necessary meaning that a doctor is able to inject drugs into a patient that could kill them? Hopefully this is just one supervisor's point of view but you never really know for sure.
JF,
Yes, there are natural supplements that work. My husband does not take RXs and at his age, they seemed determine to make sure he would by medically assaulting him with a procedure they thought would guarantee his obedience to taking RXs. However, for the past 5 years since the assault, he has not taken them. I have done a lot of research and have found ones that really work and the doctors are so surprised. They even "ordered" a huge, detailed battery of tests to find something wrong with him and could find nothing. We also have done the same with covid. We were out just abt everyday during covid and remained healthy. It takes a lot of work but it can be done. One very easy thing that I think healthy people and the Amish have in common is physical activity and eating unprocessed, natural foods. Our food sources are bad for us just as they are bad for our animals. Take for instance the way they label trans fat content. In order for most processed foods such as packaged bakery items to meet the requirement of the law, they have reduced the portion size as it must be below .5g to be listed as 0. This is tricky and fools most people into thinking they are not taking in trans fat. They have also come up with names to disguise fats. Just think abt all the chemical used on foods and the meds injected into meat sources. For example, puberty used to come a lot later years ago but when I was in elementary, I would see 1st grade girls with breasts and boys and girls with underarm smell. I believe it is all the added hormones especially to milk products.
I know one product we use for stress the FDA has been after for years. Some of Big Pharma meds are modeled after it. It works really well and that's why they hate it as it is natural and they cannot patent it so they want it gone. Statins are another drug that has been modeled after a natural supplement. The list could go on and on but with each prescription drug you will find they take the protective qualities the natural ones have out of them and do whatever they can to make them work fast. Natural remedies are not overnight miracles. They generally work slower and we live in a world of wanting instant fixes.
JR. Excellent info on natural supplements for medicine I need to look deeper into that because I’m funding the heck out big pharma also I had a lawyer draw up an advance directive and I used Misty’s example as a template because it pretty much covers everything .
If you go to the following link you will find an extensive article on PATIENT DIGNITY.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9251939/
Here is a brief summary of the study:
Background
A socioculturally appropriate appreciation of dignity is pivotal to the effective provision of care for dying patients. Yet concepts of dignity remain poorly defined. To address this gap in understanding and enhance dignity conserving end-of-life care, a review of current concepts of dignity is proposed.
Methods
To address its primary research question “How do patients conceive the concept of dignity at the end of life?”, this review appraises regnant concepts and influences of dignity, and evaluates current dignity conserving practices. To enhance accountability, transparency and reproducibility, this review employs the Ring Theory of Personhood (RToP) as its theoretical lens to guide a Systematic Evidence Based Approach guided Systematic Scoping Review (SSR in SEBA) of patient perspectives of dignity. Three independent teams of reviewers independently analysed included articles from a structured search of PubMed, Embase, PsycINFO, Scopus, CINAHL and Cochrane Databases using thematic and content analyses. The themes and categories identified were compared and combined using the Funnelling Process to create domains that guide the discussion that follows.
Results
Seventy-eight thousand five hundred seventy-five abstracts were identified, 645 articles were reviewed, and 127 articles were included. The three domains identified were definitions of dignity, influences upon perceptions of dignity, and dignity conserving care.
Conclusions
This SSR in SEBA affirms the notion that dignity is intimately entwined with self-concepts of personhood and that effective dignity conserving measures at the end of life must be guided by the patient’s concept of dignity. This SSR in SEBA posits that such personalised culturally sensitive, and timely support of patients, their family and loved ones may be possible through the early and longitudinal application of a RToP based tool.
..Maurice.
By the way, the need to maintain patient dignity is not just in the consideration of professional responses approaching the end of the patient's life. There is no reason to fail to preserve dignity throughout the life of all patients. I am sure you all agree.
..Maurice.
Is everyone of the Volume 127 now on Summer Vacation and Patient Dignity is not of any immediate concern? I hope you are and are
currently receiving Traveler Dignity which in many situations during vacation this may also be a personal problem. For example, are you comfortable with dignity behavior in preparing to enter and experience flight transportation? Do you see any similarities to flight and medical attention, behavior and care? Are there difference worthy of note between professional behavior of employees of a hotel vs a clinic or hospital? What do you remember? What is your opinion of differences, if any? ..Maurice.
Dr. B,
I totally agree with your comment about this forum providing psychotherapy. It has been instrumental in my mental health to realize that I was not the only person that has strong feelings on personal modesty and dignity.
Thanks to all the contributors over the years and belated welcome to Alicia for her comments and thoughts.
Jeff, I hope you find a treatment that will give you some peace from your ordeal. I wish others could find something to ease their minds as well but I really don't know what the answer is particularly after the fact.
After my first urology surgery and reading this forum, I no longer allow Versed to be used on me. Versed messed with memory so badly that I couldn't really tell what was real and what wasn't. This allowed my imagination to run wild and imagine all the worst possibilities. As a coping mechanism, I insist on staying awake and being introduced to everyone on the surgical team. I then observe them for a minute or so and try to lock an image of professional behavior as they are preparing for the procedure. When I start to dwell on my worst fears, I try to focus on what I actually observed.
I finally screwed up the courage to make an urology appointment to discuss BPH and kidney stone symptoms. An additional wrinkle is that I am being treated for low testosterone and a unfortunate side effect of hormone replacement therapy (HRT) is testicular atrophy/shrinkage. This makes me even more self conscious but the benefits far outweigh the negative. Some research suggests that HRT exacerbates BPH and I hope I don't have to make a choice between the two. I really don't want to go in but also do not want to ignore symptoms to the point that it causes more severe problems and results in an emergency situation. Right now, I have the ability to try and find doctors/facilities that will honor my request for male personnel. As a retired person, I will travel anywhere in the state or country to find what I am looking for.
EM
Hello Dr. Bernstein,
Many posters may be enjoying the last of summer without negative medical encounters. Hurrah! I don't travel much now but; in the past, the hospitality (as opposed to the hospital) industry (airlines, hotels, resorts, etc.) took great pains to treat everyone with the dignity allotted to royalty. The hospitality industry survives on competition and reputation. Those companies with low ratings don't last long.
Unfortunately, I don't believe that the medical industry has the same parameters. There is little competition and, there is little need to treat people with individual dignity. If you don't get the desired service at one care facility, you may need to travel many miles to patronize the "competition" (i.e. Biker's plight). Furthermore, a hospital with poor dignity ratings survives because the loss of one patient will be replaced with more seeking help.
Actually, a few years ago many industries were using the airlines as a template for exceptional service.
No. I'd say that the hospitality industry wins hands down. The same can't be said for those using their services - note the outrageous antics of airline travelers.
I hope you're happy and well.
Take care.
Reginald
Hello EM,
I appreciate your plight. Misty at Medical Patient Modesty mentions Texas as a state with a clinic with nearly total male personnel. You may wish to explore this. I have also read of a urologist in UTAH with male sympathies.
I wish you success.
Take care.
Reginald
Reginald: "Doctor in Utah with male sympathies" not Gange, I hope. An office full of nasty witches--been there,done that!!
EM. Your request for gender concordant care raises awareness every time you do it.
It may not get the desired results but I can assure you it raises eyebrows and if the medical community gets questions about this often enough it ultimately will affect change. One thing that men need to do is create their own ME TOO movement just like women did. Women still have their awkward moments in healthcare but it has improved for them tremendously. One perfect example of the double standard is catheter care. I didn’t know that people with catheters had to have their genitals cleaned periodically to prevent infection.If a woman is being tended to by a male nurse he will offer to get a female to do it. That same offer will never be made by a female nurse to a male patient and most men will except this. This one thing could start to turn the tides if men would just speak up instead of feeling like they will be perceived, as girly men. It takes a brave man to stand up instead of just rolling over and except something that is extremely humiliating to many men
Hello again,
Mitripopulos, I don't have the name of the Utah doc. I remember reading of a fellow flying some distance for the all-male care. Hopefully, this is a different doc.
Jeff, you're absolutely right. I advocate for and do the same. An additional statement to health care personnel is, "You've spent many, many years in study. You're very intelligent people. Surely, you can adapt your procedures to accommodate my dignity concerns." Throwing the ball back in their court never hurts,
Take care.
Reginald
Each student when beginning medical school is to wear a short white coat during their hours of medical education. Read this very brief article from AMA on the short white coat for students leading to the long white coat after graduation:
https://www.ama-assn.org/medical-students/medical-school-life/meaning-behind-your-white-coat
Do you see Humanism beyond some sign of Professionalism in your doctor's wearing of his or her white coat? And preservation of patient dignity is truly dependent upon physician or nurse humanistic behavior. ..Maurice.
Good Evening:
I find that Alicia's comment to EM about draping says VOLUMES about the American healthcare system.
"At my medical school we are taught to not move patients clothing or their gown if they can do it themselves or if they grant you permission. We're taught to also ask the patient to tuck the drape into their clothing if needed. This is not universal though, my significant other is a medical student in the USA and he had ZERO instructions on patient draping. It wasn't until he told me an unfortunate story of how he exposed a male patient's genitals (when it wasn't needed_ that I realized. I then shared with him what I learned about draping and the resources that were provided to me by my school. He felt bad for what he did."
It glaringly shows other countries take patient dignity & privacy seriously whereas the American healthcare system treats it as an afterthought at best.
It will be interesting when she moves on from med school into actual practice if the culture of the institution she will work in will change her attitudes towards patient dignity & privacy.
The American healthcare system needs a HUGE attitude adjustment. I just don't know how that will come about.
Too many people are going into the system simply for the money. That doesn't bode well for patients.
Best regards all,
NTT
Here is a medical ethical topic to consider and to express your opinion. It has to do with the patient demanding to be discharged and leave the hospitalization but fully against professional medical advice. The patient is diagnosed to be physically still sick and such a discharge at the time would be a hazard to the patient and perhaps others to which the patient may be in contact outside the hospital. In view of the facts and the patient's clinical condition, the physician and hospital take steps to attempt to prevent such a patient leaving the medical care and the hospital. What is your opinion of this really happened, happening clinical situation? ..Maurice.
Dr. B when you say that the patient could be a danger to others is this due to a contagious condition? Other wise they should have no moral or legal right to refuse their wishes
Jeff, first, here is the American Medical Association's view of this topic:
https://code-medical-ethics.ama-assn.org/ethics-opinions/physician-responsibilities-safe-patient-discharge-health-care-facilities
..Maurice,
The management of a hospitalized patient is much more complex than "moral rights". Every patient must be evaluated by members of the hospital staff and which may also include the hospital's ethics committee as to the patient's capacity to understand their clinical condition. This is made evident by direct communication between the patient's hospital physician or other hospital staff members. Conscious patients may demonstrate complete understanding of diagnosis, treatment and their prognosis, partial understanding or ignorance of what is being relayed to them.
Decision making in hospital medicine is made on the patient's clinical condition and understanding through questioning the patient by the clinician. If the patient is conscious but cannot be seen to understand the facts of his or her condition, the clinicians must turn to family members or other surrogates or advanced directives or other previous directives written by the patient previously regarding future clinical management. Often, the hospital ethics committee may be involved in the establishment to provide education and moderation in cases where there are no prior documentation by the patient or presence of current surrogates.
Most times, the physician is dealing with a patient who demonstrates understandings and there is no discharge problem issue. Occasionally this discharge issue will arise. ..Maurice.
Unless your professional life is participating day after day as a clinician, nurse or ethicist within an active hospital, most people living and working outside of the hospital environment may not be aware of the great variety of patients and their, at some point in time or never, have some needed degree of understanding of their illness. That is why interrogation of the current symptoms and patient's expressed knowledge of and potential communication of their disorder in terms of remaining or leaving the hospital environment. Clearly, some patients, though "conscious" have impaired reasoning, power of expressing their clinical understanding of their illness. Again, the issue of patient, at some given time, impaired self-decision making is not that rare.
That is why, along with all the other clinical tests patient need for their diagnosis and treatment, the testing of "cognition" may be critical for the clinician to make discharge decisions about and for their patient. Any questions?? ..Maurice. p.s.- Patient's can still be
treated with dignity even when unconscious or unable to understand or express to others regarding their illness. ..Maurice.
Is that why some patients that request same gender care are told they need to see a shrink ? If you don't like a room full of gawkers you are told you shouldn't have come here ? It is no wonder that some people will leave at the first chance .
On a different note . I just read about another hospital that shut it's door . I believe they said that makes 140 . They gave a lot of excuses , but what is the real reason people put off going for care ?
Al
Unless the patient has some prior record of a mental impairment, it is arrogant and insulting to have to be examined in order for the patient to have autonomy. Because a patient does not agree with the hospital or doctor does not mean they are impaired or incapable of understanding. Shouldn't there also be an impartial party examining whether the medical community's insistence on treatment is truly beneficial to the patient or just another means to enrich the coffers? This attitude is very telling as it clearly implies that the medical community has superior rights and judgment abilities over patients deciding who and what happens to their bodies. It is this very attitude that makes some like me avoid medical care. I have the sole and final say of what happens to my body. I have seen up close and personal medical assault. It is not pretty. It is also a traumatic happening to have to live with. Just like our current (in)justice system, I believe the medical system that would make a decision to either force care or a stay in the hospital would be overwhelmingly bias. Another thing is if someone forces medical care upon me, I am not "their" patient as that in itself infers ownership but then we come back to the same point that many in the medical community believe they are superior to patients and they viewed as something to own.
JR you write "Unless the patient has some prior record of a mental impairment, it is arrogant and insulting to have to be examined in order for the patient to have autonomy"
For those who do not participate in hospital patient attention, care and ethics as part of their occupation you might be unaware that the vast majority of patients who end up hospitalized, routine or emergent, are readily discharged with no confusion or impairment of patient autonomy. That's the vast majority. However, amongst the admitted patients there will be patients who are already or become severely ill to the extent, if conscious, their extent of understanding of their current illness and prognosis is severely impaired at various time or continuously during their hospitalization.
Some have no family or surrogate readily available for the clinicians to communicate with. It is common practice for a physician who is attending or is fully aware of the clinical status of the patient to interview the conscious patient regarding the patient's own understanding of their current condition and the clinical needs to yet be accomplished prior to any discharge. The physician will attempt to inform the patient and verify by questioning and listening to be confident the patient understands. This latter examination of understanding is by having the patient repeat and express their view of what was told by the doctor. It is by this informing and listening to the patient's response to determine if the patient understood and further what other details of diagnosis, care and duration of hospitalization needs to be communicated. If there is an absence of a "understanding" response by the patient, family and surrogates needs to be participating if available. Patients who are unconscious obviously cannot be informed about their hospital course at that time.
The goal of the physician to feel assured that such a patient fully understands the need for any further procedures and continuing hospitalization.
There is usually no problem in arranging discharge within the vast majority of hospitalized patients. ..Maurice.
Dr. B.,
My concern is for the patient who wants to leave despite what the medical advice is. Yes, many never encounter any issues in discharge but some do who don't fit into what you describe. For example, after the medical assault of my husband, he wanted to leave asap. He was subtly threatened into staying by them saying if he left, he would be stuck with the bill. They also used blackmail saying if he would participate in after hospital care, they would release him early. The other point I will make that in his release they did not realize even with all their testing he was impaired as that is what versed/fentanyl did to him. That impairment lasted for weeks afterwards as it does with so many older patients. (His impairment was that he was disassociated from himself as if he was still watching from above like during the actual assaults. Also, he couldn't remember some things while others like the trauma was as clear as day.) This is a researched topic that many older patients have mental decline due to the hospitalization. Some recover. Some don't. Luckily, his fog cleared. He knew he was having issues. I knew he was having issues. However, despite their "they know best" attitude, they did not know. He told them whatever they needed to hear in order to leave and then told them to take a hike once he was home out of their clutches. Their questioning of his mental state was not very thorough. They did not ask him to repeat what they told him but rather marked it done while also marking areas they did not go into. But then again, they never informed him or me they were planning to do a procedure he had refused. So yes, in theory what you say does make sense but in the real medical world, it may not work that way. It depends on the hospital system and the medical personnel within that system. It also depends on the ultimate goal of the medical provider. In my husband's case, it was never about what was best for him. It was never about his right for autonomy over his body and decisions regarding his body. It was certainly never about allowing him or me to have knowledge of his medical condition. This is from where I am forming my opinions from as I too used to believe more like what you are saying.
You said that "There is usually no problem in arranging discharge within the vast majority of hospitalized patients" and that is because most people will take at face value what a medical provider tells them. Many do not realize how the system can/may work. Does an "absence of understanding" mean there is an issue if the patient does not agree with the medical provider's plan? I have known of cases where hospitals then go and get guardianship if there is disagreement even though the patient is competent and so is their surrogate.
Why does a hospital/medical provider have the right to retain a patient? Is hospitalization another word for prison? It does seem to operate much like that as patients seem to be required to give up their rights such as bodily dignity and autonomy as the warden (hospital/doctor/nurse) rules. Is this the way medicine should be delivered? And what happens to the patient they rule incompetent and hold for medical treatment? Once they are done with that person what happens? This article from TN is a prime example. https://apnews.com/article/tennessee-woman-died-hospital-police-b2ec8c106b5af77774f529e2e96e316e
I see what you are saying was meant to be a good thing but I think times have changed far too much for this to still be used. It needs changed.
This is why I have a very detailed durable medical power of attorney-advance directive as well as a letter from my psychologist stating what kind of treatment I am able and willing to except.
Once they read this they will probably want to discharge me regardless of my medical status
Jeff, you truly should be congratulated for your creation of an accessible advance directive including your psychologist's document. Such documents should be readily available to your physicians to be read and followed. ..Maurice.
The article JR gave a link to about the woman in TN who was discharged against her will and died as a result is more the issue than is hospitals keeping people against their will. I don't entirely blame hospitals for this in that they are just reacting to the insurance companies pressuring them to push people out earlier and earlier and Medicare/Medicaid, especially Medicaid, simply not paying enough to cover the costs. In the TN case I am guessing she was a Medicaid patient which puts her in the least desirable patient grouping.
At a personal level I have been shocked at how fast family & friends have been discharged following surgeries. Just to give one example, last year my son-in-law was discharged a couple hours after emergency surgery to remove a burst appendix. A few days later he was back in the hospital with a massive infection.
Here is an excellent current article on the conflict of premature hospital discharge between hospital staff and the patient:
https://health.usnews.com/health-care/patient-advice/articles/what-to-do-if-you-feel-the-hospital-is-discharging-you-too-soon
..Maurice.
Greetings Dr. B
I am still contemplating your latest discussion concerning the discharge of patients from hospitals. In general, if a patient is not a threat to others and presents as being lucid and rational, it is ultimately the patient's decision to leave a hospital. If a patient wants to disregard the medical advice given, then a waiver or immunity should be granted to the medical provider. Fighting to stay in the hospital/facility longer because a patient feels they have not sufficiently recovered is an interesting twist and the article from "usnews" had some good advice.
I had my urology appointment today and this time I didn't have to ask an female observer to leave during the DRE. The doctor discussed the possibility of a Cystoscopy in the future but for now he wants a scrotal ultrasound performed and an abdominal CT scan because of my testicular pain and past kidney surgery/stone removal procedures. The office staff called a local imaging center where I have had several scans performed over the last two years. To my annoyance, I was informed that they only had female technicians for the ultrasound. I agreed to the CT scan and went home to search for imaging centers with male personnel. It took 3 phone calls but I found a hospital imaging center with male technicians that is located about 50 miles away. It occurred to me that I do not have to patronize the local imaging center which makes no provision for male dignity. I scheduled both the CT scan and the ultrasound at the new facility and called the local center to cancel. I had to leave a message and asked for a call-back but very nicely told them exactly why I was canceling the CT scan. I also asked for a management contact because I intend to write a letter letting them know why I will no longer be using their facility for any future imaging needs and will instead drive 50 miles to a center that provides the respect I desire.
EM
EM
Good for you! The way that will make an impact is if enough men hit them with those kind of requests change will happen.
It is just sad to know that human compassion is not what will effect change
It will be the monetary losses
Jeff,
Sadly, just because you have a written very advanced Advanced Directive does not mean it will be used. It seems hospital systems seem to "misplace" directives so make sure it is in your file. Always have a copy with you like we do. We also put on a Medic Alert that he has one & also he has one some of his very important "I won't tolerate" like intimate care by female staff, versed, fentanyl, etc. along with where he will not go under any circumstances. It took 3 medallions for all his info. They will probably "misplace" this too. He has his info on his phone too. Every time he goes to the cardiologist, he must remind them to use Trauma Informed Consent protocol because they don't read the file beforehand. It is in there but they ignore it. All in all, Jeff, just be careful because you will come across those who don't believe you have the right to say how healthcare is delivered to you. They will do whatever they can to show you they are the boss and they will be the ones making decisions for you.
Biker,
Around here, the Medicaid patients I know of have better luck at staying at the hospital longer than patients on regular insurance. However, I do believe the personal biases of the medical staff lead to many issues such as believing those people are not entitled to care and more importantly good care. I have saw that as my sister is an alcoholic and they believe they had the right to treat her badly because she was a "drunk". She made more money than most of them, lived in a better house, and had private insurance but they treated her horribly to the point where I stepped in to protect her from them. That myth we are told so that we accept however they treat us is just not true. The myth is: they leave their personal opinions/biases at the door and do not see differences in people. They do and they treat people accordingly. I believe this is why male patients are often victims of sexual abuse because they have biases against male patients It is an unfounded hatred, a belief that male patients are sexual predators or exhibitionists, etc. I think that woman in TN was a victim of bias. So many medical providers think patients are beneath them especially ones who are poor or uneducated although they also seem to have a special type of dislike for those who are highly educated like my friend Tessa who is a doctor of animal medicine.
EM.... good for you. This is how things will change. You just lost them a couple thousands of dollars. A hundred miles round trip is definitely worth it. I used to drive 70 miles round trip just for work daily. 100 is worth my piece of mind. Goggle the area, i bet you csn find a nice place for lunch after. Definitely tell your docs office why you will not go to their recommended facility. Cat
Hello EM,
Congratulations on your effort to procure all male care. Since you'll be traveling a distance for this, you may wish to call the facility on the day of your appointment to be sure that the male tech is available. Nothing could be more frustrating than to arrive and be told that he's out sick but, Alice can take care of you. Keep us posted regarding your encounter. I wish you well.
Reginald
To pass the buck even more. Maybe it isn't the insurance companies who are the root of the problem but the law makes. There's all these different insurances. And in network and out of network Anything to pay more insurance companies and put more cost on the patients. Why couldn't there just be a routine bill paid like rent or electric. Set prices. Also find out who is being overpaid. Is anybody getting passive income? JF
JF, some States have passed laws that require hospitals to post their prices so that patients can know upfront what things will cost. The result were postings with thousands of line items breaking out every little component that gets billed; essentially making it impossible to determine what you might be billed. The hospitals then claim compliance and the politicians pat themselves on the back for a job well done.
And "another thing" in bettering the patient-doctor relationship... and that is for everyone, the entire medical system, to STOP CALLING PHYSICIANS THE TITLE "PROVIDER".
Here is the AMA article regarding this request:
https://www.ama-assn.org/practice-management/physician-health/health-system-says-calling-physicians-providers-not-ok
What do you think about this concern and request? If everyone removes this "cemented title" would the patient-doctor relationship improve? ..Maurice.
Do doctors not provide medical care so therefore aren't they medical providers? However, if you are referring to me using the term medical providers, I lump all into the term such as doctors, nurses, techs, MAs, etc. in order to save character count as well as time and energy on my part. Doctors do make those seeking medical care reduced to a insulting name of patient which infers someone seeking medical services. I don't seek how a doctor can be insulted by the term medical provider while at the same time using the term patient to describe someone seeking medical service. Doctors are in the business of selling medical advice and services while patients are seeking those services. If a doctor is so insecure that they are insulted by the term medical provider then will they also react (probably badly) when a "patient" dares to assert their autonomy? Also, most "patients" will not call their doctor Medical Provider Bernstein but rather Dr. Bernstein so I am not sure how you might think this would help.
Wouldn't it be more helpful if doctors along with all the others in the medical world start exploring how to respect each and every unique person that comes through their doors? This would do a great deal to repair the patient/doctor/medical person relationship. Bodily dignity would be an simple and easy start. Stop pretending that unnecessary exposure and you must allow to be naked with whatever medical person they select is normal and does nothing to harm the other all relationship and trust. Start realizing that patients are the captains of their medical team and make sure they have ALL the information and not just the information the medical community wants them to have. These are very basic and easy solutions to building trust and respect. If these are done, I imagine the overwhelming majority of people seeking medical care will, in turn, be more respectful and trusting.
Healthcare is a business and all in healthcare are service providers and while the people seeking services are the customers. Healthcare is all about generating profit which does show in the way they operate. In days of old (before wokeness--2008), it was the responsibility of the business to set the tone by showing respect, compassion, trustworthiness, etc. to the customer who in turn dealt respectfully, politely and remained usually a loyal customer.
JR et al, now we have 3 nurses in California who have PhD (not MD or DO) degrees who insist on being called "doctor" and presumably what that title means in medical attention and care.
Here is the story and one argument by a well-known PhD medical ethics writer:
https://www.medscape.com/viewarticle/994536
..Maurice.
Dr. B.,
I have been an opponent to this ever since I learned about it. Nurses are not medical doctors just as those who hold PhD in other fields are not medical doctors. It is especially dangerous for NPs or PAs to believe they are as well educated, trained, and able to do all that MDs do. I know stories of some who purposely mislead patients into thinking they are the same as a doctor. At the hospital from hell, even though my husband was supposed to be sick enough to be held in the hospital, he didn't see a real MD but rather PAs. A doctor signed their findings and also they listed the a new hospitalist each day that would lead many patients into believing the one coming into the room to do the exam was actually a MD. Many hospital workers wear their badge backwards to avoid being IDed. My husband remembers them saying they were there to do the daily check on him and other things that inferred they were MDs.
I am active on Twitter (X) with several MDs who oppose the use of NPs and PAs as doctors. I strongly support this. If they want to be MDs, they need to get the education and training as MDs. Hospital systems also use them in the ER as my son was seen by a NP years ago. The one nurse who assaulted my husband was at that time going to school to become a NP which may account for her decision to believe she had the right to medically assault him. My mother just saw a NP because the doctor was too busy but this practice is now part of a large insurance company that is buying up private practices. The NP made a huge error in prescribing her meds. It was something simple that I caught it when my mother went over her new meds with me. NPs can be dangerous and I believe they must be supervised and left to make important decisions on their own that they really are not qualified to make.
While NPs and PAs may have their place in the medical system, their place is not of a MD. I will continue to support those MDs who oppose using PAs and NPs as MDs just as I oppose big insurance being able to override a patient/doctor's decision on meds., etc. I am also coming to support Direct Primary Care doctors as I have interacted and researched with a few of them and I believe they are on to something better than the big box approach many hospitals have such as hospitalists, NPs, PAs, and other shortcuts they take in order to make more profit.
Dr. Bernstein,
Dr. Caplan misses the point and, I'm amazed that he gives no ethical reason for his argument. Everyone in academia who possesses a PhD is called "Doctor", even if it's a PhD in basket weaving. There's no salient reason why this should not apply to healthcare. The nurses have earned their degrees and, are entitled to this distinction. I suggest that the nurses will, and should, win their lawsuit. They may be required to wear a nametag stating Nurse Smith, PhD; but, when addressed, it would be correct to be called Dr. Smith. She may need to explain that she is not a physician; nevertheless, many in academia make the same explanation off campus. Why should healthcare be exempt?
Reginald
PS As we know, MD's and OD's are not the only ones called "Doctor" in CA, notwithstanding any law referenced by Dr. Caplan. How do you address your dentist, your veterinarian? Additionally, most PhD's do not posses a PhD (Doctor of Philosophy). Welcome to the wonderful world of incorrect nomenclature. Maybe we need a return to the Analects of Confucius and the rectification of names.
I admit to being uncomfortable using the term "provider" but am whereas "my doctor" flows naturally from my tongue, "my NP" or "my PA" doesn't. Similarly in person to person dialog calling my doctor "Dr. Such & Such" flows naturally whereas addressing someone as "NP Such & Such" or "PA Such & Such" just doesn't flow. At the same time calling the NP or PA by their 1st name seems disrespectful to me. Thus far I try to avoid addressing NP's & PA's with any name or title. I see an NP each year for my sleep apnea and have a PA as my primary care, so this is a real issue for me. I have also been tended to by PA's in the ER.
On the matter of nurses or other non-MD, non-DO healthcare staff, I find it very wrong for those with PhD's to refer to themselves as "doctor" when with patients. An academic PhD is not the same as a medical MD and using it with patients only serves to confuse the patient into thinking that they are MD's. They need to set aside their egos and drop the doctor stuff. Put it on your name tag and leave it at that. Hiding behind introducing yourself as "Dr. Such & Such, your NP" may be technically correct but all the patient is going to hear is "doctor" which is perhaps the intent of the NP in introducing themself that way.
Dr Bernstein,
I was surprised by the attitude expressed in the article concerning the labeling of physicians as medical providers. I don't consider the term to be disrespectful and my only real concern is when I am searching for care and a website says "Our providers ....". I don't know if I will be seeing a MD, PA, or nurse. For routine problems I don't mind PA's or nurses but if it something serious or I will be cut on, I want an MD.
I have always found it awkward on how to address PA's and nurses. I agree with Biker in that calling them by their first name seems disrespectful. I have tried to get in the habit of asking how someone wants to be addressed. In hospitals, they usually only list the first name of your medical team.
Reginald - Great advice on the pre-procedure call. I would be incensed if I drove 50 miles and they assigned a female sonographer when I was promised a male.
EM
To All,
I was re-reading 127 and wanted to comment on the "revenge" discussion. Not sure if it would be called revenge, but I really wish that I had pursued a complaint against my nurse abuser and the hospital. I wrote the hospital to complain and received a canned response. Since I still think about the episode to this day and how it affects my thoughts concerning future medical care, I wished I had caused enough trouble that my nurse might think twice about her behavior.
To all the contributors and people replying to my comments, I want to say "Thank You". I realize that I don't always acknowledge each response specifically but I appreciate the time people take to respond. I am sure I will miss some names, but thank you Alicia, Biker, Jeff, JR, JF, Reginald, Mitripopulos, NTT, and DR B.
EM
Thanks continued
Cat - Thank You
EM
From Alicia, writing me personally last evening:
Something bothering me lately is how during surgical procedures (such as gynecological procedures) operating room staff either completely remove the patient's gown or lift it to their neck, above the chest, while they prep and position the patient. Is there a reason why they either completely remove the gown or lift the gown above the patient's breasts during patient prep and positioning? Why can't they lift the gown to just below the patient's breasts? I think the majority of patients don't realize that they will be exposed in this way in the OR - they expect only their abdomen and maybe their genital area. It just seems like unnecessary exposure of the patient's chest to me. There also seems to be prolonged exposure of people's genitals (or entire body) during prep/positioning. What are the reasons for this? I find it surprising because I think most people, including medical staff, would prefer that their body is treated with more privacy and dignity while they're sedated. I'm upset as someone entering the medical field, but I'm trying to understand the other perspective/reasonings.
I have always taught my first and second year medical students that it was the best practice to maintain the patient's emotional and physical comfort to only expose the patent in a sequential pattern dealing only with the portion of the body which is being examined an needed exposure from clothing. ..Maurice.
Alicia, I think the majority of people who work in healthcare simply don't think patient privacy & dignity matters when the patient is unaware. That they are personally comfortable viewing intimately exposed patients is all that matters to them.
You can be the exception to the rule and maybe others will observe what you do and follow your example.
Alicia... patients ARE LIED too. Look at Quora. They ALL say exposure is limited and ONLY the surgical site is exposed. What have you noticed as prolonged exposure? They tell us its immediate covering of parts not being operated on. How can that be when the dry time is a minimum of 3 minutes? When a patient gets a foley what are the other staff members doing? The genitals are the last to be prepped and since they need to be prior to insertion what is that person doing while waiting? YOU are the person we need for this change. Your honesty is refreshing. Have you asked about why cant patients have the covr undergarmets? Can you write to the JC on your observations and ask for new protocols and policy changes? Im sure people will help you write it. Misty. Jane and Cindy are good starting points. Even help with getting family member advocates into the OR up until the incision)and back with the patient as soon as the incisions are getting closed. Someone told me they had a bruise on their face ( they bruise easily) from them slapping her trying to arouse her after sedation. Thats assault. Cat
I've seen that Cat. I have had the same thoughts and feelings as you after reading them, or, maybe I hope it is different at other hospitals. I think the more common occurrence is unnecessary and prolonged exposure. They also teach us early in medical school to be cognizant of exposure, but that doesn't carry through to clinical rotations later in medical school, especially in situations where patients are sedated. It is so backwards.
You also wonder why it isn't more standard to offer disposable surgical undergarments like they do at some plastic surgery/medical aesthetic clinics. And during C sections I've seen photos of women wearing bras - so why women can't wear bras for a laparoscopic hysterectomy is beyond me.
I've personally seen an anesthetist slap a patient a few times in the face to wake them up - not a true slap but it wasn't a tap on the cheek either. It weirded me out a ton in the moment and afterwards. It was my first time ever in the OR and I didn't know what to make of it. I was surprised.
And I agree with you Biker. A lot of people in this world seem to lack this ability to put themselves in the patient's shoes and understand how uncomfortable and possibly traumatic/violating some situations in healthcare are. They also seem to have trouble imagining that they could and will be a patient one day.
As a woman a major underlying cause of my concern around privacy/dignity being respected, especially while being sedated, is because female bodies are so sexualized and because there are many creeps and harmful, perverted people in this world (even in healthcare). Do you think that medical students/residents/doctors are truly able to 'turn off' their feelings of arousal/sexual lens in the clinical context, specifically male trainees/doctors?
Alicia, your exact comments are very true in reverse. Male bodies are also sexualized and there are many female predators working in healthcare. I know this from personal experience. Too many female medical personnel from across the spectrum cannot resist the desire to analyze and judge their male patients. They cannot "turn off" their sexual interests when the opportunity exists to exploit their privileged position with vulnerable male patients. The problem exists both ways.
58flyer
58flyer, remind me of the details of your current or previous work on airplane flights.
Was it on an multi-passenger airline or a private flight. If multi-passenger commercial were you ever involved in management of an ill passenger? If so, how much protection for privacy was provided for male or female passenger-now new patient? Or if this total question is or was not pertinent to your work or observations, what do you know are the aspects of passenger physical privacy if the individual becomes very sick on the flight? ..Maurice.
Hello,
The following is an interesting, current article on patient dignity.
Reginald
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8935547/
Reginald,
You must be a soothsayer!
Image my surprise yesterday morning when I received a call from the imaging center where my scrotal ultrasound is scheduled. The woman who called me said she was finalizing the imaging schedules for next week and noticed my request for a male sonographer. She stated that they have never employed a male sonographer at that location. I said that I was confused because I made the appointment only after being told a male sonographer was available. I indicated that I was willing to drive 50 miles specifically to patronize an imaging center that respected male modesty and dignity. I must be a really, really special man because according to her, I am the only man who has ever made such a request. She then said that they could arrange for a male chaperone to be in the room. I explained that a male chaperone didn’t address the issue and would only make things worse. I canceled my CT scan and the scrotal ultrasound and asked for a corporate contact number.
I was extremely upset and when a woman answered the phone I explained what happened and went into a bit of rant about sexual discrimination against men, etc. A bad move on my part as the scheduler did not make the policy and it only succeeded in invoking a defensive response along the lines of “Well, I could describe a litany of things that are unfair to women.” She did offer to call all their imaging centers and asked what area of the state she should focus on. I told her I was willing to drive anywhere in the state. I was put on hold for about 15 minutes and had calmed down considerably and decided that “honey” was a much better approach than “vinegar” in order to achieve my goal. When she came back online she said that she had not found any centers that had male personnel. I must have sounded pretty dejected because she said, “Don’t give up. I have a few more to call” and placed me back on hold.
After a few minutes she came back online and said “Success”. She found an imaging center where a male sonographer was employed part time. In order to coordinate both scans on the same day, I will have to wait until the end of the month. The new imaging center is now 100 miles from my home. I thanked her enthusiastically and mentioned that it was very important to me because of previous abuse by female nurse. I communicated that I actually prefer female caregivers for everything except intimate procedures. She suddenly was extremely empathetic and the call ended well.
I am in a bit of a quandary now and will have to decide if my principles are worth the effort to travel outside my immediate geographic area. My plan was to boycott the three close-by image centers who didn’t offer male personnel for the ultrasound and write and tell them why they lost my business. Perhaps the scrotal ultrasound was not the proper fight because it has minimal exposure with one technician compared to many other procedures that involve multiple people and extensive exposure. Still, it really aggravates me that I don’t have the choice of staff to start with. I may write the remaining imaging centers and express my disappointment and encourage them to hire male staff rather than a boycott. I had not written yet and had only talked to one of the centers. I got a call back from a male administrator who sounded somewhat sympathetic to my plight but the center has no plans to change anything. He also suggested that a male chaperone could be provided. These people just don’t understand! I think I will stick to my guns if I have to have kidney stone surgery or any in-office BPH treatments.
I am feeling very discouraged and don’t really think things for men are going to change any time soon. I have been trying to put into words my theory as to why men are our own worst enemies and will not have the success that women have had in securing same-sex intimate care. When I get it drafted, I plan to share it and get feedback from the forum.
EM
Reginald
One thing that got my attention in that article is the author even acknowledges they are guilty of leaving patients exposed because that is the general mentality of medical personnel in that situation
They have learned to eliminate the personhood of the people they are treating and convert that person into an object and are proceeding with a series of actions
This is all conditioning that is ingrained into each new generation of medical professionals by the people that are training them regardless of what they learn in the classroom. and it continues to perpetuate itself because there is no force in place to break the cycle
Any morally upright individual that would see a person lying naked on a table would look for the first thing available to cover that person as much as possible. But after enough time in that environment and seeing the cavalier attitude, that everyone around you has desensitization kicks in and you no longer care.
What that is but never acknowledged is a part of that person that makes
Them a decent and compassionate human being has been lost
The proof of that is bring someone into the room that is not used to that and watch their response when they see a naked person lying in front of them
Medical people can’t afford to have those kind of sensitivities to naked people but they need to be aware that the horrified look they witnessed on the outsiders face can be intensified 10 fold by the patient that is lying there naked and depending on the patient’s level of consciousness you could be doing lasting psychological damage (believe me I know)
Come on folks how long does it take to toss a towel over someone’s genitals?
It’s the bear minimum of human dignity
But rarely exercised
Very interesting article Reginald. Count me in the group of people that had no idea patients are naked on the table during code blues. Then again, if they aren't overly concerned with patient dignity when the patient is breathing, it shouldn't come as a surprise that they aren't concerned when the patient isn't.
Alicia and 58flyer,
I can understand both your points concerning predatory behavior of some individuals in healthcare. I believe there are two primary motivators of abusive behavior. One is more a sexual gratification and the other tends to be one of ridicule/humiliation. While both are present in males and females, I would argue that the percentages are generally opposite between the sexes. Based on what has been reported in this forum and on the news, I think men are more inclined to pursue these behaviors for sexual gratification and to a lesser extent, the ridicule/humiliation of victims. On the other hand, I believe women are much more likely to engage in ridicule/humiliation behaviors verses sexual gratification. Of course our impressions are colored by our personal experiences. For me, I do not worry for one moment that I am being exposed by women for sexual satisfaction purposes but rather for the ridicule/humiliation effect.
EM
EM, drive the 100 miles where there is a male tech and get it done. Afterwards write a polite letter to the more local ones and tell them why you drove so far; asking that they please consider having some male staff going forward. They likely won't care but sometimes planting a seed eventually bears fruit. Also, we always need to remember that the person we are dealing with is rarely ever the person who made the hiring and policy decisions. Putting them on the defensive does not aid in making them an ally.
I drive 1.5 hours each way for all of my scheduled care. When having an ultrasound of my foot a few years back, I was assigned a male tech. I commented that it was good to know that that hospital had a male sonographer should I ever need another testicular ultrasound. He said he was hired for the comfort of male patients that also wanted male staff for that. Some hospitals do get it. It is just a matter of finding it and then choosing to make the drive. Urology there also has a male RN that does my cystoscopy prep.
The ridiculing/humiliating of a patient can be sexually gratifying to the predator as sexual gratification doesn't always involve what we perceive as physical sexual actions. For the alleged Idaho killer, they believe he got sexual gratification from each stab he made. It is also said that "power/control" is a sexual aphrodisiac but EM you are correct in how sexual gratification is generally achieved by the different gendered sexual predators. Jeff, I do disagree as I believe that most medical people do have sensitivities to naked people but it is whether they act on it or not. Medical people have sex lives. They are attracted to people just the same as we are. We know they notice genitals of patients bc we have read and heard of many stories of how they act. If there is no need for genital exposure they would not be doing it so regularly except it does give them the thrill of having power/control over people they normally do not have in real life. Even if the myth is they view patients as objects is true, I consider whatever object I have whether or not it should be exposed to sunlight, what I can use to wash it, what areas are delicate, etc. Even if 2 objects appear to be identical, I assess them to find the differences or whatever. I don't believe they really view all as objects without genitals to stare at or make comments about.
If you have a gay or trans medical provider who may be what you consider same sex, you could still have them have a sexual attraction to you so this is why I say there should be no unnecessary exposure and why patients need an advocate of their choosing to be present at all times. The patient should also have the right to video what happens. The medical community should have the right to video as it is a violation of the patient's privacy and we have no clue how that will be stored or who will view it. We need transparency in medical care.
Jeff and EM, I agree that the physical sexual abuse of patient lasts a lifetime. It is not something that goes away as those who have suffered such abuse can testify to. If the medical community truly wanted to improve patient relations and really medical care, they would be willing to talk about and make corrections to the physical sexual abuse of patients. However, we see they don't really care about healthcare is delivered just merely the fact they can deliver it whether it is harmful or not.
JR
Very well said
Hello EM,
In your case, I wish I was wrong about the "bait and switch". Biker has a point about driving the extra distance to get the medical help that you need. Maybe you can find some other, more recreational, activity that day in the area after the procedure. Again, unfortunately, I would recommend calling the day of your appointment to be certain the the male tech is available.
For others (and you, EM, of course), what impressed me regarding the code blue article was the reluctance of the author to cover the patient. He wanted to cover but, why did he not do this? Was he concerned about the responses from the other 5 personnel present? What might he have expected these responses to be? Would they view him as some oddity? The author was obviously conflicted; nevertheless, he restrained his inclinations. There are probably many reasons that someone doesn't act. The action might be contrary to her/his value system. The individual is confused and doesn't know what to do. The person knows what to do but, is incompetent to perform the action. Peer pressure restrains the individual form acting as she/he wishes. I'm sure that there are many more reasons that I'm missed.
As advocates for patient dignity/modesty it would seem important for us to understand what were the factors inhibiting Dr. Dolbow from covering the patient. He is interviewed by Matt Deaton (a fellow author of the article) at https://www.google.com/search?client=avast-a-1&q=james+dolbow+od&oq=james+dolbow+od+&aqs=avast..69i57.7152j0j4&ie=UTF-8#fpstate=ive&vld=cid:d983dc0b,vid:PfNGtW170GA,st:0
Unfortunately, this interview doesn't answer the question of why Dr. Dolbow hesitated.
JR, would you consider interviewing Dr. Dolbow and/or Matt Deaton in this regard? I couldn't find a contact address for Dr. Dolbow; but, Matt Deaton can be messaged at https://mattdeaton.com/index.html
JR, you might invite either or both to be interviewed by you on your blog. We really need to determine what factors restrain health care personnel from just "throwing a towel over the person's genitals." Answering this question might be a step in changing protocols. I hope you have the time to explore their motives.
Take care.
Reginald
Reginald,
Talked with Cindy and we will try to get one or the other on the show. At the very least, we will talk about the article. If we can't get either of them on, would you like to be on the podcast?
Reginald,
I talked to Cindy and she extended an invitation for them to join us on a podcast. We'll see if he responds. We are always interested in trying to get information out and to try to get changes made. Our next guest for at least 2 podcasts will be a man who experienced the "deer in the headlights" ambush at a scrotal exam. I think he is going to try to go to some nursing/tech schools to see if they would allow him to speak to students about how the unnecessary exposure has adversely affected his life.
JR and Cindy,
Would it be possible for you to provide information (links, url) pertaining to your podcasts again? Thanks
EM
Hello,
Many posters have stated the long-lasting effects of their perceived dignity violations. Someone is finally studying this situation with children and, its life-long implications. Maybe healthcare personnel will realize that any medical procedure can provoke detrimental emotional and psychological consequences. I think that this study (see below) should finally "put to bed" the idea that adults requesting dignity/modesty accommodation are just "outliers". Please see:
https://www.statnews.com/2023/09/11/vguc-children-test-uti-stress/?utm_campaign=morning_rounds&utm_medium=email&_hsmi=273662843&_hsenc=p2ANqtz-_cNfqKa49hJopoQGq1S6sKyj29OOuRG25wZKPSpKpSOmlXrLLCDyxyVRF_ZgWsuNsrAWDgQsjNMrgytKoAVdq0vWbcjQ&utm_content=273662842&utm_source=hs_email
JR, thanks for making an attempt to interview Dolbow and/or Deaton. I hope you're successful. I doubt that I'd be a useful candidate for your podcast. Fortunately, utilizing the SPEAK UP mantra of Dr. Bernstein's blog, I've been able to obtain dignity accommodations. Thankfully, I haven't had some of the very negative encounters of fellow posters. Nevertheless, at every opportunity, I advocate for dignity/modesty in the medical setting. Keep up the good work.
Take care.
Reginald
I came across that article yesterday myself and all kinds of bells and whistles went off.
I suffered dissociative amnesia when I was ambushed by a teenage girl and my pre op nurse for genital shaving and thought that I had never experienced anything like that before. Now I question that based on the childhood I lived.
I never had VCUG done to me but I did suffer some pretty severe ACE’s as a child including sexual assault when I was in 2nd grade on more than one occasion.I remember the beginning of the encounters but not the end? Now that I look back it followed the same path as my hospital experience.
I think everyone that gets stripped naked by medical personnel feels at least some discomfort but there are those of us when put in that position suffer catastrophic emotional damages and may never know exactly why if dissociative amnesia is blocking memories from earlier in your life.
I never had any thoughts or fears of what they do to people in a medical setting throughout my adult life until that incident and everything must have come rushing back at me but the crazy thing is I still have no memory of anything except the very beginning of the incident.
THE BODY KEEPS SCORE
Very interesting article Reginald. I had never heard of the VCUG procedure before, let alone how common it is. It seems that many people who struggle with healthcare privacy and dignity matters can trace back their feelings to childhood trauma. I know I can.
Hello Jeff,
I believe that, whether we remember it or not, THE MIND ALSO KEEPS SCORE.
Take care.
Reginald
Hello Biker,
What's really interesting in the VCUG article is that healthcare is still hesitant to accept that some medical protocols can cause unexpected collateral emotional or psychological damage.("When asked about research on the psychosocial effects of VCUGs, both the American Academy of Pediatrics and the American Urological Association declined to comment.") Isn't this what many of our posters have been saying for a long, long time? Those in healthcare need to begin to listen to patients' traumatic experiences and to change protocols when it becomes apparent that these protocols may cause lasting damage. A telling statement in the article is "“I am more interested in knowing whether these patients refuse to get care in the future. If they’d rather risk having cancer than screen themselves, because of the trauma.” " Isn't this what we've heard expressed by some on this blog? Hopefully, Ms Smith's support group will bring some attention to the unexpected harms of some medical procedures.
Take care.
Reginald
Has anyone here ever been a patient in a medical school hospital and was interviewed and examined by a first or second year medical student? What was your experience and how did the student behave as compared with your clinical and personal interactions with physicians and nurses? ..Maurice.
Dr. B
I have had major surgery done on more than one occasion at a extremely large teaching hospital in my area . Every time I have been there and in recovery I have had students brought in to either observe or attempt to practice on me. I have already told the story of the two young nursing students that were brought in without permission to watch my catheter be removed and when I asked for them to leave it created an awkward situation for everyone involved and I didn’t feel that I or any other patient should be put in that kind of a situation. After my aortic valve replacement (anyone that’s never had that done there is nothing pleasant about that whole experience) I had just had the drainage tubes removed from my chest and was in a lot of discomfort and couldn’t move without intense sternal pain from the incision. A very young student came into my room and asked if they could perform a head to toe physical on me? I asked why and was told that it was needed to meet their training requirements and when I declined I had to decline several more times before they gave up and left me feeling like the bad guy.
I understand that it is critical for them to get the experience they need but to come into my room after what I had been through emotionally and physically and ask if they could take my body for a test drive was a little bit much.
They should interview patients prior to any procedure in a teaching hospital to ascertain and seek permission from patients that are willing to receive and offer their bodies as a teaching tool
There is verbiage in the consent forms but they pertain to the surgery procedure
They seem to think that if you were willing to be stripped naked in front of a group of strangers for a life or death procedure that you should be fine with them using your body for the students benefit.
I know there is all kinds of sound rationale for why they do this and there may be many patients out there that are more than willing to accommodate . I personally don’t change gears in the modesty department just because of a change in my location but they make that leap for you all the time
Which keeps a modest patient in a constant state of hypervigilance in an already unfortunate situation
EM,
The best link is on Spreaker. Look for Patient Partners. https://www.spreaker.com/show/cindy-schwarzs-podcast
Reginald,
Both men turned us down but we will still be addressing the article. Keep on looking and sharing these articles as they are great to talk about. Thanks
Hello,
I found another "interesting" article from 10 years ago. You can view the cover by checking the June 2013 Outpatient Surgery issue. The questions that were broached were important; nevertheless, I don't think that any changes have occurred in 10 years.
https://www.aorn.org/outpatient-surgery/article/2013-July-editors-page-another-photo-bomb
Take care.
Reginald
Hello again,
For those of you who'd like to see the cover referenced in my 15 Sep 5:34 post, the URL is below.
https://i.pinimg.com/originals/7c/9a/cd/7c9acd5da2974dfb8a25a4b5638c1b23.jpg
Take care.
Reginald
I suggest everyone read the response to the cover that Reginald posted. It is refreshingly honest, and a quick read. Here it is again:
https://www.aorn.org/outpatient-surgery/article/2013-July-editors-page-another-photo-bomb
After all these years nothing has changed except for possibly many more meetings in the conference rooms on how to keep what happens in the OR hidden from the patient.
My pre op prep for aortic valve replacement was the most well orchestrated deception imaginable
Why don’t they spend as much effort on preservation of a patient’s dignity as they do hiding the humiliation that they are going to subject you to
They are constantly adjusting their protocols to be more and more secretive because the Internet keeps busting them out and exposing them
I wouldn’t doubt that all their hours of deceptive plotting doesn’t somehow show up on our bill.
Its a good thing that they did not take a picture sometime in the preceding 10 minutes.
EM
I just think the patient should be asked if the picture could be displayed. It's not such a bad picture. Her genitalia isn't being displayed and her face isn't in the picture.Just clear it with her first JF.
I hate the nurses who post on that Allnurses page. Each and everyone are the unethical ones we speak of. Did anyone read the comment from the one that stated she is the one that would need to place the Foley under the drapes if necessary and how SHE would rather avoid the UNDIGNIFIED position of her butt hanging out.. so its ok to strip patients naked have strangers watch someone put in a Foley, but not your covered butt peaking out from under drapes. Several have also said you cant keep underwear on because the solution stains and would ruin a pair of underwear. THANK GOD, they protect me from having to buy another $5 pair. I would much rather be splayed out naked then have to worry about my underwear getting stained. They tell the patients you can keep your underwear on then just pull them down after you are asleep anyway. Not only is that a unethical, uninformed lie, but thats dignifying to a patient having someone pull down your pants how? Cat
Hello JF,
I'm sure that the woman in the picture gave permission. I would guess that she was someone working for the publication and, that she volunteered. You're right that little of her private area was shown. What's telling is that some of the nurses objected to the pictures although (as one commenter mentioned) "real" patients are much more exposed. Why would nurses object to a display of what (almost) really happens? As others here have commented, if there's no problem, why hide the true situation? Might one answer be that if the truth was known, an outcry would ensue and, protocols might need to be changed. Again, contrary to the patient-first mantra of healthcare, does protocol take precedence over the patient?
Take care.
Reginald
Cat
I did read that comment by that nurse and was blown away by the tone deafness of what she was saying. If she thinks that her dignity is being violated she should have to pull her pants down to her ankles while she climbs under the drapes and then maybe she would come close to the amount of indignities that patient is having to endure. She as well as others like her are exactly the type of nurses that I want to avoid at all costs. There is no way a patient can identify the bad ones in the bunch even the hospitals acknowledge (amongst themselves)that they employ voyeurs, sexual predators, sadist and some just devoid of any empathy but don’t know who they are, where they are, or how many . But we are told to trust them they are only there for our benefit when they know better by looking back at their own track record and the amount of violations that almost all of those institutions have had to cover up in the past. The story’s that make the news are just the tip of the iceberg
Reginald
Yes protocol trumps patient every time
Biker,
This is the part I found most offensive from the follow up article: "Three men positioning a women in a compromising position — no woman wants to imagine that prior to having surgery," writes Stephanie Deeb RN, recovery room manager at the Pediatric Surgery Center in Odessa, Fla., in an e-mail. I would be willing to bet this nurse would have no comment if this was a male patient with 3 women positioning him. It is ridiculous how sexist medical care is.
I also know of a woman on X (Twitter) who was permanently injured by having one of those vaginal clips (positioner)as she has lost sexual feeling. This was risk she was not advised of happening with back surgery.
If I remember correctly, Misty found this article a number of years ago and made official complaints to the magazine but I think that although this article is from 10 years ago, we know this is still for most hospital systems how they deal with patient dignity. I would say their definition is what they believe they can do to a patient under the guise of saying they respect patient dignity. However, we do know much of the genital exposure does not need to happen and that same gender care should be offered. We also know that patients should be informed of potential genital exposure and the medical staff should be transparent in how they deal with it. If there is nothing wrong in how the medical system handles genital exposure/intimate care, then why do they purposely hide it by not talking openly about their protocols and by using drugs to erase a patient's memory of what they have endured.
JR
Many years ago I was proscribed Valium.
I don’t remember why but I remember the effects which were mild but had a calming effect but left me fully aware of my surroundings.that is what they would have you believe you are receiving
I have heard many people request drugs like Versed that are aware of it’s effects because they don’t want to know or remember. In most cases no options are given and in my case I was told they were giving me something to help me relax. That’s where this whole thing goes sideways!
When you are given a drug that takes away everything that makes you who you are ,a full explanation should be given but rarely is if ever. This is the beginning of ethical lines being crossed and in many cases many more lines will be crossed but at this point you won’t be a participant of any of it by design
The fact that these kind of drugs are administered to people is not the problem it’s the deception that is employed that I feel is criminal and it’s being done to someone right now as I write this and continues to happen every hour of every day where someone is having a segment of their life removed from them without their knowledge or consent.
I ruminate about these things way too much and need to brake free of the constant ruminations for my own benefit
But what I pray for is the ability to forgive the people that inflicted so much pain and suffering in my life and never looked back at the wake of destruction they left in their path.
Hatred is like a cancer and it’ll eat you alive
Jeff, as you wrote:
"But what I pray for is the ability to forgive the people that inflicted so much pain and suffering in my life and never looked back at the wake of destruction they left in their path." And those people are also humans and they are, like you, looking back in their own lives as how they were treated by others. It happens to everyone unless they have amnesia. ..Maurice.
Adolf Hitler was a person also and so were his largest number of people who told themselves they were just doing their job. We wrestle not against flesh and blood. Even so we're accountable. JF
I really doubt the ones who abuse patients actually look back and have any regret. Even if a patient did not treat them exactly as they expect, aren't they supposed to be professional enough not to allow their personal feelings to encroach into their job duties. I don't really care what their personal issues are as those should not have anything to do with how they handle their job duties. Remember "they are professionals" and "have seen it all before" and "we don't have anything special" so why should we give passes for their personal feelings as they said they don't have any.
However, we know this is not true. We know they allow their personal issues into their "professional" area. Some of this blog like Jeff and my husband have suffered harm from nurses acting out on their personal feelings. Some believe they are so superior to patients that the harm they inflict is acceptable. Reflection is impossible for those who cannot admit they are at fault. They deflect by blaming patients or whatever they can because they will not admit they are in the wrong.
Jeff, As for hate being a cancer, since I never loved them I don't hate them but I do totally despise what they are. I wish for them nothing but the worse in life and in any form of afterlife but other than that, I have no interest in them. I believe in Karma and that it does have a way of delivering bouquets. I have known of it several times over the years.
. I've talked about my sister here before. In Arkansas awhile back she was told she had Stage 4 Cancer and that she was gonna die in approximately a year. No if ands or buts about it She says it was 3 years ago. I re entered her life a year and a half ago so for sure it's been that long. Then she came back to Florida in May of 2022. When she went to a doctor here she was told she didn't have Cancer and her health vastly improved and her hair grew back. She is still raising her kids aged 7 and 9. But in recent months her symptoms came back and she's been diagnosed with Cancer again. These Florida doctors said they can't make any promises but they're really going to try to save her.
Just so I don't get off of our dignity issues I need to mention she told us of having to completely undress from the waist down for radiation and multiple people observing including two males. JF
JF
I’m sorry to here about your sister my prayers go out to her. Was there any indication why she had to be naked from the waist down?
I’m getting ready to go see my cardiologist and I will be giving her my letter that was provided by my psychologist explaining my need for trauma informed care. It will be interesting to see how well it will be received? I really like her and I have no concerns about her being a woman because the only exposure that is required is my chest.
Each day that goes by my hernia gets progressively worse and I’m trapped by their insistence of performing gender neutral care and my inability to submit to that kind of humiliation. I’m going to discuss with her why my request is such an impossibility. Before all this is over I will probably be barred from receiving treatment at this hospital not because of my appointment today but because I will not back down from my demands that in their opinion are unreasonable requests from someone with a mental disorder and that’s exactly how they see it
Jeff
My sister started out with cervical cancer so I guess it's just called by where it was first discovered. Right now it is in her spine. I don't know why she had to undress but I think sometimes medical workers have just normalized it. Some of the people posting here have talked about certain of the problem staff gravitating towards medical work for wrong reasons. It's not hard for me to believe that. JF
JF
I am so sorry to hear about your sister and her battle with cancer.
Jeff,
Try to hang in there with your fight for male personnel for your procedures. I can really empathize with your struggle. I had my abdominal scan today and am afraid it is a return of kidney stones. It was 9 years ago when I had my first taste of abuse and unnecessary exposure when being treated for kidney stones. If it requires treatment, no doubt I will be sharing my attempts at getting male personnel for the procedure.
EM
To All,
I finally had my Scrotal ultrasound and Abdominal CT performed at an imaging center associated with a large hospital organization. I drove 2 hours specifically because the center had a male sonographer available for male intimate procedures.
I am dissatisfied and discouraged with how the procedure was conducted. I don’t know if what I experienced was simply a case of typical hospital nonchalant attitudes towards nudity or what.
The male sonographer called me back and led me to an exam room that was very brightly lit. He had me lie down on the table and pull my shorts and underwear to my knees. He then placed a folded towel over my penis and another folded towel under my scrotum. He conducted a very short scan and when it was over had me use one of the towels to wipe off the gel and pull up my underwear and shorts. I had specifically asked him to provide the measurement of my testicles because I am concerned about the effects of atrophy due to hormone replacement therapy. He didn’t provide the measurements and when I asked he said “Uh, the information isn’t on the screen now, but the measurements weren’t too far off normal”. I wonder if the same process would be followed if the sonographer was female or if a patient would be provided a drape and privacy while he undressed.
I did ask the male sonographer if he ever does intimate exams on women. He replied that he had done some in the past but the center no longer schedules those exams with him because the center had received complaints from female patients who objected to a male sonographer. This is an example of women finding their voice and getting things changed while men meekly accept the status quo. He also stated, with annoyance in his voice, that if he had a female patient, he was required to have a chaperone while the female sonographers have no such constraint with male patients.
This scan was radically different compared to what I experienced in 2010 during my first Scrotal ultrasound at an unaffiliated image center in Washington, DC. I did have a female sonographer, but she conducted the scan in a manner that was consistent with what this forum would consider text-book appropriate.
She gave me the two towels and a drape. She explained how to position the folded towels and to cover myself with the drape. She left the room and knocked before entering. She then lowered the lights and removed the drape. She conducted a lengthy scan, included scans while I was standing. She covered me with the drape and left the room so I could clean up and dress. It was still awkward with a female sonographer but I would have felt pretty good about the procedure except that when I exited the room, the sonographer and receptionist were giggling and laughing. It could have been a coincidence, but I have often wondered if I was the subject of the joke.
I will be writing the center to thank them for having a male sonographer on staff but intend to question the manner in which the exam was conducted. I am also still planning on writing the imaging centers near me to encourage them to make a male sonographer available for their male clients who desire a same sex provider for intimate care.
EM
EM...could it be the male tech didnt think you needed as much privacy since you specifically drove 2 hours to see him? After all you do have the same plumming? I wouldn't be as shy if it was a female doing an ultrasound on me. We do change in the same locker rooms. If it was a male tech id expect the same privacy as the female tech gave you. The problem is we dont know who we are getting until its too late. You now have 2 different experiences. Kudos to the female tech for being the kind we all want. The next one you need ask the tech how the scan will go before you get undressed. If she describes it in a way that makes you uncomfortable tell her of your other experience and this is how youd like to proceed. A professional would agree a staff member is their way or nothing. You have your voice, you speak up for yourself. I think one of the most important parts of us getting the changes we need is to THANK the ones who act appropriately towards us and TELL them why. Tell the others that you will be writing a letter to their bosses and telling of their inappropriate behavior and give examples of the ways you were treated with dignity from others. The ones you thank will keep that in mind for the next person. Cat
EM, writing a letter thanking the imaging center for having a male sonographer is a good idea but I'd think twice about inserting what is essentially a complaint. I say this because most imaging depts seem to only want to hire female staff so as to make their scheduling easier (not risking only having a male available for a female patient) and I wouldn't want to give them a reason to get rid of the only male that they do have.
Hello EM,
Biker and Cat have good points. Write a complimentary letter re the male tech and encouraging other clinics to do the same, without any negative comments. At your next appt with the male sonographer (or any other health care person) express your desire for draping, etc. Let the person know your "requirements" before or during the procedure. This accomplishes both your desire for a male and your "training" of that person regarding your needs. It's a win-win. Congratulations on achieving your desire for a male tech.
Take care.
Reginald
Check out our new article, Medical Sexual Abuse at https://sexualmisconductbydoctors.com/medicalsexualabuse.aspx.
Misty
I don't know why what Twana Sparks did would ever ever be considered genital exams. It wasn't. And how is it that her hand wasn't crushed with a wooden paddle? When there's no accountability ANYTHING can happen. JF
Biker, Cat, and Reginald,
Thanks for the comments and advice. I will send only a positive letter to the center that employed the male tech.
I do plan to write several imaging centers near my home that I have previously used to explain why they lost the opportunity to conduct two scans as well as any future scans I might need.
Cat, the sonographer most likely would not have known that I chose to have my scans at his facility because a male sonographer was available. However, I think it is possible that he looked at his schedule and saw a male patient was next. Based on that information, he selected the level of draping that was appropriate. My original thought process was to question whether there was a difference in protocol between a hospital based center versus the independent imaging center that I went to in Washington, DC. My theory was that a hospital facility would be more casual about nudity than an independent facility.
I guess I will never know unless I repeat the test with a female sonographer at the same facility.
Reginald, I agree that it is better to ask questions prior to procedures rather than being upset after the procedure.
I only hope that the most recent ultrasound was sufficient to diagnose any problems. The recent test took less than 10 minutes while my first scrotal ultrasound took more than 30 minutes.
EM
EM. The length of the test could be the pictures taken and the test ordered. The male knew exactly where to go, what to look for. The female could have been looking everywhere. If this was the undraped/unprofessional one she could have "gotten her jollies" out of having you exposed. Cat
I just read on Quora about a guy talking with his female doctor about mens privacy and she said she "didn't think it mattered" to men as much as women. That got my response of well. Women are the ones that wear microbikinis, flash their boobs at parades,trains whereever, work at stripclubs. Men wear long swimtrunks ( exception is speedos that are not common). Women post tiktok videos "accidentally" exposing themselves. When was the last time this doctors father, brother, uncle,husband flashed others? So unless the guy is a pervert or molester of some kind. Guys junk stays in women expose themselves. So whose fighting for privacy here? Who doesn't it matter to? Cat
EM
I know you said that you traveled 2 hours to receive a male sonographer but I can’t figure out if you traveled 2 hours to Washington DC or away from? I am in the northern Virginia area and a person on a different site also from northern Virginia couldn’t find any locally but was able to find a place in Washington DC. The distance from DC to Northern Virginia is only about 20 to 30 miles
I’m trying to figure out where did you find your preferred treatment?
Thanks Jeff
JF
What Dr Sparks did was not only appalling for what she did but in reading about it the most shocking thing to me was the fact that she had been doing these types of sexual violations for 10 years and received the laughter of the female nurses in the OR when they should have been reporting her!!!
This is what gives patients pause when entering a hospital and allowing themselves to be placed in a position of total vulnerability . The chances of you encountering, a total wacko like her are very low but the response of the support team is just as appalling . Any medical professional that may never consider performing such an act but responds with laughter only supports such behavior.
It causes patients to believe that no one in the medical profession has got your back and reinforces the adage what happens in the OR stays in the OR.
It is immoral and disgusting
I have a question. As everyone knows, I advocate more for not having unnecessary exposure of genitals/breast rather than same sex care. I feel this is better because you can still be sexually abused/assaulted by same sex care as we have no way of knowing a medical provider's sexual preference. However, having said that, I believe that same sex intimate care with no unnecessary exposure is the best method.
From what I have read from others here, most are only asking for same sex intimate care. Is it okay to be unnecessarily exposed by the same sex even though you do not know their sexual preference? It is not concerning to be viewed sexually by even the same gender?
EM I see the male ultrasound tech did not respect your right to bodily dignity. No medical provider should be in the room while you undress/redress unless you are requiring help. By not providing you a gown or towel before draping, he certainly did not respect your bodily dignity. I do not know if he was gloved my he touched your genitals but he should have been. Most will be very careful abt the manner in which they physically handle genitals such as some will avoid cupping rather using the back of their hand to move the genitals. In what you described, the female offer better respect for your bodily dignity except for the laughing outside. Medical personnel should be taught that during office hours they must present a professional demeanor at all times. You will never know for sure what they were laughing at and certainly that should not have happened. Because they want their freedom to express themselves is certainly why here in the US patients are given versed to make them not remember the good times the staff have which demonstrates the care of the patient is not the most important part.
Cat I was having a heated discussion with someone named Randy on Quora and what I got from this person was the belief that men do not have the right to bodily dignity and I should not be critical of female nurses who also appear to believe this. Randy was more on male doctors sexually harming female patients which I said happens as it does get publicity whereas female crime on males getting little to nothing. It is always interesting on how sexist, biased people are who label themselves as "fair-minded" as really they are closed-minded. Randy's solution is no medical care for men who want their bodily dignity to be respected.
JR
I totally agree with you about same sex versus opposite sex when it comes to exposure. Neither one is comfortable to me but I guess for me I’m forced to pick the lesser of two evils. If a woman is exposing me there is 100% surety that what I am emotionally and Morally opposed to is occurring. If it is a man then I am left with the question IS HE GAY. If he declares to me that he is then I would refuse his services. So all of this becomes a gamble and makes the prospect of entering a medical facility that tells me to get naked so triggering .Exposure when not necessary is the biggest problem.
I don’t know if you read it but I also responded to that Randy guy on Quora and pretty much called him an insensitive prick
One more thing I probably won’t have to worry if the guy is gay or not because a can’t get them to accommodate my wishes for gender concordant care anyway
Jeff,
Thanks for answering my question. I think you summed it up pretty well. I haven't seen your answer to the Randy guy but he must be some sort of medical troll as he is completely absurd as he is gaslighting and lying. At one point, Randy was talking from a woman's point view and I later saw some other posts where he was talking like he was a man. Whatever he is still a bad joke. What I don't understand is how so many think that bodily dignity respect is a joking matter. I simply don't understand how we live in a society that says your bodily privacy must be respected in all circumstances other than if you are in a medical setting and more to the point if you are male.
Cindy and I are going to discuss how/why/when the medical's community need to unnecessary expose and disrespect patient bodily privacy came about. Any ideas? We know textbooks (as of a few years ago when I did my research) still taught proper methods of keeping patients "modesty" intact during intimate care. We know there is a huge disconnect between schooling and actual practice. We need to find the "root cause" for this.
JR.. that randy is a jerk. Somehow i think its a female. Im for both depending on what is happening. I would rather not be unnecessarily exposed, but if it were to happen an OR full of female nurses doesnt seem as bad to me. You dont really hear about them posting videos or sending pics of our boobs to their husbands. In all honesty i never paid attention to the sexual preferences of them either. We have several gay guys as friends and my husband never once thought that they would take advantage of him in anyway. Or even interested. Maybe because they know he is straight? I don't think you really hear of gay nurses taking advantage of their patients either. The docs that have assaulted same sex patients have all appeared to be straight. So maybe thats more of a fetish thing. I am definitely more of an unnecessary exposure from opposite sex hough. Cat
Even if all intimate care is done by straight same sex providers it still doesn't confront exposing patients to other people who are in the room but possibly shouldn't be. Doors left open or maybe just opened at the wrong moment. Or a small child running and opening the door before anyone can stop them. Actually NOBODY should be opening the door and nobody should be walking in. Lock the door and don't position the patients to be exposed if the lock should fail. JF
JF
You are absolutely right in what you said. People’s nudity and their bodily need for dignity is so often ignored in medical settings with no logical excuse except for a seared conscience and being completely desensitized to what they are doing. I think of the parallels in regards to how enough time in any situation can numb the conscience like the young boys that were pressed into service in the German army during World War II and the unlucky ones that got assigned to a concentration camps they started out I would imagine as caring young men and look at what they were capable of in the end. Don’t get me wrong I am in no way comparing the delivery of medicine to the atrocities committed in a concentration camp but it does serve as an example of how thoroughly the average sensitivities of a person can be desensitized to a level that you no longer possess the proper amount of empathy and compassion for a person to avoid the possibility of doing severe emotional harm and never even realize the damage you have done and possibly not care
JR
What you have just asked is the biggest question I have in all of this? HOW DID WE GET HERE. I think it all is driven by money but that is where it gets really complicated and when you start to tie it all together it creates a very elaborate web. There is a long history of medical atrocities that I would say began in the 1840’s that is when medical universities started to spring up in the United States. This site doesn’t allow me to go into the amount of detail necessary but one example I could give is a doctor named Marion Simms there is a statue of him at one of the universities in New England he is known as the father of modern gynecology. He is a perfect example of the philosophy that still exist in medicine today , the end justifies the means. He found a perfect audience for his experimentation. Female slaves ! I guess you could call that a captive audience. He performed 13 or more experimental procedures on this one particular slave woman with no anesthesia
And she was only one of many. Needless to say the me too movement wants his statue torn down. I can’t say that I blame them. I’m sort of going down a rabbit hole with all of this but there are a lot of skeletons in the medical closet but it all plays into the climate that exist only in the medical world, which plays in to today’s medicine. There are different forces that drive today’s medicine but the same mentality that the ends justify the means
I’m thrilled that you are Cindy want to explore this
it seems that everyone missed NBC Evening News on Sept. 19,2023 when a national presentation was done on vaginal exams on women and DRE exams on men while sedated in OR. This is really the kind of presentation needed to make the general public wake up to what is being done to them in the name of implied consent or better known as RAPE.
JR. Densitizing themselves. They constantly say we protect your dignity at all costs in the same sentence they say leave it at the door. I also dont think they know the true meaning of bodily dignity. They just dont care how uncomfortable others are. They are entitled people who think they are Gods gift. Its a paycheck to most. We NEED MORE Alicias going into nursing. SHE can make a huge difference. Im still not sure if its the older nurses or the new grads that have the less respect. Carmel on Quora seems to be old school and has no respect. Tricia seems new school who has no respect. Ria is old school and delusional. Oliver im totally confused about. Sometimes respectful other times no. Chris seems new school and totally gets it. Ive also noticed a lot has to do with if they say theatre. Thats a EU phrase which is more respectful. Those patients are given paper undergarmets to weae for every surgery. No naked under gown. Cat
The demographics of healthcare are what they are and even were there to be a concerted effort to balance the male-female numbers, it would take decades to achieve any semblance of balance. I may not like that reality but I accept that it is the reality. Of course they could cut the associated timeframe were they to concentrate on just a few areas in which there is substantial male patient intimate exposure.
The reality is also that sometimes healthcare requires intimate exposure. All that said, I think the largest issue that can be controlled in the here and now is not needlessly exposing patients (duration, extent, or audience). I can accept that female staff are my only choice for intimate matters if at the same time they made an effort to minimize my exposure. My experience is that despite being polite and maintaining a proper gameface, they do not make that effort. This is the primary problem.
Just a note of appreciation to all those who continue contributing to this blog thread. It's a must read for me [since 2007].
When I was a young teenager, the nurse [probably a nurse 75 years ago] just walked in [no knock] while the MD was examining me. I clearly remember it since I was only wearing briefs and the MD moved to cover me. Even at that age I appreciated his unnecessary {?} gesture.
My wife's two old maiden aunts were visiting when my wife changed our baby son's diapers. Both aunts moved to his bedroom to see this diaper change. Why? Is there something about females that feel the need to control by observing male's genitals - even a male several months old? Then again both were in the board field of medicine. They were social workers. Is there a correlation? Do those females who want to control others make a career of medicine where they know they can control "patients' with impunity.
BJTNT
Biker Maybe it WILL take decades or maybe it'll never change at all but it definitely COULD change..A staff meeting led by former patients or family members of patients who didn't make it. Many people saying the same things. Requiring proof that providers actually read the revews and letters patient send. If don't make it then make accountable who should have passed it along but didn't. There would be resistance at first because the medical staff would not want to admit many patients suffered long term or even died because of their lack of common sense or more sinister motives
JF
For anyone interested in the Sept.19th presentation regarding vaginal and DRE nonconsensual exams in sedated OR settings can be found on You Tube. Presentations like this will surely get corporate medical institutions attention faster than individuals crying an d hand wringing. In my personally situation at age 21 I pushed for hospital settlement which today would be 1.25 million, termination of a nurse's and doctor's license or a court case involving thee rape of a 20 year old male who under state law was still a minor. It also helped to have the right to wear a Roman collar as I was junior under grad studies to be a Catholic priest. During the attack a female orderly had her arm broken in 2 places, a nurse lost her front teeth and a do nothing female doctor ended up with a broken nose and black eye. I didn't cry about it nor wring my hands but with my attorney, doctor's support and that of the hospital's insurance company I went after those who attacked me and defiled me for their personal enjoyment by using the legal system.
Mitripopulos
I could find no mention of DREs being and this only address female patients with racial inequity being inferred. We know that men also suffer the same fate but this was basically ignored. The other part of this that was very misleading was the inferring that only one medical student did the exam while we know most of the time it is a group effort.
All this goes back to the consent forms being very vague on purpose. They feel they are covered by saying medical students might be present without saying what their role will be. It all goes back to they feel they own your body once you enter their doors.
Indiana where I live is one of those states that have not addressed this issue. When I talked to the Senate President, he said he didn't know this was even an issue. Even Florida, who supposedly passed a law protecting from this very thing has seemed to gotten around this. I have seen a consent from a Florida ob-gyn practice and it is still very vague. I wonder if it is the same with the other 24 states that have passed this type of law?
Also, did you win your case? I don't know how long ago your case was but we pursued the avenues and really got nowhere. It is a well-oiled machine. We found that even though the govt. agency sworn to protect its clients, CMS via Livanta, admitted there was no consent and such, they eventually did pretzel twists to protect the medical community. Lawyers wouldn't take the case actually saying he didn't die and it would be too much time and money for them although clearly he had a case. We didn't have the money needed to pursue the case which is what the medical mafia counts on.
Jeff,
Sorry for taking so long to respond to your question but I have been out of town for several days. While my abuse occurred in Washington DC, I now live in West Central Florida and drove to Clearwater, Florida.
EM
I thought you lived in Ocala Florida. That's where I live. JF
EM Mystery solved! Thanks
Embarrassment vs humiliation is very different. I was humiliated in the hospital at 7/8 yo more than a few times. I don’t think the nurses understood how humiliating some of the things they did to me in front of people were. Except 1 nurse that maybe had a clue when I cried.
If you think patient modesty is somewhat lacking for adult males, it was sometimes nonexistent for preadolescent males in the hospital, at least it use to be.
She was treating me with the door open, no curtain drawn, and I was totally naked/uncovered on the bed. At that point I was close to humiliated, but not quite. Just extremely extremely embarrassed. And starting to freak out mentally.
The final blow was when she let a 13 or 14 yo candy stripe girl (yes, they were that young) come in the room and walk around my bed to get something. She never even bothered to drape me.
When she let that girl to come in all my senses went into overdrive and then the freakiest thing of all happened, time actually slowed down.. My hearing, sense of smell, and focus all went into overdrive. My mind was racing and I became totally paralyzed. I couldn’t move expect for my eyes.
She made me tell her why I was crying when the girl left although I didn’t want to because I knew she was heartless.
When I did she just belittled me saying “Oh stop it. Your just a little boy. Those girls work here and see little boys getting enemas all the time so you just better get use to it. Now why don’t you stop crying and acting like a baby.”
Being honest, most guys I know would have maybe been embarrassed but that’s all. I unfortunately was extremely shy and introverted.
I mostly agree with this article below. It explains humiliation and some of the potential consequences. Might make an interesting topic. I think most people on here were very embarrassed, but if your humiliated the whole game changes.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560131/
Most nurses assume you can “man up.” Most can, but a small percentage of us can’t. I’m still ashamed to this day I didn’t stand up for myself.
I truly believe that if those nurses understood what happened to me mentally, the cPTSD I’ve suffered for 50 years, the memories playing over in my mind multiple times per day, senses on overdrive 24/7, the drugs and alcohol I’ve used to medicate myself, they would be truly horrified.
They just didn’t understand the mental consequences.
Even if there’s only a small percentage of patients that would be affected, nurses should be taught protecting a patients modesty is an absolute regardless of age or sex.
Maybe nursing schools should include a small professionally developed collection of some of these horrific stories about how peoples lives can be affected when you disregard modesty, especially in children. Then a few class lessons about it.
I’m not letting the doctors off the hook here either. That procedure she did took a good 5-10 minutes. My door was open and I was exposed to anyone walking by in the hall that whole time. Not 1 person, nurse or doctor, stepped up and closed the door or suggested to her she drape me.
Kind of reminds me of cop vs cop, doctor vs doctor. Never interfere.
The only thing that helps me survive is knowing that God’s permissive will allows all these things for a reason. We just don’t understand it, but 1 day we will.
I do agree with Reginald when he wrote “Yes, there are some bad actors; but, overall health care personnel don’t plan to harm.”
I should also mention I’m very successful in my field. You would never guess I’ve been traumatized by the medical profession as a child.
Some of the consequences have actually helped me thru the years. Like being able to hear like a blind person since my senses are on such high alert. I hear things people say and they have no idea I can hear them.
I posted on here a few years ago. Doesn’t seem like much has changed.
Very interesting Brian. I had never thought about the difference between embarrassment and humiliation given the manner in which the words are often used interchangeably. Having read the article, I understand how humiliation carries a far greater impact than embarrassment.
I too had my completely naked on the hospital bed for all to see incident at age 11 (3 months shy of 12), my having already entered puberty having added to my embarrassment. In my case it was a bed bath in which she never said what she was going to do but rather just yanked my gown off and started; never even speaking to me as she did it. Fortunately there was not a candy striper involved. I was too shocked to speak and just laid there as if I were immobilized. What perhaps made it worse for me at the time was that I was already traumatized by the event that put me in the hospital in the first place.
Shifting gears for a moment, I never experienced a candy striper myself but have read of 15 and 16 year old candy stripers sometimes being assigned genital shaving of teenage boys and men awaiting surgery. If that doesn't speak to the mindset that males had no need for or right to privacy, nothing does. Things aren't good now but they are monumentally better than it was some decades ago.
I would imagine things have gotten better after all these years. I’m just not sure how much. I haven’t been in a hospital, in particular the children's wing in a very long time.
I know 1 thing. The few times my child went to the ER, they were never left alone. What happened to me was never going to happen to them. Even when the nurse said I have to take them for an x-ray, you can wait here. It was like “Um we’ll be coming along.”
I’d be somewhat skeptical of a story where a candy stripe did an actual procedure. Just saying. Maybe it’s true.
Brian
I'm so sorry that you were abused that way. In my opinion that nurse was a sex offender and the other staff that allowed it were at fault also. Unlike you I don't think that a lot of male patients would have been fine with it. They would either love it or be destroyed by it. I also don't think the nurse would concern herself with the harm she inflicted on you. She'd just deny it.
Sexual gratifacation for the girls and whoever walked past was her goal. Sexual deviancy isn't just a male flaw . JF
In all honesty JF, I don’t believe she did it out of sexual gratification. For sure she wasn’t a compassionate nurse, far from it. And there was absolutely no reason to be treating me with the door open. Lazy, maybe.
Truly thinking young boys didn’t need modesty is what I believe she thought and many others as well.
I know the girl that came in was either embarrassed herself or embarrassed for me. I could tell by how she was acting. She never looked at me although she could certainly see everything. She could have glanced or looked at my genitals if she wanted, but instead she looked directly at the door as she was leaving the room.
I say others as well because they used me for a training class, maybe 6-8 nurses aids. At 1 point after a shower I was left standing in front of the class naked while 2 of the girls were finishing getting the bed ready.
It wasn’t sexual gratification. Stupidity maybe. But I also believe they truly thought boys don’t need modesty. Her words just summed it up. “Your just a little boy.”
Some fallout from this was my mother. I must have still been crying when she got there for visiting hours, I don’t exactly remember. But I do remember she went and got the head nurse and made me tell her what happened. I can still see the confused look on her face and her saying after I was done “It won’t happen again.”
If she was saying that to appease my mother I don’t know. But you know how when you meet someone under strained circumstances you can tell if their bad ass? My mom was bad ass. If she thought that head nurse was blowing her off, there would have been consequences.
It never did happen again.
Brian what I can’t help but think of and they don’t, is the damage they have already done and that can never be undone . All the apologies in the world and promises it will never happen again can’t take away that memory. That is the problem that I suffer with to this day and nothing has gotten any better.
They make even harder to protect yourself because of the dishonesty of deception that they practice. In many cases when they think a patient may find something uncomfortable or embarrassing they employ ambush tactics. I guess their thoughts are the less time you have to think about it the better and that’s total BS That’s what they did to me and here I am 4 years later on my third psychologist with no end in sight for the PTSD they drove me to
Or maybe it just didn't happen to you. I wonder if there were any consequences for the nurse. JF
I truly feel for you Jeff. I know PTSD is the gift that keeps on giving for the rest of your life. And as you say, there’s no taking it away it seems. 50 years for me. I’m just hopeful these practices aren’t continuing today but seems in some cases that’s wishful thinking.
That was why I suggested training for nurses by reading some of these horrific stories.
What helps me is prayer.
I’ll keep you in my prayers Jeff.
Thanks Brian my prayers are with you also
I pray without ceasing
To All,
There are always so many interesting comments on this forum to think about and try to respond to.
Dr. Bernstein – I haven't seen any comments from you in a while. I hope this post finds you well.
JF – I live in the Dunnellon area but am often in Ocala to visit my age-management doctor.
I did mail my only-positive thank-you letter to the imaging center with the male sonographer as well as letters to three imaging centers explaining why they lost my business. It will be interesting to see if I even get a response from the three centers.
Biker and Brian – Pertaining to the discussion of humiliation versus embarrassment, I was recently reading a psychology article somewhere that added the idea of shame to the mix. The author made the argument that humiliation was something done to you whereas shame was self-directed. What a complex issue.
I am so thankful that my negative experiences happened to me as an adult. Being a child or teen would have compounded the negative impacts tremendously and caused far more psychological damage. The stories from Biker, Brian, and others are very upsetting.
I received the results of my scans but have not seen my urologist yet. The results of the scrotal ultrasound were negative and will probably get diagnosed as undefined chronic pain and something I will have to live with.
My abdominal CT scan showed kidney stones on both sides and some mild hydronephrosis. If I am not a candidate for Extracorporeal shock wave lithotripsy (ESWL) which has little or no genital exposure, I will be left with undergoing a Ureteroscopy procedure which results in genital exposure for the entire procedure.
Jeff - I will probably be feeling your pain as I try to negotiate an all-male or mostly-male surgical team. The last time I needed this procedure, it took 4 tries to get the stones. I was able to cope (after therapy) with a mostly-male surgical team consisting of male urologist, male scrub nurse, male circulator nurse, and male anesthesiologist for procedures 3 and 4. Only the C-arm tech and laser tech were female and did not have any physical contact with me. I am sorry you are having so much trouble getting the care you desire for a serious condition. My kidney stones are only causing me some mild and intermittent pain and I can hold out for quite some time while I try to get the care I want.
EM
Cont'd
JR – The sonographer did not make genital contact and he neither left the room nor did anyone else come into the procedure room causing me to be exposed.
While I would be very upset with unnecessary exposure, I am more bothered with exposure to female providers. As Cat mentioned, we are generally more used to same-sex nudity via locker rooms etc.
I can more easily tolerate exposure to a single female provider particularly if there has been some time to develop a relationship and I am awake. It is being knocked out, helpless, and exposed to multiple female providers that really bothers me.
I would probably change my rankings if I was awake and purposely exposed to multiple women. I really don’t want to even think about that scenario.
Sometimes you have to pick the fights. A typical urology exam consists of the doctor asking a man to drop his pants and eventually turn around and lean on the table for the DRE. I have always felt that this is a very undignified way to proceed. In the past, I had a couple of PCP’s who had me don a gown and then lie on the table on my side for the DRE. I am not that sensitive about my backside and had my urologist chose this method last year, I might have let the female med student stay in the room. It is generally a very short exam and I usually let it slide.
I have not given much thought to whether my same-sex provider was straight or gay because I am mostly concerned with the idea of being ridiculed or humiliated and not the subject of anyone’s desire. If I was mistreated by a man versus a woman, I would not have a problem with physical retaliation.
I have also never experienced the hypocritical and condescending attitudes with anyone saying “You don’t have any special” or “I have seen thousands of naked men”, “Grow up”, etc. I am a very peaceful and non-aggressive person, but I would go absolutely ballistic if that were said to me.
EM
Something that has just been jarred in my memory through therapy that I wanted to share that gives context to the extreme reactions that I have to being stripped naked by a female in a medical setting.
As a child I was a bed wetter into my early teens. I won’t go into the details of my childhood that probably drove that but at one point at about the age of 9 or 10 my mother was fed up with the bed wetting and decided to put a diaper on me. At that age a boy has usually developed a strong sense of modesty and in my upbringing this was strongly instilled in me. I was forced to lie naked on the bed and diapered by my mother feeling extreme humiliation. My therapist believes this was the nucleus for my Exstream adversion in a medical setting to have a woman take authority over my body and expose me intimately because unlike a sexual encounter that setting to me feels totally degrading, disrespectful, humiliating and emasculating. People feel varying different degrees of discomfort in those settings but mine are pretty extreme. Knowing this doesn’t make things better but it is relieving to have some explanation to why my reactions are so heightened. These are things that are known as childhood ACE,s and they can stay with you until the moment you die
Hello Brian,
Welcome. The 2013 article on humiliation articulated what many of us have endured. Unfortunately, after another decade, the medical profession has still not implemented protocols to alleviate patient humiliation. A statement in the article could be instructively altered to read: "The therapist [here one could insert health care personnel] should help ... to empower ... [the patient] to ‘challenge and change social and environmental [ and medical] factors that are likely to support or promote humiliating social [ and/or medical] practices’ (p. 273)." Sadly, we have no "therapist" advocating for us. We are still alone in our resistance to medical humiliation. How I wish it could be otherwise.
Take care.
Reginald
On November 6 2023, I turn 93 years of age and I don't know what my, even immediate, future holds.
On Volume 127, we are averaging around 20 visitors/day and there is almost daily postings of 2 or 3 or so on 127 of the Patient Dignity title..and for the entire blog itself with well over 1000 different topic thread titles beginning virtually 20 years ago where I get 200-400 visitors daily from all over the world (including, for example, interestingly, many from Russia) covering all topic threads but for years NO posts except on our current Volume topic. The issue, now is, what happens to this active topic and the entire Bioethics Discussion Blog when I am no longer able to be active here or die. That is our current issue that deserves discussion here among our current participants.
You can write your suggestions here or write me privately to
doktormo@aol.com with your true e-mail address so I can return a comment directly to you.
So that is the current status of the blog to which you all have been participating. ..Maurice.
SO Dr B. Happy Birthday a month early. I'm praying to live to see 80. I'll be 64 the day after tomorrow.
I hope that either our issue gets resolved before you go or otherwise someone here in this group will keep it going. It's an important issue and people are harmed by it. Lifelong sabatoge. I also think all widespread abuse of power is connected. Lawmakers make the laws and have no accountability to the general population. Cops can murder suspects and generally not have to be charged for it. Children Services are part of the child abuse problem instead of the solution. So long as the medical world has the option to silence our voices it's exactly what will occur. JF
Dr. Bernstein, what you have done these many years is create a valuable catalogue of discussions on many healthcare and ethics related topics that goes far beyond this one enduring "patient dignity" topic. I can imagine future researchers mining it if it is preserved in a suitable repository. The anecdotes, experiences and opinions expressed might not lend themselves to controlled studies but there is value nonetheless. I say this as an amateur historian (or perhaps not so amateur) who routinely mines old documents (newspapers, letters, receipts, publications etc) for research that I do. I also say this thinking of the total body of work rather than just this one ongoing thread.
I think the best repository would be an ethics association or group that is in a position, not to keep discussions going but rather to keep it available as a static body of work for those seeking info such as those that continue to find it online. Keeping discussions going requires ongoing administration which is a whole other endeavor. I say ethics organization only because it is subject matter that they'd relate to more than most others. A university special collections library would be an alternative if they were in a position to host it online (in static form for researchers).
You are to be commended for all the good that you have done for so many. The discussions have certainly been of value to me.
Excellent suggestion Biker. I am a participant in the major clinical ethics organization in the United States and they would be a proper source for such review and consideration and review of my blog. Actually, in the past, a number of ethicists who are part of the organization have written postings to various topics on my blog.
Biker, again thanks for your valuable suggestion. Hopefully, if we shut down, you and the other current participants on this active blog thread will find other worthy internet to express their feelings and advice. ..Maurice.
Dr. B.,
I, for one, would like to see this particular blog keep on going. There are not many sites out there dealing with this subject. After my husband was harmed, we both felt alone. We didn't have anyone to talk to abt what happened. This blog has helped by letting us know we are not alone. Without this blog, I would not have met Archie who was beyond helpful. For some, this blog is therapy for it allows us to tell our stories and to get feedback from others who have experienced or who are sympathetic to bodily dignity issues. There are other sites like MPM, Quora, and Patient Partner blogs but this site is important to keep going. These conversations help provide insight as to what people who have been harmed by the careless, thoughtless way medical care is delivered to some. I would think there might be someone willing to carry on as moderator if you so desired.
I would also like to add my thanks for you hosting this site for so many years. Although you and I have had our differences, I am a person that believes all points should be out in the open and discussed. Jeane
I would like to second what Jeane had to say
Hello Dr. Bernstein,
We're hoping for another decade with you; and, we wish you excellent health for those years. You don't want to be called a "short hitters", do you? (Amusingly.) We cannot thank you enough for sponsoring a venue for us to express our dignity concerns.
Toda raba!
Reginald
As a "reminder", all participants in the interactions between patients and the medical providers here are the 4 main Medical Ethical
Principles. It would be interesting to us all for my participants here to define those 4 Principles. How would you want them to be defined in the doctor-patient relationship. and used?
BENEFICENCE
NONMALIFICENCE
AUTONOMY
JUSTICE
Dr. Bernstein, I haven't looked up the formal definitions but to me beneficence is focusing on what is good for me, nonmalificence is focusing on not harming me, so in reality just another way of saying the same thing, autonomy is giving me as much control as possible, and justice is doing the right thing, though I have never thought of the word justice in a medical sense.
Biker,
Beneficence entails promoting the well-being of others; nonmaleficence is an intention to avoid harming or injuring others.
The difference between the two words would be, in the medical profession, showing the primary need is to differentiate between what is the professional's requirement for intent towards the patient and if possible relieve the symptoms and hopefully cure the patient vs at the same time making an ethical effort to prevent intentional behavior aimed directly at the goal of causing emotional or physical harm to that patient.
That is the difference. ..Maurice.
Biker, JUSTICE is an important factor in how medical care is administered. There, throughout the United States (as an example) laws and regulations as set forth by U.S. federal government, U.S. state and local community laws which have been publicly set forth in various legal documents and these laws must be known by all medical providers, physicians, nurses and others. These laws must not be ignored or compromised otherwise those performing the illegal behavior or acts can be taken to court. Both patients and their surrogates or professionals and medical institutions must follow the law.
Usually, it is the medical institution or professionals who have broken laws. Occasionally, a patient may have demonstrated and found guilty of actively ignoring these laws by their behavior. Educating patients, families and employees of a hospital about Justice is an important part of a hospital ethics committee duties.
That's how Justice got into the 4. ..Maurice.
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Hello, Everybody.. I miss your commentaries on the patient dignity subject for the past entire week--there apparently were none and yet. Do you think that the subject matter has been adequately dissected (medical term) such that a "diagnosis" has been established and there are no further "tissues" to pull apart and analyze? Let me know, if the dissection is complete.
By the way, relative to the current U.S. national news: Biker, I thought the area of the U.S. where you live is a relatively benign and peaceful area of our country and a safe place to live and work. But, as you must know, the country and perhaps the world is looking at the northeast with grim interest and concern. ..Maurice.
This country has a mental health crisis. This country has normalized bad behavior and the result is violence as many people are led to believe they have the right to impose their bad behavior on others. For example, if a medical provider abuses a patient that is acceptable but it is not acceptable if the reverse happens. You can find article after article where the medical community is talking about violence towards them but there is silence on the reverse.
I will go on to say that I know of no gun that has chosen to harm on its own by walking into a space and firing but I do know of many mentally ill people who are freely walking around that select their weapon of choice to harm either a gun, a knife or even a vehicle. Why is it only guns are being attacked when we know it is truly a mental health crisis? I really have little faith in those who believe doing away with private citizens having the means to protect themselves will solve the problem as we know from Chicago and other gun free zones that the criminals still have guns. Why is this so?--Because they don't follow the laws. Just like medical harm is an epidemic and is not truly being addressed, crime is not being addressed properly. Until we fix people, we will still have an issue. They will just use other means so should those means also be banned?
Yes Dr. Bernstein, what happened in Lewiston, Maine has shocked Northern New England to its core. Northern New England (VT-NH-ME) has long had the lowest violent crime rate in the nation, to the extent that the "can't happen here" mindset has been widespread. I can't think of anytime that I have ever been anywhere in Northern New England that I didn't feel safe or thought I had to be on guard. I've never locked my 3 car detached garage that also has an upstairs & some pricey stuff in it or my greenhouse with lots of gardening tools & supplies. My vehicles aren't locked either when in the garage. My house is unlocked until I am in for the night. Our town hall where I work parttime in an elected capacity doesn't have a security system, nor does the Grange Hall that community groups use for meetings. My town doesn't have its own police and contracts with the county sheriff's dept for 20 hours coverage per week. The other 148 hours of the week there isn't any police presence in town. In many ways we've been sheltered from the dysfunction of the larger world, but we've now been reminded that there isn't a bubble somehow protecting us.
I agree with JR about guns. There was a bumper sticker out that said if you outlaw guns only outlaws will have guns! How true. The real problem is like she said it’s a heart problem. mental illness is rampant and only seams to be gaining steam. Our world has become so difficult to navigate and to make things worse is the belief that everyone can have their own truth even when it contradicts science and nature and this is the mess that children are being thrown into. Is it any wonder they grow up to be maladjusted and confused?
I have remained quiet on this site lately because it felt as if I was kicking a dead horse on the patient dignity issue. I enjoy hearing from everyone because it lets me know that I’m not alone in this battle and for me it is a battle. I have another appointment with another surgeon for hernia surgery and I’m certain that my requests will be met with the same indifference and unwillingness to accommodate. No one will discuss if it is a lack of male personnel to accommodate or it’s their belief that what they do is perfectly acceptable and I’m the one with a mental problem. If I have a mental problem it’s complements of them but until they are willing to acknowledge the devastating affects it can have on an individual all the talk in the world won’t change a thing. I tried with all my heart to find out while I was on the phone who I could talk to about my concerns and all they could offer me was my 15 minutes of fame with the surgeon that they can bill for and when I bring up my concerns I’m going to get that deer in the headlights look.
Media and public awareness is the only way this kind of treatment and emotional damage will ever end
I have to give the medical industry credit for doing their part in advancing the levels of emotional distress in our society
Dr. Bernstein,
Congratulations on your upcoming birthday! I wish you all the best and continued good health.
You have created quite a legacy with this blog. I would like to thank you for the time and effort you have expended over the many years. I am retired now but can’t imagine being dedicated to something for over 20 years. I have seen several other blogs/sites that have addressed the same issues but none that have reached the quality and quantity of the discussions on your blog. It has been very therapeutic for me even though it took 8 years for me to contribute. I agree that the existing content should not be lost no matter what happens to the blog in the future.
I first found the site in 2014 and eventually went back and read all the posts since its inception to gain an understanding of what people have experienced. You added great value to the blog because of your medical background/perspective and thoughtful questions which prompted lively discussion. That does not really occur on other non-moderated platforms although there are responses from classes of people such as doctors or nurses. I don’t know how much time and effort that is required of you to maintain the blog but I would certainly understand if you were ready to step back from it.
I think the concepts of medical modesty/dignity have been thoroughly discussed and illustrated. Most participants in this blog understand what should be done to address the issues but the big question is whether there will be any movement towards the goals in the future or even how to accomplish them. I would hope that societal norms might change to embrace the concepts this blog espouses but due to the looming shortage of medical personal and the major problems the country faces, I am pessimistic that things will change.
The drop-off in readership could be due to a number of reasons. There are newer platforms that people may be more familiar with, such as Quora. I also think that interest in the idea of Medical Modesty/Dignity is somewhat random and occurs when people have a negative experience while seeking medical care. People who have positive experiences generally are not going to be doing searches on the topic. I also think that the horrific state of affairs in this country and the world over the last several years could have distracted people and suppressed interest. I personally find it difficult to think about the blog when we seem to be walking towards nuclear war and the economy/financial future of the country is in jeopardy due to indifference of our elected officials.
EM
cont'd by EM
I don’t really think I am a deep enough thinker to discuss the meanings and implications of the words:
BENEFICENCE
NONMALIFICENCE
AUTONOMY
JUSTICE
Yours and Biker’s explanations seem to make sense to me and I wonder where a concept such as same gender/sex care would fall. It could be under Justice assuming that the right to same gender/sex care could be codified into law. Perhaps it would fall under Nonmalificence but this also assumes that the medical professionals recognize the issue. I am never quite sure if people just don’t care or that they are so used to a certain behavior that to act differently never crosses their mind. This blog has also illustrated that there is deliberate action by some people.
I thought I would share an update concerning my quest for same sex care. I wrote 3 letters criticizing the lack of male personnel for my scrotal ultrasound. I actually received a call from the medical director (MD) of one center where I have previously had imaging performed. He explained that he is one of the few doctors who is certified to perform ultrasounds. He said that he doesn’t routinely do ultrasounds, but that if I ever needed another scrotal ultrasound, he would be willing to perform the exam.
I had my follow-up appointment with my urologist and based on the CT Scan and KUB, my kidney stones have returned. I asked for options and the two non-surgical treatments are ESWL (shockwave) and Ureteroscopy with laser lithotripsy. I said I would prefer to try the ESWL first and elaborated on my reasons for not wanting the Ureteroscopy. I briefly narrated my experience 9 years ago and said I could probably tolerate the process as long as most of the surgical team were male. I was prepared for a negative response, but to my astonishment, he said that my request for a male team could easily be accommodated. He was incredibly caring and said he understood completely.
I may have female pre-op and post-op nurses but they would not be involved in intimate care and typically there isn’t any exposure following this type of procedure. Since I will be sedated for the ESWL with a male team, I have asked him to perform a Cryptoscopic examination of my bladder due to some BPH symptoms I have been experiencing.
Jeff, I am sorry that you are having so much trouble getting the type of care you require. I think I mentioned it before but if your surgery is possible at an outpatient surgical center you might have better luck since the surgeons are often owners of the centers. I would think that owners would be more flexible than doctors at a large medical group/hospital.
EM
NOTICE: VOLUME 127 IS NOW CLOSED FOR ANY FURTHER POSTINGS HERE.
POSTINGS WILL NOW BE PUBLISHED ON
VOLUME 128.
HERE IS THE LINK TO THE NEW VOLUME:
https://bioethicsdiscussion.blogspot.com/2023/11/preserving-patient-dignity-formerly.html
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