Preserving Patient Dignity (Formerly Patient Modesty) Volume 133
This is a Continuing Way to express your views of the current and past medical system.
posted by Maurice Bernstein, M.D. @ 2:57:00 PM
27 comments
Bioethics Discussion Blog
What have you been reading, hearing or TV viewing that has provoked some feelings of comfort or concern about what is happening in the world of medicine, medical care, treatment or science? Ethics is all about doing the right thing. Are you aware of any issues in medicine or biologic science which are being done right, could be improved or in fact represent totally unethical behavior? Write about them here.. and I will too! ..Maurice (DoktorMo@aol.com)
REMINDER: I AM POSTING A NEW TOPIC ABOUT ONCE A WEEK OR PERHAPS TWICE A WEEK. HOWEVER, IF YOU DON'T FIND A NEW TOPIC POSTED, THERE ARE AS OF MARCH 2013 OVER 900 TOPIC THREADS TO WHICH YOU CAN READ AND WRITE COMMENTS. I WILL BE AWARE OF EACH COMMENTARY AND MAY COME BACK WITH A REPLY.
TO FIND A TOPIC OF INTEREST TO YOU ON THIS BLOG, SIMPLY TYPE IN THE NAME OR WORDS RELATED TO THE TOPIC IN THE FIELD IN THE LEFT HAND SIDE AT TOP OF THE PAGE AND THEN CLICK ON “SEARCH BLOG”. WITH WELL OVER 900 TOPICS, MOST ABOUT GENERAL OR SPECIFIC ETHICAL ISSUES BUT NOT NECESSARILY RELATED TO ANY SPECIFIC DATE OR EVENT, YOU SHOULD BE ABLE TO FIND WHAT YOU WANT. IF YOU DON’T PLEASE WRITE TO ME ON THE FEEDBACK THREAD OR BY E-MAIL DoktorMo@aol.com
IMPORTANT REQUEST TO ALL WHO COMMENT ON THIS BLOG: ALL COMMENTERS WHO WISH TO SIGN ON AS ANONYMOUS NEVERTHELESS PLEASE SIGN OFF AT THE END OF YOUR COMMENTS WITH A CONSISTENT PSEUDONYM NAME OR SOME INITIALS TO HELP MAINTAIN CONTINUITY AND NOT REQUIRE RESPONDERS TO LOOK UP THE DATE AND TIME OF THE POSTING TO DEFINE WHICH ANONYMOUS SAID WHAT. Thanks. ..Maurice
FEEDBACK,FEEDBACK,FEEDBACK! WRITE YOUR FEEDBACK ABOUT THIS BLOG, WHAT IS GOOD, POOR AND CONSTRUCTIVE SUGGESTIONS FOR IMPROVEMENT TO THIS FEEDBACK THREAD
Saturday, June 28, 2025
About Me
- Name: Maurice Bernstein, M.D.
- Location: Los Angeles, California, United States
Previous Posts
- Preserving Patient Dignity (Formerly Patient Modes...
- Preserving Patient Dignity (Formerly Patient Modes...
- Preserving Patient Dignity (Formally Patient Modes...
- Preserving Patient Dignity (Formerly Patient Modes...
- Preserving Patient Dignity (Formerly Patient Modes...
- Preserving Patient Dignity (Formerly Patient Modes...
- Preserving Patient Dignity (Formerly Patient Modes...
- Preserving Patient Dignity (Formerly Patient Modes...
- Preserving Patient Dignity (Formerly Patient Modes...
- Preserving Patient Dignity (Formerly Patient Modes...
Links
- Bioethics Discussion Pages
- Complementary and Alternative Medicine Law Blog
- HealthLaw Blog
- The American Journal of Bioethics Editors Blog
- Shrinkette
- Women's Bioethics Project
- Medical Modesty Blog THOSE INTERESTED IN DEVELOPING ADVOCACY FOR PATIENT MODESTY, GO TO
- THIS ADVOCACY DEVELOPMENT BLOG
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27 Comments:
Move on to Volume 133
Please, someone text a message here as soon as possible. I am trying to
get this system to work. ..Maurice.
Here's a message Dr. Bernstein. Hopefully this is working.
HOORAY.. and THANKS BIKER ..WE FINALLY GOT A VISITOR PUBLISHED HEERE ON VOLUME 133!!! ..Maurice
Do you find anything in the current Trump presidential occupation that has
improved or contrarily impaired the goals you hold as the best of medical system
service? ..Maurice
My nephew believes that AI will be a good solution for a substitute. I guess we'll see JF
Please feel free to SPEAKUP..of course identified by your selected and
unique pseudonym. You don't need to get a formal identification name
from the Google company to participate on this bioethics blog.
No I don't think the current administration will have any impact on patient dignity or privacy issues. Their issues, as with past administrations, always boils down first and foremost to who pays for healthcare whether that is directly by govt., via govt subsidized insurance, or via patient-paid insurance.
Of course the answers to those questions impacts healthcare accessibility for many, but that is still something apart from the main topics of discussion here. I will add that accessibility issue is more than who pays for the actual care delivered, but in rural areas, whether there even is a hospital. Many small rural hospitals are dependent upon govt. subsidies to survive.
Patient dignity and privacy issues is not a topic for the current administration, nor has it been for past administrations. In the context of what is discussed here, being those issues primarily impact males, it isn't likely to be a political issue anytime soon.
Biker you’re right neither party gives a rats butt about patients dignity and I don’t think they ever will. Without a ground swell of vocal out cries nothing will ever happen. I have brought the topic up to people I know and most of them say it’s no big deal, they don’t care, and it’s just a medical procedure. This is because they have been indoctrinated into the normalcy of what is done. The amount of exposure that men are expected to except from the opposite sex has increased significantly. All you have to do is look at the history of many things done today that didn’t even exist 50 years ago. Women didn’t do male catheters until sometime in the 70’s because it was considered inappropriate. The micro camera used in cystoscopies and colonoscopies wasn’t invented until 1982 the transducer used for sonograms was too large to use for testicular ultrasound until about the same time frame when they got the the transducer to the size of a Handheld wand these are all things that have brought women into close proximity to men’s genitals. None of these things were ever broadcast to the public. It was usually discovered by the patient as it was happening. A man is left with the option of excepting their mode of delivery or walk away from needing care because they offer no alternative
Enough of my rant but none of these things are ever discussed or acknowledged because one of the best accomplishments of the medical community is their ability to avoid transparency and Excel at deception and I know this because I’ve lived it
Does any visitor to this blog knows what it is like to be a physician- male patient for female LVNs and RN.? I am and I do and I just see them doing
their "job" in the same manner as with any male patient. They make NO
effort to avoid "patient genital exposure" than with any non-physician male.
I have written about this on "distant" volumes of this bioethics blog in the past. ..Maurice.
So that you know my current status: I am 94.5 years old and I have
an indwelling male Foley urethral catheter which has been attended to
once monthly in a nearby urology office by female LVNs for catheter replacement for the past many years. Yes, they know I was an active
internal medicine physician but they follow the standardized Foley
replacement procedure as has been established for all, physician or
not. ..Maurice.
Dr. B I take from what you are saying is they don’t discriminate their application of care regardless of status. Physicians and non physicians are treated equally. I think what isn’t taken into consideration on their part is the wishes and needs of the patient. For those that are comfortable and unconcerned with the gender of the person performing such an intimate task then I guess there’s no problem. There is a wide range of reasons that doesn’t sit well with many. Sometimes it’s cultural sometimes moral or religious reasons. But for some it’s even more intense driven by complex PTSD. I don’t know what the medical community thinks of these beliefs or conditions but from my experience not much. To take the stance that it is the patient’s problem and the emotional wellbeing of the patient takes a backseat to the task at hand is short sighted with a lack of understanding that the emotional wellbeing of a patient is as important as their physical wellbeing. I sometimes wonder about the person that performs these kind of tasks? I know they weren’t always comfortable performing intimate tasks on an opposite sex patient. What was going through their mind and what was their emotional feeling the first time they were tasked with exposing and intimately touching an opposite sex patient? This is a process of numbing down and desensitizing oneself to an act that doesn’t feel natural and depending on the provider’s internal moral compass maybe more difficult for some than others. Eventually they become comfortable with these actions and it becomes another day in the office. This is not a daily routine for a patient and is not always received with the same comfort as the provider. Coming from your background I can see your acceptance of what you have done on a monthly basis because these kinds of treatments became acceptable for you many years ago as a practicing physician.
All of this is driven by the medical institutions need to utilize the people at their disposal which would be 90% female. It forces them to normalize something that is not found anywhere else in our society.
In the meantime unknown numbers of people are sent out of facilities changed people and in some cases broken. But for them it’s not their problem and if they acknowledge anything it is that patient needs a check up from the neck up. NEXT PATIENT!
Jeff, just a clarification. The non-physician healthcare staff mix may be 90% female, but it is likely a far higher female mix in doctor's offices. Male staff tends to congregate in the ER, OR, ICU, and to a lesser extend in MedSurg areas of hospitals. Lots of guys will be found amongst the ranks of EMT's and certain tech areas like xrays & scans too, but rarely are males found in medical practices. A non-physician male in anything urological is a rarity.
Biker I 100% agree! to give a personal example, though my life I have had the opportunity to visit 3 urology clinics I would only go to practices that had male urologist but in every case every other person on the staff was female.
I may have said this before but my wife worked in OB GYN for 30 years in three different practices she said that she never had any males in any of those practices and never heard of any OB GYN practices that had males in the practice. When I asked why her response was it would make the patients uncomfortable 😣?
75 to 80% of all urologic patients are male so wouldn’t you think that they would try to hire a few males for patient comfort?
Sometimes when I feel like I'm the only person in the world medical trauma has impacted as a kid I look at some sites, like this one, where other people share their experiences. It helps to know your not alone.
But when I read this article I was astounded that it still happens today. Horrifying.
https://www.statnews.com/2023/09/11/vguc-children-test-uti-stress/
It just makes me realize that never ever leaving our kids alone for ANY hospital test or doctors visit was the right call. What happened to me was never going to happen to them.
A lifetime of PTSD. High alert 24/7. Avoid large crowds. Notice things no one else sees. Hear like a blind person because senses are so high strung. Self medicating. I never realized till my 60's I had PTSD. I just thought I was different. lol.
Doctors not so much a concern. Still, a little.
But medical staff, including nurses, that's a serious risk for a child. To staff this is just something they've done a hundred times. They need to get you in and out so they can get to the next patient.
The doctor needs the test done so they can figure out how to fix whatever is wrong. But mental health, your on your own. And for children that means parents have to step in.
Their still conducting research to determine if using 4 people to strip you and hold you down on a table with your legs spread open while they shove something in somewhere could be detrimental to a child's well being mentally. Seriously? Are we idiots?
Absolutely horrifying.
As a child you don't get to say "no" or anything else. In the hospital you either cooperated or you were forced.
During my 2'nd hospital stay I fought. It didn't work out so well for me. But I wasn't going to allow what they did to me during my 1'st hospital stay to happen again.
I fought until I was exhausted both mentally and physically. Then I just collapsed and went limp. A young boy being held down by a group of girls. Humm.. I wonder if that may have an impact on his mental health and life? We'd better research that someday.
I'll say it again. Seriously? Ya think....
It may be unintentional but that doesn't change the impact.
Parents have to be the protective layer. Doctors aren't. It's not their job. And it doesn't seem to be anyone else's job either.
I try and always include this in all of my writings. God doesn't do random, that much I know. So I know and have faith that what He allowed to happen to me happened for some reason. Some reason I may never know or understand. I'm still thankful even for this.
I think this will be my last entry. I had hoped that by sharing some of these stories some medical professionals might see them and think "Hey, maybe we'd better stop doing that to kids."
That doesn't seem to have panned out.
Brian i fully understand where you are coming from. My experiences started in early childhood and the damage that was done to me were not fully realized until I ended up in a surgical setting that closely mimicked some of my childhood memories that had been suppressed my whole adult life.
There is no way that the medical providers have no idea of the lasting emotional damage they can and do do but they justify it as medical necessity and never look for alternatives. Alternatives usually take more time and we all know time is money!
I totally agree with Biker and Jeff’s assessment of the willingness of any government administration to address the issues of male choice in healthcare. As I have posted previously, nothing will change until men start protesting in mass. Women are much better at group solidarity and were very successful as shown by the creation of official government agencies focused on women’s health and specialty “Women’s Centers” in many hospitals. There are a number of reasons for the lack of men in non-physician roles such as societal pressures where men are expected to “man-up” and instinctual feelings where men do not want to thought of as weak and perhaps sub-conscious feelings of competition with other men. I also think there is resistance from women to hiring men in nursing and other roles as they threaten the “old-girls network”. As biker mentioned, many men favor the more intense areas such as ER or ICU. I recently talked to a male student-nurse during one of my volunteer hospital shifts. He indicated that he wanted to work in an ER or ICU environment and eventually become a nurse practitioner.
I sometimes get very angry at the lack of choice of same-sex staff in health care. I am willing to bet that there is not a single gynecology clinic in the country (world) that has an all-male staff below the physician level and probably not a single urology practice with all-male personnel. It is amazing to me to see the number of sexual health clinics that are staffed by only women. I am lucky that my urology practice in Florida has a number of clinics with male PA’s and nurses. I must have under-estimated the number of men that ether don’t care or prefer female health providers because these practices and clinics seem to be successful. Perhaps many men have just given up and accepted the process as inevitable. When I talk to my elderly uncle about having intimate care provided by women, he just kind of shrugs as says I should just get used to it and accept it.
My volunteer activities at the hospital are focused on the post-operative floors” and not ER, OR, or critical care. I work covers four floors doing tasks such as disinfecting telemetry devices and stocking gloves in every room. It is very rare to see a male-nurse and the ones I have seen may have been there temporarily from their duties in the OR or ER while they are moving patients post-surgery. I did over-hear a nursing supervisor discussing the use of a male nurse to convince a patient to take a bath because the patient was refusing. If the patient was a man, perhaps he didn’t want a shower from a female nurse.
I have told the volunteer supervisor that I am available if a male patient didn’t want a female nurse to help them dress. I may look into training so I can get certified to help lift patients or do limited care. I had to decline a patient’s request to help him to the bathroom. I told him that I would make sure the nurse was aware and he waved me off and said the nurses were a pain in the ass.
While my bad experiences were trivial compared to most contributors to this blog, they still bother me 11 years later. As I age, I expect to be subject to more intimate exams and procedures and it is on my mind all the time. I am working with a counselor to cope and to focus on what is actually happening and not dwell on what might happen. PTSD has a pretty good hold on me and is not easy to ignore. That said, this blog has helped me to take a proactive approach and ask how and who delivers intimate treatment before it happens. So far, I have been lucky and not been in a position of having no choice in the matter.
EM
EM bless you for your efforts to make a difference. Trying to change the mentality in the medical world is an uphill battle. I think the problem is two fold, the industry has no need of change because most people seem to be fine with the status quo. And so many men just won’t speak up. I am going in tomorrow for hernia surgery. The surgeon said he would not use his surgical assistant because she is a female and working with all the people I have been communicating with say they have an all male team assembled as long as no one calls in sick. I am very impressed with them hearing me explain the complex PTSD that I live with and doing everything possible to accommodate. If enough people would speak up change is possible
PTSD is as is many medical disorders potentially treatable and symptom resolved. Don't accept the disorder as "untreatable". Don't give up the chance
to enjoy your remaining years. ..Maurice.
EM, the demographics of healthcare below the physician level are such that it would take a generation of specific effort to balance it gender-wise. It would need to start with career fairs directed at high school boys to encourage them into nursing & various tech programs. Regretfully, there is almost a complete void encouraging boys in any direction currently.
What the healthcare system could accomplish in a relatively short time (if they had the will to do so) is to train staff on avoidance of needless exposure and on basic professional conduct. Accepting the reality of current demographics is one thing. Accepting needless exposure or unprofessional conduct (you don't have anything I haven't seen etc) is something else entirely.
The lack of standard protocols is another issue that could be easily addressed if they wanted to. How hard would it be to expect all staff to pull a gown up from beneath a sheet in order to examine the abdomen vs fully exposing the patient by just lifting up the gown? Yet it is left up to each individual nurse or other staff member as to how they prefer to do it.
I agree. A patient who has PTSD should make this valid clinical diagnosis clear
to each and every clinician (physician, nurse, LVN and hospital administrator) since It is a valid clinical disorder and must be accepted as such and the
patient should be attended to with this disease as with every other purely medical or psychiatric condition. Any bit of ignoring this diagnosis is
clearly malpractice, "nothing more and nothing less". ..And cannot be legally ignored. ..Maurice.
Maurice.. even though you dont care yourself have you EVER brought up.concerns of the people on this blog to your female Healthcare providers? It doesn't seem like you have. Maybe if YOU brought up that YOU care it will get them thinking of the next guy. Cat
Where I get a monthly Foley catheter change there is currently both female and a male LVN. It is the reduction of Foley catheter removal and exchange PAIN which is of my concern and not the gender of the LVN providing the service (both genders attentive to my concerns). ..Maurice
“Why So Many Men Avoid Going to the Doctor” (https://www.healthline.com/health-news/why-so-many-men-avoid-doctors)
Not surprisingly, this article is written by a woman who is very willing to tell men what is wrong with us. Below are the reasons given in the article:
• Men don’t like being vulnerable
• Men worry about a bad diagnosis
• The “superhero syndrome” that states that men think of themselves as strong and that going to a doctor is a sign of weakness.
So, doctor avoidance is all the fault of wrong thinking males. Interestingly, there is absolutely no mention of modesty as an important issue. Like so many articles about this subject, the writer avoids mentioning male modesty because if she wrote about that she might be suggesting that the medical profession should do something about it, and she and other female providers are certainly not interested in doing anything to encourage men to become nurses, PA’s, x-ray techs, etc. because they like it fine the way it is.
Fields like law enforcement, construction, the military and many others have done a great deal to encourage women to enter formerly almost all male fields. Has the medical profession done anything similar to encourage males to enter the health care field? Not much that I know of.
Unfortunately, we are still in a situation where all we can do to protest this situation is to ask for accommodations or walk out before allowing our modesty to be violated. Of course, in some situations we may be too ill to leave so we are forced to accept the “gender neutral” care they force on us.
MG
Don’t like yo be vulnerable
Worry about a bad diagnosis
See it as a weakness
MG
MG, thank you for your article referral. In actual medical practice of patients, the role of family members or
intimate individuals of the patient can play an important
role in the "protection" of the patient from medical system
unaware or unethical behavior. Every patient, on entry, should have available the name and location for that individual to participate in the patient's decisions and care.
..Maurice.
MG, modesty considerations is a missing component as you point out but it goes beyond that to a matter of respecting the inherent dignity of male patients. Topping the list in my opinion is the practice of bringing female chaperones (by whatever name they give them....assistants that don't assist). Bringing low level female staff to just stand there and stare at the male patients is demeaning and dehumanizing. Why can't they see this? They would never bring a male chaperone in for a woman's intimate procedure or exam.
Next on my list is the lack of focus on minimizing exposure in terms of extent, duration, and audience. In the near term there isn't much that they can do about the demographics of healthcare, but they can easily address the manner in which they deliver care. But they choose not to.
Biker, what about the patient's assigned relative or personal companion to attend to the issue of a patient's communicative personal desires or acceptance or that of
a clinically non-communicative patient's known personal desires? These persons are part of a patient's "medical team". ..Maurice
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