How to fight effectively against sexual violence during gynecological consultations ? In his new notice published on March 29, 2023 and for which more than thirty people were interviewed, the National Consultative Ethics Committee (CCNE) announced new recommendations to better understand consent during gynecological examinations and even calls for a “consent revisited“.
During her life, a woman will experience between 50 and 80 gynecological consultations, during which the practice of certain gestures can directly affect their intimacy, their nudity or their sexuality. CCNE therefore recalls that “examinations affecting intimacy require redoubled attention to know-how, precaution and tact at each stage of the consultation”. For their part, patients must feel that their modesty is taken into account by the healthcare professional, and a special attention to pain or discomfort occasioned by a gynecological examination, whether expressed or not.
Each gynecological or intimate examination must be based on the patient’s explicit consent. At my request, the CCNE opinion published today will be sent to all doctors, in order to raise their awareness of this major issue for women’s health.https://t.co/Td7RxiCrkK
— Francois Braun (@FrcsBraun) March 29, 2023
If the majority of caregivers are, of course, attentive to the well-being of patients according to the CCNE, some may sometimes be led to neutralize their emotions automatically, at the risk of frustrating or worrying some patients. Hence a call for an effort of mutual understanding between patients and caregivers, in particular to restore the trust eroded by various cases of gynecological rape in recent months, in France and in Europe.
What are the risks of a lack of patient confidence? Contempt for the profession under the effect of a “collective opprobrium” and attacks on social networks, evolution of non-compliant practices but above all loss of chances for patients due to a renunciation of consultation or refusal of examinations… A lack of trust can have serious consequences for both parties , in particular for women’s health because of difficulties in detecting certain diseases if they are not monitored, in particular gynecological cancers (cervix, ovaries, etc.).
Should the patient’s written consent be obtained?
“Contrary to what has been done in other countries, CCNE did not consider this measure relevant, nor to request that a third party be systematically present during the examination., the statement said. Nevertheless, “the consent should no longer be tacit or presumedbut explicit and differentiated for each examination carried out during a consultation”, estimated the CCNE. Additional precautions must also be taken with minors, people with disabilities, mental distress or victims of violence.
If the patient refuses, the healthcare professional must accept it and hear and consider the difficulties of certain women, especially those who are victims of violence.
Source :
- CCNE Opinion 142 “Consent and respect for the person in the practice of gynecological examinations and affecting privacy”, CCNE, 29 March 2023
