Examination Under Anaesthesia

Pam, a 34-year-old woman with fibroids, was clerked in yesterday by a fourth-year medical student on an obstetrics and gynecology rotation. Pam is scheduled to have surgery today for removal of the fibroids, and the consultant asks the student if she would like to scrub in to assist during the operation. The student has assisted the anesthesiologist before the operation and has reassured Pam about the planned operation. Once Pam is anaesthetized, the consultant asks the student to demonstrate how she would perform an internal examination on a female patient. The student realizes that Pam was not asked for permission to do this and feels that it would be wrong to carry out the examination. However, she also thinks that it would be a good learning opportunity and she is slightly in awe of the consultant and she knows that he has shouted at other students. The student decides to point out that she does not have Pam’s consent, but the consultant reassures her that as Pam is anaesthetized, she will not know anything about it.

• Should the student perform an internal examination on Pamela?
• What should she say to her consultant if she refuses?

Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)

Clinical Ethics and Law, Second edition. Carolyn Johnston, Penelope Bradbury, Series editor: Janice Ryme