Thread by @R_Denhollander

I can't even count the number of stories I know like this. Medical sexual assault is extremely common, and rarely exposed.

What we need to wrestle with is why, and what has to change legally:
nytimes.com/2021/10/11/hea…

This article inadvertently plays a part in one of the major reasons, when it notes that sexual contact between Dr and patient is an ethical violation. As if what is described here is consensual contact that just breaches some ethics rules.

Yes, the ethics rules are important and yes there is always a power dynamic, that's why the rule is there.

But when predatory abusive and criminal behavior is flagged as wrong because of an ethics violation, it severely mischaracterizes the abuse and downplays needed response.

I don't think that's what the author meant, but it actually is exactly what usually happens.

Several years ago the Atlantic published a major multi-part investigation into medical sexual abuse. They were way ahead of their time. Unfortunately, few people listened...

But here's what they found: sexual assault is usually categorized as an ethical violation, not a crime.

This means no one reports it to police and the only repercussions is a few hours of ethics education, as if the Dr. just didn't realize the rules.

Medical review boards are stacked with peers who have little to no understanding of sexual abuse or trauma, and almost always give the Dr. the benefit of the doubt and assign, naivety, confusion or outright malice to the woman bringing the complaint.

Systems of appeal for a decision rarely exist outside of that same review system, and no victim protections are in place.

Investigations, decisions and repercussions are all kept private. So there's no way for anyone to search to see if reports have been made by anyone else...

No accountability for the investigative process that was used, and no notice of any requirements put into place.

So even if you get a physician who is supposed to have a chaperone, here's the problem:

1. You are highly unlikely to know of this requirement and it's not likely to follow up on or be enforced.

2. Medical professionals don't usually believe reports against other professionals and don't report on them. The chaperone is not likely to be effective.

3. Babysitters don't stop predators. While a chaperone will prevent some overt conduct, MANY physicians abuse in the presence of other people. Larry isn't the only one. Abusers are skilled manipulators who need to be given no power, not just a chaperone. Predators will abuse.

And we foster a culture especially in medicine of unquestioned deference to what is told to us to be medically helpful or necessary. What a doctor says becomes the truth, period. And extreme deference is typically given to other doctors by doctors.

Extreme deference is typically given to doctors by other doctors, and bucking a system or individuals is treated with disdain and professional penalties.

Couple this with the patients being in desperate situations where they MUST be able to trust and receive care...

And it's a recipe for complete control, fear, and abuse, with swift repercussions for speaking up, like these women being unable to find new medical care.

This goes so much deeper than sexual abuse, but make no mistake, it directly feeds it.

I know women who were denied pain medication during significant stitching after birth by doctors who were mad they didn't accept pit and an epidural to make the Dr's. life easier.

I have friends who are nurses who could tell me which physician was known to cut unneeded episiotomies in retaliation for women who "labored too loudly".

I have friends who were experimented on for hours by medical students without their permission or knowledge.

Once I refused a forced catheterization for my 3 yr old son during a hospital stay, after confirming with the lead physician that there was zero reason for it. The other doc just wanted him to pee NOW and he was sleeping after a spinal tap and profuse vomiting. But...

Even though I confirmed zero medical necessity with the lead physician, I got written up in my son's medical records as refusing medical care for him. That can have massive repercussions with CPS, I've seen it happen. And it's now part of our permanent medical history.

I've taken in medical studies directly from government websites to have to prove to Dr's when I'm advocating for someone, that they aren't being honest about the risks of certain medications. Twice after producing info Dr's actually admitted lying right to me.

I have had to physically stand in between medical professionals who categorized a suicidal rape victim as uncooperative, when in fact she was CLEARLY in a flashback, to keep them for pinning her, stripping, and forcibly sedating. She was in a flashback.

They began to call security to physically remove me, but stopped when I told them I was an attorney.

It should never have happened.

I've has hospital attorneys lie to me about their policies and even lie to me about my own physician's recommendations for my care, which I was able to verify with my doctor later. But I was still denied accommodations for my 3rd birth which my PT and OB noted I needed.

I could go on for hours. The fact that over half of medical studies students report doing vaginal exams on unconscious women without their consent after they were sedated for surgery... the almost zero training in trauma and abuse...

The massive uphill battle I constantly face to get adequate pain control for infants and minorities, not because it's too risky to use the medication, but because it's easier not to.

Did you know that routine surgeries like lip and tongue ties are always done with little or no pain medication for infants? Even though adults get full nerve blocks because the procedure is so painful? Yet infants have HUNDREDS more pain receptors? Why?

Because only infants can be pinned down, mouth pried open, and surgery performed and have no recourse.

The science on infant pain being much higher than adult pain is clear. But it's easy to do to infants. So Dr's do, and tell parents it's no big deal because they heal fast.

We have a long, long way to go changing the culture of medicine, to get to stopping all forms of abuse