IEEE Women in Engineering Magazine - December 2023 - 28

Whistleblower Film Festival, the Audience
Award at the Worldwide Women's Film
Festival, and the Spirit of Activism Award
at the Nevada Women's Film Festival.
The film informs audiences about the
issue of nonconsensual exams but is also
the starting point for advocacy work that
A'magine and Bergan hope will make the
practice illegal across the United States.
Asking to Be Asked
A'magine and Bergan have spent years
raising awareness about this issue. Still,
educated people are consistently surprised
and horrified to learn that medical
students are learning on nonconsenting
anesthetized patients. The typical response
is disbelief and then anger, and
then it becomes personal. " I can literally
see the wheels turning in their brain as
they're thinking, 'Oh my God, did this
happen to me?' " says Bergan.
A goal of the film, therefore, is helping
people understand what informed
consent " really means " and what it is that
patients are signing up for when they enter
a hospital. But there's more: much of
the film is about the experiences of medical
students and the system in which they
have found themselves. Medical students,
the film shows, often do not feel that they
have a choice.
As A'magine explains, when students
are told to practice their bimanual exam
on an anesthetized patient who did not
give consent to a pelvic exam, because of
the structure of the medical system, the
students are expected to follow instructions.
This practice is not confined to teaching
hospitals, and it's not confined to procedures
related to genitalia. It does not
only happen to women, but to men and
trans folks as well. It occurs at all hospitals,
from the smallest clinics to the largest
hospitals. " It mainly depends on where
their preceptor got trained and if their
preceptor thinks that it is a good way to
teach, " A'magine explains. Often, she says,
it's not happening across the board at a
facility, and students in the same medical
class will have different experiences.
According to The Journal of Surgical
Education, recent peer-reviewed research
shows that 84% of medical students have
practiced without consent like this on at
least one patient. Twenty years ago, the
research showed that number at 90%.
" It's a negligible difference in 20 years, "
A'magine says.
Although it was challenging to find
women to talk about their experiences
for the documentary because women
are not informed of the practice, Bergan
and A'magine interviewed three patients
who discovered, postprocedure, that
they had been subjected to gynecological
exams. One was in for a gastrointestinal
procedure, another for knee
surgery, and a third for undiagnosed
stomach pain. Although the three
women discovered what had happened
to them in different ways, there was
one commonality: none were told upfront.
One abdominal patient found out
only because of a verbal slip-up when a
resident remarked that the patient had
started her period. When questioned
how they could know this, the resident
explained that they had noticed when
they had inserted the speculum.
" It generally doesn't go in the chart, "
At Your Cervix is a social justice film
about the gynecological teaching method,
still legal in many states in the United
States, of practicing on anesthetized
patients without prior consent.
28
A'magine says. " It's not usually notated
even though it should be. "
" It's often times sadly very sneaky. It's
not above board and that's something
we're working toward, that transparency
that patients deserve, " says Bergan.
IEEE WOMEN IN ENGINEERING MAGAZINE DECEMBER 2023
Consent and transparency are critical
to a patient's mental health. All three
women interviewed in the film had experienced
a history of sexual violence. All
three women experienced posttraumatic
stress disorder symptoms after their hospital
experiences retriggered trauma.
" We're asking for people to be asked.
It's not that hard. They act like it's asking
for so much. On the consent form, there is
some vague statement that students will be
involved in your care, " says A'magine.
" It does not say you will receive one,
three, or five extra pelvic exams by medical
students, " adds Bergan.
A'magine calls At Your Cervix a " huge
social justice film, " and " just the entryway "
to the advocacy work they are doing
to make the practice illegal in all 50 states.
Today, the practice of performing gynecological
exams without consent is already
illegal in 23 states, although Bergan says
there are different levels of enforcement,
and many of the laws could be strengthened
with more inclusive language. Their
goal in each state is a law outlining a clear
consent process that would be a separate
and discrete process from the other general
surgery consent forms a patient signs
when entering a hospital or clinic.
In May 2023, Colorado became the
22nd state when new legislation was
signed into law by Lt. Governor Dianne
Primavera in her capacity as acting governor.
" Written from scratch, " this law is
the strongest one yet in A'magine and
Bergan's opinion. It includes whistleblower
protections, a clear consent process, and
liability for lawbreakers that puts the licenses
and accreditation of the institution
on the line. " It's a really strong law
that we hope will be a model law for the
country, " A'magine says.
It's challenging work, and some states
move faster than others. Missouri Governor
Mike Parson signed a bill into law
in July 2023, making Missouri the 23rd
state. A bill in Pennsylvania is currently
making its way through the House and
Senate. The bill in Kansas ended up stuck
in committee, and, despite a strong start
IEEE Women in Engineering Magazine - December 2023

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