Unconsented intimate exams (UIEs) on men and women are known to occur for training purposes and diagnostic reasons, mostly during gynecological surgeries but also during prostate examinations and abdominal surgeries. UIEs most often occur on anesthetized patients but have also been reported on conscious patients. Over the last 30 years, several parties—both within and external to medicine—have increasingly voiced opposition to these exams. Arguments from medical associations, legal scholars, ethicists, nurses, and some physicians have not compelled meaningful institutional change. Opposition is escalating in the form of legislative bans and whistleblower reports. Aspiring to professional and scientific detachment, institutional consent policies make no distinction between intimate exams and exams on any other body part, but patients do not think of their intimate regions in a detached or neutral way and believe intimate exams call for special protections. UIEs are found to contribute to moral erosion and moral distress of medical students and compromise the sacred trust between the medical community and the general public. This paper refutes the main arguments in favor of the status quo, identifies a series of harms related to continuing the current practice, and proposes an explicit consent policy for intimate exams along with specific changes to medical school curriculum and institutional culture. Because patients are the rights-holders of their bodies, consent practices should reflect and uphold patient values which call for explicit consent for intimate exams.

中文翻译：

---

一个被忽视的锅沸腾：持续呼吁明确同意亲密体检

众所周知，出于培训目的和诊断原因，男性和女性会进行未经同意的亲密检查 (UIE)，主要发生在妇科手术期间，但也发生在前列腺检查和腹部手术期间。UIE 最常发生在麻醉的患者身上，但也有报道称发生在清醒的患者身上。在过去的 30 年里，医学界内外的几个政党越来越多地反对这些考试。医学协会、法律学者、伦理学家、护士和一些医生的论点并没有推动有意义的制度变革。反对正在以立法禁令和举报人报告的形式升级。渴望专业和科学的超脱，机构同意政策不区分亲密检查和任何其他身体部位的检查，但患者不会以超然或中立的方式考虑他们的私密区域，并认为私密检查需要特殊保护。发现 UIE 会导致医学生的道德侵蚀和道德困扰，并损害医学界与公众之间的神圣信任。本文驳斥了支持现状的主要论点，确定了与继续当前做法相关的一系列危害，并提出了明确的亲密检查同意政策以及医学院课程和制度文化的具体变化。由于患者是其身体的权利持有者，同意做法应反映并维护患者价值观，即要求明确同意进行亲密检查。