Patient modesty concerns pertaining to surgery

[creinkent]

Want to get feedback about how we all handle pt concerns about modesty and/or being naked as part of surgery. Concerns about who sees them and for how long? Why do they need to be naked? When is the gown removed, etc? How much do you tell them? How do you handle pt that is concerned about students practicing pelvic exams on them without concent? How to handle the situation when after the surgery they realize they had been "exposed"?

[orsonic]

The "double standard" is very common in american medicine and alive and well in the ultimate form, male genital mutilation on helpless babies who never give consent, commonly called circumcision because it sounds a lot less barbaric. Of course we all instantly realize how horrible it is it it is done to baby girls. I imagine this comment will be quickly removed with the excuse that it doesnt fit with the thread (but it does). It is just too horrible to face the fact that millions of men have had their genitals forcably mutilated by the medical profesion. They would not ever submit to it as an adult so it is forced on them as a baby and the doctors pretend that it was "informed" consent from their parent. Of couse the doctor wouldn't cut of any other healthy body parts of the inocent baby with the parents consent, just the most pleasurable part on a male baby, the frenulum of his member. too bad he wasn't born a girl!

[CaDad]

hmmmm-your right-and personally, I am a Dad and me and my sons all preferred the circumcision. I did take the time to ask them what they thought and so you have it, Most guys prefer it also-it would be different if it was otherwise.

[morte, LPN, LVN]

hmmmm-your right-and personally, I am a Dad and me and my sons all preferred the circumcision. I did take the time to ask them what they thought and so you have it, Most guys prefer it also-it would be different if it was otherwise.

but it is not an infomed dec......and it is "preferred" because the person knows no other way to exist/feel.

[advo-kate2]

good article imawonderer. we should note:

"without a word, one of them - a man - leaned over ms. duffy, pulled back her blanket, and stripped her nightgown from her shoulders."

so, to me, the article does begin with a bit of a gender overtone. not carried throughout, but present.

i would have liked to have seen incorporated here an obsevation from a male point of view, but perhaps at the time the article was written the newness of gender issues still seemed predominately/only/most importantly/ female.

i hope things are changing.......

[tbrd450]

good article imawonderer. we should note:

"without a word, one of them - a man - leaned over ms. duffy, pulled back her blanket, and stripped her nightgown from her shoulders."

so, to me, the article does begin with a bit of a gender overtone. not carried throughout, but present.

i would have liked to have seen incorporated here an obsevation from a male point of view, but perhaps at the time the article was written the newness of gender issues still seemed predominately/only/most importantly/ female.

i hope things are changing.......

yes!.. good point.

the relevance in mentioning that it was "a man" (not a "nurse," not a "doctor," not a "medical student") was because in so doing it drives the message home better. it is clearly recognized that when an indignity is endured by a female victim at the hands of a male perpetrator,.. well, it is just understood to be far worse than the reverse.

honestly, i believe that if this were a story about mr. duffy and his female physician, the qualifier "a female" would not even be mentioned. instead, the author would have to make the case absence any gender reference. if a gender reference were attempted in the story, then the author runs the risk of having it backfire.

the false perceptin for many is that males are supposed to be "getting lucky" when they are mistreated by females. and, what is really scary is that even seems to apply to boys (children) being mistreated by women (adults). but, i digress.

when the sufferer/victim is female, and the inflicter/perpetrator is male it is perceived to be far worse than when the genders are reversed. that is just the culture. it is the same thinking that ultimately leads to males arriving in trauma centers uncovered, remaining uncovered, and just generally having modesty concerns minimized relative to female patients.

[tbrd450]

The "double standard" is very common in american medicine and alive and well in the ultimate form, male genital mutilation on helpless babies who never give consent, commonly called circumcision because it sounds a lot less barbaric. Of course we all instantly realize how horrible it is it it is done to baby girls. I imagine this comment will be quickly removed with the excuse that it doesnt fit with the thread (but it does). It is just too horrible to face the fact that millions of men have had their genitals forcably mutilated by the medical profesion. They would not ever submit to it as an adult so it is forced on them as a baby and the doctors pretend that it was "informed" consent from their parent. Of couse the doctor wouldn't cut of any other healthy body parts of the inocent baby with the parents consent, just the most pleasurable part on a male baby, the frenulum of his member. too bad he wasn't born a girl!

As this thread is pertaining specifically to patient modesty I, also, suspect a warning is coming.

However, this sort of post clearly shows that it is futile to discuss something like patient modesty without tackling the obvious double standard. And it is futile to discuss something like the double standard without addressing its scope.

Male genital mutilation is absolutely horrible. It is just one more example of a double standard on which males find themselves at the losing end. It is not so much a modesty double standard as it is a mutilation double standard. There is no valid medical reason to routinely remove boys' membere skin. It is not anyting but painful and unnecessary. It is even risky to some extent. Conducting male genital mutiliation files directly in the face of the medical mantra "do no harm."

Like much of what we, as a society, often do is to try to rationalize the irrational. We couch the mutilation under justifications like it is more hygenic, aesthic, normal and ... well... just because.

By the way, most males walking the planet have their foreskin.

Is "because it looks nicer to my girlfriend/wife" really a good enough reason?

I was in college years ago when I first recall hearing about and discussing female genital mutilation. I was appalled to learn of it, and immediately recognized it as nothing short of barbarism. I recall discussing this with a female friend (a self proclaimed feminist) and we were outraged as we unraveled more and more of the truth behind this third world practice. At the lunch table, another friend interupted the conversation and she asked me directly: Are you circumsized? I paused. Silence. After a little embarrasment at fielding such a question, I answered "yes." She then said "why?" I didn't know how to respond because I instinctively knew that the only answers for that question that I have to draw on are "because my parents had me circumsized." The insightful question sort of took all the wind out of our sails... as I recall now, I think we just switched topics.

A discussion on track within this thread may have no room to accommodate a discussion on male genital mutilation per se, unless done so within the context of ensuring the male infant's mutiliated genitals are quickly covered afterward to minimize his exposure discomfort and embarrassment -- his modesty consideration.

However, within a more free flowing discussion on a topic given wide birth, the latitude to fully explore the scope and magnitude of double standards is legitimate. In such an environment, we are pemitted to go beyond covering the mutilated genitals and asking a much more important question... why is it even done? It isn't done to little girls except in a few remaining ostracized pockets of the third world.

Double standards negatively impact females and males. They transcend society and bleed across all settings, including the medical setting. Why isn't the medical community -- the doctors, nurses, advocates and patients -- outraged over male genital mutilation?

[dianah, ASN]

Thread closed for staff review.