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Testicular lumps
Published in Alexander Trevatt, Richard Boulton, Daren Francis, Nishanthan Mahesan, Take Charge! General Surgery and Urology, 2020
Davoud Khodatars, Sarah Y. W. Tang
As part of a full abdominal examination focus on the external genitalia. It is important you offer the patient a chaperone and document clearly if they refuse one. In many hospitals, for doctors’ protection it is stated that a chaperone is mandatory for all intimate examinations.
Chaperones
Published in Paul Lambden, The Osteopath’s Guide to Keeping Out of Trouble, 2018
Sources of chaperones may either be members of staff (in circumstances where there are suitable staff that are available for such duties) or friends or relatives of the patient. There has been discussion about: whether the chaperone should be able to see what is being done or whether it is adequate simply to hear any exchanges between patient and clinicianwhether a chaperone should be in the room in which the treatment is being provided or whether an open consulting room door and a receptionist sitting in a nearby (say) waiting area is adequate.
Trauma in pregnancy
Published in Ian Greaves, Keith Porter, Chris Wright, Trauma Care Pre-Hospital Manual, 2018
Ian Greaves, Keith Porter, Chris Wright
External blood loss from the vagina must be identified with an assessment of the amount and the presence of any clots or active bleeding. There may also be clear fluid if the membranes have ruptured or a yellow-green fluid suggesting meconium staining. There is no indication for a pre-hospital vaginal examination. Verbal consent must be obtained from conscious patients and information provided to the patient and relatives about the need for inspection. The patient’s dignity and modesty must be maintained at all times and another health care practitioner should be used as a chaperone when possible. The patient may refuse or may request a female member of staff.
Serious Ethical Violations in Medicine: A Statistical and Ethical Analysis of 280 Cases in the United States From 2008–2016
Published in The American Journal of Bioethics, 2019
James M. DuBois, Emily E. Anderson, John T. Chibnall, Jessica Mozersky, Heidi A. Walsh
Related to the preceding point, efforts to educate the public about serious ethical violations in medicine and possible warning signs make up a two-edged sword. On the one hand, patients have a right to know this information. Patients should know that some physicians do engage in serious misconduct and they should know, for example, that when an intimate examination is indicated, they have a right to a chaperone, or where they can find information about unnecessary procedures. Knowledge is a key to empowerment. Nevertheless, sharing statistics on serious ethical violations in medicine runs a risk of harming patients if it further erodes trust in medicine, particularly within groups that already access medical care less frequently, and that adhere to physician recommendations less strictly, due to mistrust (Blendon et al. 2014; Ferrera et al. 2016; Khullar 2018). Problems may be particularly acute in medically underserved areas where patients may have few choices among physicians; in such cases, is it beneficial to promote concerns about physicians who fit a common profile in our studies (e.g., are trained outside the United States, are not board certified, and are male), when patients may have no choice to change physicians and when the majority of physicians who meet this profile never generate complaints with their state medical board? Withholding information on serious ethical violations would seem overly paternalistic, but promoting information about these matters could have unintended consequences for patients.
Lessons learnt: ophthalmology service organization, single-center experience from a COVID-19 highly affected area
Published in Expert Review of Ophthalmology, 2021
Mario R Romano, Alessio Montericcio, Luca Pagano, Raffaele Raimondi, Davide Allegrini, Gabriella Ricciardelli, Martina Angi, Vito Romano
The patient and doctor’s dress code has not changed after easing of the lockdown. Patients who are requested to come to the hospital for a visit must sanitize their hands and wear a surgical facemask; if they are not already wearing one, they will be provided with one at the entrance of the clinic. In addition, chaperones are allowed only for minors and patients who cannot manage alone. The patient is asked to explain symptoms before or after the examination to avoid conversations with patients during the slit lamp examination. Slit lamp examination and direct ophthalmoscopy require contact between clinician and patient that is much closer than that encountered in most face-to-face medical consultations. Since tears may represent a possible transmission route, we also avoid multi-dose dilating eye drops [8]. All healthcare workers wear surgical facemasks and goggles that have good adhesion to the face. The goggles can be reused after proper disinfection. [8] Alternatively, it is possible to use disposable face shields, although these may prove to be uncomfortable for ophthalmologists. Hand hygiene with alcohol hand rub and glove changes after each patient are crucial [9]. Breathing shields have been installed on all slit lamps, which are cleaned and disinfected after every patient. All healthcare workers wear scrubs, plus disposable aprons and gowns for body protection, which can be changed after each patient appointment. We also recommend keeping all the doors open in order to enhance ventilation and reduce contact with surfaces. Privacy is still achieved since new protocols lead to minimal presence in waiting areas.
Sexual Modesty in Sexual Expression and Experience: A Scoping Review, 2000 - 2021
Published in The Journal of Sex Research, 2022
J. Dennis Fortenberry, Devon J. Hensel
Sexual modesty is often explicit in reasons for forgoing or delaying health care by women (Vu et al., 2016). A majority of women express preference for women clinicians although exceptions may be made for life-threatening conditions (Alqufly et al., 2019; McLean et al., 2012; Padela et al., 2012). Even peripubertal adolescent girls voice preference for women during genital examinations, citing immodesty of being viewed by a male as a reason (Robbins et al., 2012). “Desexualizing” and therefore reducing affronts to sexual modesty in physical examinations is attempted by professional attitude, emphasis on privacy, and by use of chaperones (Giuffre & Williams, 2000; Guimond & Salman, 2013). Although people expect a family member as chaperone during all physical examinations without regard for the examiner’s sex, many are comfortable without chaperone if the examiner matches the patient’s sex (Fiddes et al., 2003). Men sometimes prefer same gender concordance in choosing physicians for genital and anorectal examinations based on shared experiences rather than sexual modesty per se (C. E. Dubé et al., 2005). Sexual modesty may also influence gender composition of the health-care workforce. In nursing, for example, sexual modesty is an implicit reason that both women and men prefer female nurses unless they have previously received care from a male nurse (Adeyemi-Adelanwa et al., 2016; Sundus & Younas, 2020). However, in some settings, care by male nurses is rejected for provision of intimate care (Duman, 2012; Inoue et al., 2006). Male radiographers may have limited training and experience with mammography because they may be less acceptable to patients (Ashton & Warren-Forward, 2019).