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Samples, palpation, vaginal examination… During a gynecological or obstetrical examination, which gestures are authorized and which are not? Where does abuse start? Let’s take stock with Joëlle Belaïsch Allart, president of the National College of French Gynecologists and Obstetricians.
While Chrysoula Zacharopoulou, the Secretary of State for Development, Francophonie and International Partnerships, is still being criticized by two patients for gynecological procedures carried out “without their consent”, we asked Joëlle Belaïsch Allart a few questions, to enlighten us on the concept of “rape” in the context of a medical examination.
Why is a consultation in gynecology or obstetrics not a consultation like any other?
Joëlle Belaïsch Allart, President of the National College of French Gynecologists and Obstetricians: It is an intimate examination, which affects the intimacy of women. The practitioner must therefore operate with kindness and respect. This benevolence must of course be mutual.
Where does abuse begin during a gynecological or obstetrical examination?
Joëlle Belaïsch Allart: Abuse is linked to the feelings of the woman. From the moment the patient has an unpleasant feeling, it means that there has not been enough empathy. This feeling is of course personal and subjective.
What is rape during a medical examination?
Joëlle Belaïsch Allart: The law defines the notion of rape as “any act of sexual penetration, of whatever nature, or any oral-genital act committed on the person of another (…) by violence, coercion, threat or surprise“. Reason why a medical examination, carried out without threat, neither surprise nor constraint cannot be qualified as “rape”.
General practitioners, who are taking more and more smears; midwives, who perform many gynecological examinations; radiologists and all other medical professions are exposed to the same problems as those encountered by gynecologists. If all the examinations – and in particular the preventive ones – are called into question… We will no longer be able to do our job and this will turn against the women.
Can you remind us of the difference between “rape” and “gynecological violence”?
Joëlle Belaïsch Allart: Gynecological violence is a lack of benevolence, a lack of empathy on the part of a professional. Nevertheless, in the word “violence”, there is the word “rape”, and this term disturbs me.
We obviously condemn all violence against women, we have heard their complaints. But we must keep a little discernment: these events remain rare. The majority of gynecological examinations go well and surveys show it.
What we would like is to find a more serene climate, to restore the dialogue between patients and gynecologists.
What practices are prohibited during a gynecological consultation? And those allowed?
Joëlle Belaïsch Allart: Everything is summarized in the gynecology or obstetrics consultation charter, which must be displayed in the waiting room. It specifies in particular that the patient has the right to dress and undress out of sight, that she has the right to refuse an examination, that the oral agreement of the woman must be obtained before any clinical examination… Before any action, there must therefore be oral consent and a medical explanation. The specialist must respect the wishes of the patient.
However, I hope that we do not fall into excess and that women are not afraid to consult their gynecologist… Otherwise they risk suffering from it.
When and how should the patient’s consent be obtained?
Joëlle Belaïsch Allart: Consent must be oral. Now, is the oral enough? Asking for a written document from the patient to review is a possibility today, although it would be sad to come to that.
Is the gynecological examination compulsory?
Joëlle Belaïsch Allart: No, of course. For example, for a simple pill prescription, the gynecological examination is not systematic. On the other hand, in certain situations, it is justified, but once again, the woman must give her consent.
Finally, what to do in case of rape during a gynecological examination?
Joëlle Belaïsch Allart: We advise patients to contact the National Council of the Order of Physicians. Their role is to organize conciliation meetings between patients and doctors. The board also monitors compliance with medical ethics.
Gynecological violence: How to react?
Some of this violence is criminally reprehensible: sexual violence of course, but also obstruction of abortion, which is a crime.
If it is not possible to lodge a complaint, this violence can be the subject of a report. at the Regional Health Agency (ARS) or at the National Council of the College of Physicians.
Associations of patients and users can come to the aid of women, such as the CIANEinter-associative collective around birth.