Medical Chaperones in Intimate Exams: An Analysis of the Perception, Experience, and Needs from both the Provider and Patient Perspectives

Nouri Alhachami – University of Missouri; Sandipta Ghosh – University of Pittsburgh

Abstract: Policies and laws regarding medical chaperones in intimate medical exams have been slow to emerge. There have been fewer than 26 articles across the world discussing this topic since the Me Too movement revitalization in 2018, despite acknowledgement by the American Medical Association regarding patient reports of sexual assault by practitioners. Staffing issues are a primary constraint to implementing mandatory medical chaperone policies during exams. On the flip side, if a patient is comfortable with their practitioner, shouldn’t they be allowed the right to privacy? Organizations are confronted with questions such as whether medical chaperones policies should be an opt in/opt out approach, what the documentation requirements should be, and what the appropriate qualifications of the medical chaperones should be. Philosophically, it is unclear if medical chaperone policies are intended to protect patients, providers or both. In this paper, the authors summarize the ethical issues related to medical chaperones in intimate exams. The researchers then share data from the 359 patients and 106 providers surveyed over the course of one year to determine the collective perception, experience, and needs of each group. Analysis of this data reveals there are inconsistencies in how, why, and when providers utilize chaperones in intimate exams as well as patients’ perception of the purpose of medical chaperones and their experience in this area. Future directions discussed in the paper will help inform new policies in this area that will meet the needs of both patients and providers.

Keywords: Medical Chaperones, Clinical Ethics, Ethical Issues related to Intimate Exams