and Your Modesty
Surgeons, nurses, and other medical
professionals rarely talk about patients’ modesty for
procedures. However, with proper communication and education
that patient can have maximum modesty for many procedures. For
example, during a colonoscopy
procedure specially designed shorts can be worn and only part
of the buttocks will be exposed.
It is the doctors and their assistants’
jobs to make the patient feel as comfortable as possible. Medical
professionals often skip over details of the procedure and/or
try to make the procedure sound as clinical as possible. In
that effort, many times patients are not told about prepping/positioning
for surgery and during surgery or what parts of their bodies
might be exposed. Maintaining modesty in these instances is
paramount for the patient’s well-being. Wearing underwear
and/or a bra (for women) can effectively ensure this modesty
especially if routine surgical procedure is for the patient
to be stripped naked such as during shoulder surgery.
It is possible for a woman to wear a specialized
bra that covers the breasts but allows full access to the shoulder
being operated on. One Illinois orthopedic surgeon invented
a special bra for his female shoulder surgery patients after
he received concerns from his own employee who felt uncomfortable
letting him operate on her shoulder due to exposure of her breasts.
Watch a video of this orthopedic surgeon who invented the Modesty
At many hospitals once the patient is in the
operating room his or her gown will be removed or pulled up
depending on what parts of the body are being operated on. If
a patient does not have surgery shorts and/or underwear on under
his or her gown the genitals will be exposed for these surgeries
(ex: knee replacement surgery).
Sadly, many people are completely unaware that their bodies
are unnecessarily exposed for surgeries; surgeries which don’t
even involve the patient’s private parts. Some medical
facilities routinely require patients to remove their underwear
for all surgeries. This is ridiculous. Check out our article,
Unnecessary Underwear Removal For Surgeries.
For example: think about a patient who wears no underwear under
his/her gown for knee surgery; when the gown is lifted the genitals
are exposed. Some patients are stripped naked for surgeries
involving a finger, hand, arm, etc. Some surgery patients found
out because they woke up naked before medical professionals
could redress them. A nurse who worked in surgery for many years
made this confession a number of years ago: “They
will wait until you are asleep to remove your gown and place
the catheter and when you wake up you'll have that gown back
on like nothing ever happened.”
When a patient is under general anesthesia and/or does not have
a personal advocate present,
such as a spouse, it is very common for medical professionals
to ignore patient's wishes for a same gender medical team for
surgeries. Multiple medical professionals representing a gender
different than the patient’s gender are often brought
into the OR while the patient is under general anesthesia and
his or her private parts are exposed. There have been some cases
when patients were deceived by medical professionals that their
wishes would be honored and weren’t. This is unethical.
Some examples include: removing a patient’s underwear
and gown while under anesthesia and then redressing him/her
before he/she wakes up; promising a patient a same gender medical
team and then not actually honoring that.
A patient can often find out if his or her wishes
for a same gender team were respected by getting an operative
report after the surgery. This report lists all of people (ex:
surgeon, anesthesiologist, circulating nurse, medical student,
etc.) who were present for the surgery. Also, look at the facility’s
Patient Bill of Rights to learn what rights
patients have. One right is: Know the names, positions
and functions of any hospital staff involved in the surgery/hospital
care and refuse their treatment, examination or observation.
This means that a patient can refuse opposite sex medical professionals
or even intimate exams.
It is common for surgeons to arrive after patients have been
prepped, draped and readied. Sometimes surgeons do multiple
procedures a day—one after another—and they don’t
pay specific attention to prep procedures; they depend on the
OR staff to handle that. A patient may make his or her wishes
known to the surgeon and that surgeon may agree with the patient
keeping his or her underwear on, for example, but then this
request is never communicated to the OR staff. Therefore, when
the patient arrives for surgery prep, if nothing is in writing,
their conversation with the surgeon is often forgotten. The
OR staff then proceeds to prep the vulnerable and scared patient
as usual. This is why we recommend that a patient get a surgery
agreement in writing and also, that a personal advocate be present
in pre-op, surgery, and post-op to advocate for all patient's
rights and requests. Keep in mind that the surgeon will be busy
operating and may not pay attention to who will be on the OR
team. Often the hospital assigns the OR team rather than the
surgeon choosing it.
Check out the blog
of this photographer who took pictures of patients who were
naked for surgeries. One man had hernia surgery. The other man
had surgery on his arm. The man undergoing the arm surgery was
not allowed to wear underwear and surgery shorts. We find this
a ridiculous requirement. Check out the picture
of the man with arm surgery. Notice that a gown on the man
has been removed and placed over his genitals to cover them.
This man most likely had no idea this happened; that his genitals
were exposed as the gown was removed.
Medical professionals often challenge
patients who are concerned about their modesty during surgery
and try to minimize patient concerns by withholding information
about what really happens during surgery. Check out some examples
of ways patients under anesthesia have been violated at this
link: surgery patient violations
in the news.
How to Respond to Arguments
By Medical Professionals:
nudity occur in most major surgeries but the exposure does not
last long (with prompt covering) and during surgery the patient
is fully covered.
Our rebuttal: Many patients do
not want to be exposed even for a few seconds. There are some
surgeries that do require exposure of genitals such as hernia,
gynecological, urological, etc. But there is absolutely no reason
for patients to be routinely required to take off underwear for
many surgeries. In fact, some hospitals have started allowing
patients to wear 100% cotton underwear for certain surgeries.
Check out Unnecessary Underwear Removal
Here’s an example for the doctor who argued
that a patient being exposed for a minimal amount of time is
okay: Let’s say you are showering for work thinking no
one is home. You get out of the shower to find out you forgot
a towel and walk out naked to get one and your female neighbor
who has come to see your wife is sitting there. You then make
a hasty retreat to the bathroom. Does the brevity of your exposure
make it not embarrassing or uncomfortable? There are so many
justifications such as it is brief, we are professionals, we
are used to it, or it is no different than an arm to us.
patient’s modesty does not matter while they are under
anesthesia during surgery because that patient won’t know
Our Rebuttal: Many people feel that their body
is sacred, even when they are asleep. If this warped surgery
modesty mindset were true, why then is it legally not okay for
a male next-door neighbor to view his female neighbor’s
nude body while she is asleep without her consent?
Also, this argument that modesty doesn’t matter when a
person is under anesthesia would mean that all crimes committed
while someone is attacked while unconscious—such as with
date rape drugs—would also not matter because the victim
was unaware of what actually happened. These arguments are—if
carried out to their indicated conclusions—ridiculous.
need access to your groin for any surgeries in case there is
an emergency. The groin - which can be dirty with bacteria—needs
to be scrubbed with antiseptic before the area is covered.
Our rebuttal: Underwear or
shorts can be removed easily and quickly if there is any surgery
emergency. Patients can scrub their groin area with antiseptic
before surgery. In most surgeries the groin will never need
to be accessed. Patient should be able to do as much as possible
to prepare for surgery so they do not have to worry about their
Here are some articles about how patients can
prepare for surgery at home:
the Skin at Home Before Surgery
Many patients are rushed into signing consent
forms without adequately reading them. Also, most surgery consent
forms do not give details about many surgery factors. For example,
there is no known consent form for a urinary
catheterization for surgery. Patients must write on surgery
consent forms that no urinary
catheter may be inserted. All patients should get consent
forms at least one day before the surgery. It is difficult for
patients to object to anything if they are given consent forms
at the last minute.
Please read an example of how a man
was rushed into signing a document when he was about to be sedated.
February 8, 2014 at 1:49 am
Here is the problem with teaching
hospitals. You’re right when you say most patients have
little experience with teaching hospitals. Unfortunately, that’s
the way physicians and these hospitals want it to be. I went
into the hospital where my physician practiced for repair of
an anal fistula. I had no idea of the processes or procedures
and, when told to sign a document while lying naked under a
hospital gown, I just signed it. You guessed it. It
was a consent form that included allowing observers (undefined)
to be present during my surgery. I was wheeled into an operating
room with eleven people in it. Before I could question who these
people were I was injected with versed
and an epidural. I later asked for my medical records, including
those from the operating room, and found out all the disgusting
details. Without my INFORMED consent five nursing students got
to observe a colonoscopy on me I was then put in the jackknife
position, my buttocks were taped open and one of the student
nurses got to do the prep of my buttocks and genitals. I was
completely exposed during this entire procedure for all to see.
I would never have known, thanks to the versed, had I not been
awake long enough to feel the dread before I went out. That
prompted me to investigate.
The dirty little secret
of the medical profession in general is that their idea of informed
consent is to hold back the consent form until you’re
a half hour away from surgery. Mr. Patient, please
sign this 16 clause form which overrides any oral conversations
you may have had with physicians and nurses. In this form you
give up all rights to privacy, modesty and dignity while undergoing
your surgery and while in the PACU.
Don’t believe me? There
is not one hospital or surgery center in Southern California
that provides the consent form on their website. All the other
forms needed to be filled out by the patient before surgery
can be accessed from the web sites. But not the consent form.
This is a morally repugnant practice and destroys any hope for
patient/ provider trust. I know I will never trust the medical
profession again to do what’s right. This is the same
profession that thinks it’s okay to do pelvic exams on
unconscious women without their permission and to do rectal/prostate
exams on unconscious men going in for prostate surgery. This
only ended as a result of legislation expressly forbidding it.
The paternalistic attitudes of the medical profession persist
to this day.
Patients who are sedated or under general anesthesia
are entirely vulnerable because they cannot willingly speak
up for themselves which is why we advocate for a personal
advocate not employed by the hospital to be present during
surgery to advocate for the patient’s wishes.
Less use of general anesthesia and more
regional and local anesthesia will be significant for patient
modesty issues because medical professionals will not have as
much occasion to expose patients who are awake and alert.
Please read Modesty
Concerns for Procedures and Surgeries to get an idea of
what steps to take for ensuring that patient's wishes are honored.
Take time to research what body parts might be exposed for surgery
and how maximum modesty can be achieved.
We recommend that all surgery patients consider opting for local
or regional anesthesia instead of general anesthesia for most
surgeries thus ensuring less patient vulnerability and modesty
violations. Medical professionals will have less chance to expose
patients unnecessarily or ignore patient's wishes if the patient
is awake and alert. Also, there are generally less complications
and a quicker recovery time with regional anesthesia. Surgery
patients who plan on utilizing general anesthesia should contemplate
having a personal advocate
not employed by the hospital present for that surgery to ensure
that requests are not ignored. Insist that they do not give
you an IV until you have been prepped for surgery so you can
observe all of the things they do to you before surgery such
as cleansing your abdomen.
Surgery and Your Modesty video.
Check out some articles
about being awake & nerve blocks for surgeries:
Going Under the Knife, With Eyes and Ears Wide Open
– Notice the picture of a woman watching her doctors operate
on her wrist. She was able to drive herself home after the wrist
surgery because she was not under general anesthesia. Another
man in this article had knee replacement surgery with nerve
blocks and was able to read a magazine while he was being operated
on. This shows that regional anesthesia has fewer complications
than general anesthesia and is less expensive. Recovery time
is swifter and side effects are fewer which can reduce the need
for postoperative opioids.
2.) Watching My Surgeon Cut Into My Knee - A female
patient shared her story about undergoing knee surgery with
a regional block.
Sedation Before Nerve Block Increases Risks, Not Pain Relief
- Dr. Cohen, a professor of anesthesiology and critical
care medicine at Johns Hopkins University School of Medicine
says that while many physicians may use sedation in a sincere
effort to make the procedure less traumatic for patients, there
is also a perverse financial incentive to use it. “Unfortunately,
medicine in many places has become a business. The fact is,
you get paid more money to do the procedure with sedation,”
he says. “The costs of anesthesia can be more than the
fee for the procedure itself. And patients are getting harmed.”
It is interesting that there is a financial incentive for sedation.
Is nerve block anesthesia better for surgery?
Surgery is a multi-billion dollar industry.
Many surgeons and hospitals are driven by monetary gain. Patients
should fight to have modesty wishes—before, during and
after surgery— accommodated. Surgery is a big moneymaker
for hospitals. These facilities will give in to patient modesty
demands if patients stick together and demand these choices.
Canceling surgery is another option if patient's wishes for
modesty are not being honored. Walk out and cancel the
surgery if wishes will not be honored. Find another hospital
and/or doctor willing to accommodate those wishes.
Also, research surgery alternatives and make sure that that
specific surgery is absolutely necessary before moving forward
with it and make it clear that you do not consent to Versed,
a terrible sedative drug that causes amnesia.
Case for Continuous Nerve Blocks - Dr. Nadia Hernandez,
an anesthiologist shared that her anesthesia group performs
10 times as many blocks at the Texas Medical Center's trauma
center than they did when she became director of regional anesthesia
five years ago. She shared that Regional anesthesia is significiantly
less expensive and as safe. "The use of continuous nerve
blocks to manage post-op pain provides many benefits. Patients
require fewer opioids, which lowers their risk of opioid misuse
and eliminates prolonged PACU stays caused by opioid-related
side effects such as nausea, vomiting, urinary retention and
sedation." Notice how Dr. Hernandez said that opoids can
cause urinary retention (this is one of the reasons an urinary
catheter could be needed). The article mentioned that light
sedation could be used for patient comfort. This is concerning
because light sedation could mean Versed,
a horrible sedative that would cause amnesia for patients that
would leave them powerless to speak up.
Underwear Removal For Surgeries
Versed, and Your Procedure
Concerns for Procedures and Surgeries
You Should Have a Personal Advocate For Surgery?
Should You Know Before You Have Surgery
Under the Knife, With Eyes and Ears Wide Open
My Surgeon Cut Into My Knee
Before Nerve Block Increases Risks, Not Pain Relief
nerve block anesthesia better for surgery?
Hidden Dangers of Going Under