If you have gone to a doctor for a health concern that is unrelated to your reproductive health, and if you do not want a pap test/pelvic exam/STD test, but find your doctor pressuring you into one – even after you have already said no – then here are three ways to combat the doctor’s unethical behavior:
1) Bring a tape or digital recorder along on your visit. Some cell phones have one built in but if you need to purchase one they are fairly inexpensive. You can put the recorder in a discreet location such as a pocket, bag, or propped in an outer purse pocket. This way if your doctor refuses to treat you based on your decision to decline a pap test/ pelvic exam, and the health condition you had gone to see your doctor for worsens – or if you end up in emergency due to being ousted from your doctor’s office – then you will have recorded proof of the doctor’s unethical behavior. Recording a conversation without the doctor’s knowledge is legal in most countries as long as you are involved in the conversation, but check to determine laws in your own country.
2) Bring a companion along on your visit. With a second person present the doctor will be less likely to be aggressive regarding a pap test/vaginal exam. If the doctor refuses to allow your companion into the consult room, leave and find a different doctor. If you have brought your recorder with you, try to get the doctor’s response on record.
3) Prepare a typed or written document and ask the doctor to sign it, for example:
I, Doctor ____________, am refusing to treat the following patient ____________, on this date_________, based on the patient’s refusal to consent to an optional cancer screening test (undergo a pap test/vaginal exam).
Of course the doctor will most likely refuse to sign such a document, but simply preparing the document and asking the doctor to sign it will help isolate and highlight the doctor’s unethical behavior.
Information on informed consent for cervical cancer screening: http://www.kevinmd.com/blog/2009/11/informed-consent-missing-pap-smears-cervical-cancer-screening.html
Research regarding unnecessary pap tests/vaginal/bimanual exams: http://forwomenseyesonly.wordpress.com/2012/09/30/battle-brewing-over-pointless-pelvic-exams/
Story of doctors bullying women into pap tests: http://forwomenseyesonly.wordpress.com/2012/10/17/what-some-male-doctors-do-when-women-say-no/
Sue, another great article.
Given they don’t play fair, I think women should do whatever they feel comfortable doing and saying to avoid being pressured or coerced into pap testing. (or anything else) I know women who say they were tested while overseas, know they’re HPV negative (which normally throws our doctors, we’re not supposed to understand the significance of that)…they’re menstruating, they’re in a rush, they only see a female doctor or their regular doctor for that sort of exam. Or you can set out the research in writing and test the water…is this a doctor who’ll respect your wishes? Or, discuss the matter with the doctor when the subject arises…again you’ll know pretty quickly whether this is the doctor for you. I’ve found doctors rely on our ignorance and retreat quickly when faced with an informed woman…and some GPs simply don’t know the facts, they’ve accepted the “facts” as well. Others take the view while the program is in place, it’s safer for them to recommend it, or if there is some benefit, no matter how small, they should keep recommending it…a bit concerning when most don’t mention the rareness of the cancer or the risks associated with testing.
I haven’t been able to post over at Blogcritics for a few days, my comments have been blocked…I’ve sent an email to their technical people and hopefully, I’ll be online again shortly. I’m sure you didn’t think I’d run out of things to say…
Elizabeth, I also have not been able to post a comment. And now when I click on my bookmark for the most recent page I am taken to a different page/site. That’s a first! Have you heard from the technical people? And you’re right, I didn’t think you had run out of things to say
They asked me to try and post another comment, no luck…the
problem still hasn’t been sorted out and I’m also having trouble loading the site. My husband jokingly said Papscreen have paid a hacker to shut down the site. Once that would have wiped out almost all of the available real information, now there are several places, including your excellent site, where women can visit and read critical comments and real information…we’ve definitely made progress. Hopefully, we’ll be back online shortly..
Some more news in the right direction – the Scottish will raise the starting age for cervical screening to age 25, in line with England. It’s amazing that some countries still screen those under 25, harm for no benefit at all.
Of course, there is no evidence of benefit up to age 30 and now we know it’s only about 5% of women aged 30+ who are HPV positive that have a small chance of benefit…most women are not even at risk. That’s how concerning the situation is…they begrudgingly “release” women from the program…all that money from over-treatment lost to them.
http://www.gponline.com/News/article/1163720/Scotland-raises-cervical-screening-age/#disqus_thread
I suspect the reason there are so many places for women to access real information is in large part due to you and other pioneers and your tireless efforts to inform and educate. I know I would not have started this site if I did not have access to blogcritics and support from all the amazing women who post there. And there might be some truth to what your husband said – but good luck with that, we have gotten too big to sweep under the rug that easily!
Thank you for the link – it certainly brightened my day. My favorite piece of the article was this one:
“Evidence considered by the NSC showed cervical cancers among women under 25 were extremely rare and most abnormalities clear up on their own. Screening this group would mean a high number would be unnecessarily referred for further investigation, leading to anxiety, the committee said.”
How about that, they are admitting cervical cancer is EXTREMELY RARE among women under 25. However, they still don’t highlight the fact that it is extremely rare amongst ALL age groups. Cervical cancer does not suddenly or magically become rampant after age 25.
I keep waiting for others to make their way here and am hoping they remember how to get here! I still am not able to access the site but get directed to a different site instead.
Sue, one of the major problems is the imprinting of women, they then pass on their fears and lecture their daughters and other young women.
This is a thread I found disturbing…
http://able2know.org/topic/166140-6
I got this response,
“@Eliz52,
I think your single mindedness diatribe is dangerous. But continue to parrot your beliefs and have
the preventable illnesses and deaths of the women you counsel on your shoulders. Hope it helps you sleep at night.”
Some women are unreachable, but it’s worth the fight to help those with an open mind and the next generation of women. Hopefully, they won’t spend their lives in stirrups and having “treatments”.
I marvel at your website…I use the computer a lot, but as far as setting up a website, sorting out graphics etc, well, it’s beyond me. It really is comforting to know some tech savvy women are also, informed women…and I love the snowfall feature.
Elizabeth I found it! It was in the spam section but buried in there where I didn’t see it. Anyway I rescued it – as always it’s a beauty. And thank you for the comments about being tech savvy and I’m glad you like the snow.
I like to practice resisting pressure from other people in all kinds of situations. Although people sometimes catch me with my guard down and I have to remind myself to be strong, I find the more I practice, the easier each new situation becomes.
For instance, when someone offers me one of those discount cards at a store that would require me to give my address and phone number, I say, “No.” When a salesperson in a store asks me if I need help deciding what to buy, I say, “I’m okay. ‘just browsing.” When a “boss” at work tells me to do something that I find unethical, I say, “Umm…I may not be comfortable with that, ethically speaking.”
I stopped flying once those TSA pat-downs started in the U.S. I flew once, back when they only required baggage to be searched and didn’t physically touch people, and that was annoying enough, but once the pat-downs became a possibility, I decided they’d gone too far. I refuse air travel. It’s a boycott. Let the airlines go bankrupt until they learn how to treat people with respect.
I once tried to get a prescription for contact lenses fulfilled and found the person I was dealing with to be kind of rude. After a few minutes, I just interjected that I was no longer interested, asked for my prescription papers back, and walked out. I don’t care if it’s socially awkward.
Social pressure is tough because there’s an unconscious element to want people to like you, and you feel the urge not to hurt people’s feelings either, but if you don’t stand up for yourself then people will be able to do whatever they want with/to you, and you won’t be in control of your own life. That’s why I think you should always be prepared to say “No.” and always be prepared to walk away from any situation that makes you uncomfortable.
Personally, I don’t want a world full of submissive women. I want a world full of women who know how to say “No.”
A horrible example of pelvic gone wrong exams made it into the news today with the headline:
Dr. Chung gave patient unnecessary pelvic, rectal and breast exams, disciplinary hearing hears.
Amongst the witness testimony – the physician would prescribe small quantities of birth control pills and require refill in 2 to 3 months time, and then be subjected to pelvic and breast exams.
The full story (warning – the material is disturbing) is at: http://www.thestar.com/life/health_wellness/2013/04/10/dr_chung_gave_patient_unnecessary_pelvic_rectal_and_breast_exams_disciplinary_hearing_hears.html
How was this doctor exposed for what he did? It appears that a witness (possibly a medical assistant) validated the patients’ complaints. What if there was no witness? Of course, the women who complained would have their complaints taken seriously (insert tones of sarcasm) because the system is designed to support them (again note the sarcasm). Unfortunately, the complaints process is stacked against women who complain, and complaints seldom seem to carry much weight unless they include a reputable witness, physical evidence (DNA from semen on the woman complainant in one case) or a tape/video-recording.
Also – pretty sure many of the women victimised by the physician tried to say no, or questioned the need for the exams, but their conditioning (“trust me, I’m a doctor”), and the system (pap screen pressure, pelvic exam linked to pap screen propaganda and pressure made it very difficult for them to prevail. Even if they said no, unlikely that no would be accepted as “no”.
All this = REALLY AGREE WITH THIS POST!
Know your rights & be prepared to actively defend them.
Have a witness/companion, a tape recorder, or any other support that you need to defend your rights. Informed dissent sometimes requires more than a polite “no”. At least it would have with Dr. Chung.