Informed Consent for Pap Tests/Pelvic Exams Still Not Offered to Women

New guidelines recommend pap tests every three to five years, but many doctors are continuing to ignore recommendations and to pressure women into yearly testing.  This is not surprising given doctors have a business to run.  Bottom line, however, is the lack of informed consent being offered to women.

Informed consent is defined as follows:

Consent, particularly informed consent, is the cornerstone of patients’ rights. Consent is based on the inviolability of one’s person. It means that doctors do not have the right to touch or treat a patient without that patient’s approval because the patient is the one who must live with the consequences and deal with any discomfort caused by treatment. A doctor can be held liable for committing a Battery if the doctor touches the patient without first obtaining the patient’s consent. Federal Patients’ Bill of Rights legal definition of Federal Patients’ Bill of Rights. Federal Patients’ Bill of Rights synonyms by the Free Online Law Dictionary..

In theory every woman should be offered informed consent prior to doctors gaining access to the most intimate area of her body, but in reality this is simply not the case.  Women are not being given information regarding the facts and potential harms of cervical cancer screening, nor are they being given the right to choose to screen or not – in fact, women often face a penalty of having prescriptions or other healthcare withheld if they refuse screening.

Men, however, are respectfully given information and then offered a choice in deciding whether or not they want to screen for prostate cancer – even though prostate cancer is roughly 19 times more prevalent than cervical cancer.

Do your research,  protect your healthy mind and body. jwh.2010.2349 (application/pdf Object).  Above all, remember that women have the same right to informed consent as men.


  1. When I last saw a GP because of a persistent chest infection, once he’d finished grilling me over my unwillingness to bare my bush for a pap test, he then asked permission to lift my shirt & listen to my chest. Which I had no problem with… but it’s odd, isn’t it? Asking me if it’s ok to expose a little bit of boobage, yet at the same time he expected me to drop my knickers & bare all without batting an eyelid…
    My theory is that it only becomes important for medics to obtain consent when there’s a danger that the patient may accuse them of wrongdoing. We live in such a litigious society now – people are quick to complain if they feel a medic has harmed, neglected or assaulted them, but there’s never any danger of that when it comes to screening, at least when it comes to women’s health ‘care’. After all, the people we trust (well, some of us, anyway) to provide us with information have been lying to us for decades. They’ve been relentlessly churning out the same ‘screening is good, not screening is bad’ mantra for so long now that many people just can’t get their heads around the notion of overdiagnosis – try telling a woman that she may have been butchered because of a false alarm is like trying to tell a two-year old Santa doesn’t exist.
    ‘No! I don’t believe it! I just KNOW it saved my life! Infidel!’
    So… back to the main issue… when we have so many women who have been successfully brainwashed into believing that these god-awful tests can only be beneficial, when women are so pathetically grateful that their lovely GP bullied them into tests because ‘it saved my life’… it’s of no benefit to the medical profession or the screening authorities that are busy gobbling up OUR money to encourage informed consent. That would mean actually admitting that these tests are reliable and hazardous to your health, and we can’t have that can we?

  2. Thanks so much Katrina for this. Drs must be taught very carefully to ignore/downplay/manipulate how women feel about vaginal invasion. Speaking of that, here is an interesting article – yet another dr convicted:
    And an article in support of your comments regarding screening:

  3. This article irked me.
    Women should not be screening out of fear, guilt or because they’ve been told they should, pap tests should only be offered to those women who’ve assessed the risks and benefits and made an informed decision to screen. I’d go further and say pap tests should only be offered to those women aged 30 to 60 who test HPV+…
    Telling women they “should” test is disrespectful and inappropriate…these sorts of articles are used to convince/pressure other women to screen. So a woman has overcome her fear of the test..but has she provided informed consent. Of course not…
    She was prompted to screen after Jade Goody died…did the doctor mention Jade Goody had an adenocarcinoma, and they’re usually missed by pap testing?
    Chances are this woman is HPV- and couldn’t benefit from the pap test anyway, but could have ended up in day procedure. When women stew about this test and greatly fear this cancer, it says to me they’re reacting to the hype and propaganda…after all, is she also, stewing about thyroid cancer? Why not? It’s more likely than cervical cancer.
    The answer: Women haven’t been trained to greatly fear thyroid cancer.

  4. Saw this on a UK Health Forum, great that some women see through the scare mongering and recognize how improper this “invitation” actually is….they “say” they respect informed consent, but then behave like bullies.

    “Dear Doctors,

    Thank you for your recent letter in which you informed me that I am at risk of dying from cervical cancer. I know that you are busy people and it was so thoughtful of you to take time out of your day to remind me of my own mortality. Prior to receiving your letter, I had really been too happy and carefree but this really brought me back down to earth where I belong.

    Although I am a perfectly healthy young woman, I do not feel I have enough fear and anxiety in my life. Please could you also enlighten me about the following possible threats to my health? How liklely am I to die of other cancers? Also, how likely is it that I will die in a car crash?

    After all, my body belongs to you, dear doctors and you know what its best for me. I am sure that, whatever you decide to do, you have my every happiness in mind”

  5. Before my doctor was always pressuring me for a Pap test. I would say no. I even send an anonymous letter saying that one of his patients was a survivor of childhood abuse and what considerations could be made for pelvic exams or just informed consent. Now he is asking me to come in for a “physical exam” from “head to toe”. He gave me some blood tests (glucose, cholsterol) already which I assume we’re fine otherwise he would trying to medicate me. So really is he going to try to give me a pelvic exam (Pap test, bimanual) and breast exam? I do not want those. I cannot even understand why he needs to check anything else since if I knew I had a problem I would see him about it specifically. So is this this just a trick? Now he has me flagged to book a physical in the computer.

    • It’s a trick. You will be ambushed by the doctor and his nurse. He wants you to come in for a “head to toe” physical because HE thinks he is offering you care.

      I assume you are fit and healthy, so why do you need a physical? Yes, he will coerce you into having a pap, pelvic and breast exam, but the only person who will benefit from this exam will be the doc and his bank balance.

      Just say no if you don’t want the tests. What can he do? He can’t force you to have them if you don’t go to his office. If he drops you as a patient, get another doctor!!

    • I totally agree with Mint. Keep in mind that it CAN get steered any which way (to cause pain, injury, maybe “date night” directions, lying about results to try & generate repeat costs, etc…). It doesn’t matter if it has any utility, anyway- this being lauched outside of your discretion.

      It sounds like maybe he’s lashing out against someone trying to not have these tests if he wants to give them. You sent an anonymous letter & he just randomly sends this one out right after? That’s suspect & it does sound like the goal is to “apply influence” in this direction, whether it’s a response to that letter or not.

      By-the-way: What do you mean he has you “flagged” to book an appointment? Like he “pre-scheduled” it?

  6. The modern medical office has electronic not paper files. All the doctors notes are made into a computer file and all the lab reports and reports from specialists are emailed and stored with my computer file. He has some little pop up reminder about paps on it. He even sends a message to his receptionist’s computer to book me for an appointment before I even got to the door.

    Most likely it is about $$$$$ because of the 80 percent rate for pap gives a $2200 bonus for him. Apparently theOntario average for pap is 72 percent and dropping. They want to have 85 percent for the screening programme. Plus it is the power thing he was palpitating my stomache for a problem and he then went down too low and traced over my uterus and ovaries. Somewhat creepy. Difficult to get another doctor right now. Like I am complaining about nothing but I appreciate the support here even if I cannot leave the situation.

    • Why bother with a doctor at tall? Certainly sounds like Canada has a real problem with people being maneuverable as far as medical things go (it’s like assigned seats in school, from what it sounds like). If the medicine is going to be a problem, why not abandon it?

  7. I need some health when I am sick. I just do not want all the screening tests.

    I might not mind a Pap test once in while from a FEMALE doctor just to make sure everything is ok
    . The problem is if it came back abnormal (or false positive) then I would not want any biopsies or conventional treatments. I would use herbs or go to naturopath if I could afford it. So I think why even bother going to get a pap at all. I hate the psychological effect of it plus no symptoms like hapeavy bleeding, pain or abnormal bleeding. Some women soup I’ll say that they had no symptoms but in fact they never had cancer just dyspasia.

    • It makes sense to not bother at all, just lead a less cancerous lifestyle. You’re eventually going to die, anyway- and even if you weren’t, the quality of life is still an important point. You, I’m sure, don’t get liver cancer screenings (sporatically or regularly) and that’s much more common of a cancer to have. I think a lot of things turn into a “right answer” or “wrong answer” kind of thing- like there’s an academic value to it (with medicine, in general- but particularly with this type of subject). The idea that they insubstantiate agency by their discretion is false. That’s a very fancy, lawyer-like way of saying that they don’t kick the chair out from under someone’s decision’s with their bad grade.

      I’ve heard recently that women were made to survive better than men, by-the-way. Might be something to think about.

      I don’t understand your last sentence, though.

    • Moo, a pap test doesn’t guarantee everything is okay, false negatives occur as well.
      Women should be told about false negatives and false positives, otherwise decisions cannot be informed, many women rush into biopsies terrified an “abnormal” result means cancer is likely, others ignore symptoms reassured by a normal pap test.
      The best decisions are made with all of the information, good and bad, and the final decision should rest with us.
      I think many women would be surprised to hear that cervical cancer is rare, the pap test is unreliable and over-treatment is common.

  8. Why there is no informed consent in Ontario Canada with regards to government collecting of pap test information. Any women having a pap test in Ontario is automatically enrolled in Ontario Cervical Cancer Screening Program which is which is administered by Cancer
    Care Ontario. Personal information about a woman: name, address, phone number, pap test dates, results are recorded from 80% of all pap tests. This information is available to all medical caregivers who the patients gives consent to access information. A patient cannot selectively block out a caregiver to the cervical screening information specifically. A woman cannot also access her own information without first sending in a form, presenting appropriate ID and a notarized letter confirming identity. Any information is owned by the government and a woman can never ask to have it deleted or edited (except for address changes).

    This was allowed by government act. So let me post up some of the discussion at the committee for debate before the act was passed. Some discourse from Dr. Ken Shumak of Cancer Care Ontario.
    “The Personal Health Information Privacy Act affects a number of Cancer Care Ontario’s programs and services. For the purposes of this presentation, however, I’m going to focus on one section of the legislation, section 30 in part VI of the act. This section specifically identifies Cancer Care Ontario as an organization to which health information custodians can disclose personal health information without informed consent. My purpose in presenting today is to explain why this provision is critical to Cancer Care Ontario’s ability to provide the people of Ontario with the best possible cancer control services.”…….

    “However, there are some very important programs and activities that require access to personal health information where it is not practical and/or possible to obtain informed consent. Cancer Care Ontario has the mandate to operate such programs. These programs are the Ontario Cancer Registry, the Ontario breast screening program, and the Ontario cervical screening program. “…..

    “First, obtaining informed consent would be the responsibility of health care providers who, in addition to obtaining consent to treat, would have to educate patients about the Ontario Cancer Registry. This would be time-consuming, and it is unlikely that physicians and other clinicians would be willing to routinely obtain consent. Many cancer cases therefore would be lost. Second, if even a small percentage of patients chose to opt out, the registry data would be biased, and in our opinion therefore would be of limited use.

    The same two arguments can also be made in support of the requirement for personal identifiable health information by both the Ontario breast screening program and the Ontario cervical screening program. Let me quote an example. In Germany, where informed consent was required in the 1980s and 1990s, cancer registries collapsed and epidemiological research in that country was halted.”

    He goes on the support some good points. However, having no choice in being part of the registry means that I must submit to continual harassment by doctors who can access my pap screening data while I cannot. So much for Health Privacy Act. I feel as if I have no privacy. So if I answered about how many sex partners I had 20 years ago or other tidbits – is that still in the database for every health care provider I ever use to see? Much of the problem lies in that doctors are receiving incentive bonuses to do pap tests not that there is accessibility to information.

    I am not interested in being an unwilling participant in experiments that Ontario gyncologists are doing on women. Because the treatment and testing protocols are just that: experiments.

    To get informed about pap tests I had to do research on the internet because all my doctor would tell me is that I don’t get a pap test then I will die from cancer. I am not stupid enough to believe that pap test PREVENT cancer like some women.

    • 19 women opted totally out of the cervical program in Alberta, 19, that’s a big lie that 19 people or even 100 would mean you should have no consent and the data is useless and biased. Women are just plain stupid unquestioning sheep falling for these lies.

    • This is outrageous violation of patient privacy, but that’s how it is in countries like Australia or Canada, and there is no politician or bureaucrat that is willing to stick their head out and change anything. Privacy Acts and Privacy Laws are there to describe and legislate how the individuals’ privacy can be infringed and violated, not to protect people from such infringements or violations.

      In Australia, health information is the property of the health provider and/or the government, by law. It doesn’t matter it is very personal and highly sensitive information, it doesn’t matter that the patient paid for it (directly out of pocket or indirectly by feeding Medicare through taxes), the patient has less access to their health information than medical professionals or the govt. And there is no way to control it except for stopping seeing doctors altogether.

      This is damaging the health care accessibility for many people, especially women. I know quite a few women who would like to do an HPV test to know their risks, but they don’t do it because they don’t want their personal information to be entered into all sorts of registers and later used for any dubious purpose the govt sees fit. They already had enough of being Guinea pigs with the pap-screening. They no longer trust a single promise about medical privacy that comes from Australian government.

      At the moment, Australia is in the process of moving from the current voluntary eHealth system to a system that will include everyone who didn’t manage to quickly and explicitly opt out. The government specifically changed the privacy law to allow this to happen (before, it was against the law). They covering themselves up with a carefully crafted “trial”, where the trial sites were purposely chosen to ensure the highest support and the lowest opt-out. Though the very same govt will b1tch and whine about statistical bias when people don’t want to participate in census.

      • Alice
        Have you opted out of e-health?
        I’ve looked at the website and it doesn’t seem possible to opt out yet, it seems they’re still doing a trial and moving from the opt-in to an opt-out system.

      • Elizabeth,
        At the moment, eHealth is still opt-in for all Australians, except for those unlucky Guinea pigs who happen to reside within the trial sites (Far North Queensland and Nepean Blue Mountains). So unless you live in those regions, you are still a free person, and don’t have a forced eHealth account to opt out of.

        However, because these trial sites were chosen carefully to insure maximum support from medical professionals and minimum ability of the population to opt out, it is most likely that the “trial” will be declared successful and eHealth will be forced onto the rest of us. That’s when we have to be vigilant and opt out ASAP, before the government removed the opt-out option altogether.

  9. Ever encounter the fanatic that shows up at your door or follows you on the street frantically trying to convert you to their religion? Seems like my doctor is getting like that with cancer screening.

    Yes I read your propaganda and done my own research but I am never going to join your cult. So hey doc stop preaching. I am tuned out, shutting the door in your face. No convert here.

    • If you don’t mind me asking have you told him your aware of the facts aboutbpaps and what was his reaction. Not that you should even have to explan yourself.

  10. Yes! I recently went to the doctor and told them that pelvic exams are against my religion and I even wrote it on several documents. In my religion, a pelvic exam as a virgin is the same as having sex and it would ruin my life because I would be disgraced and cannot marry.

    Nonetheless, the nurse kept preparing things as if I was getting one and even told me that I would soon be removing my underwear. I ignored her and didn’t even sit on the bed. The doctor simply told me that he was required to offer me a pelvic exam, but if I didn’t want it, I didn’t have to get it. He gave me an ultrasound instead with no problem. I later found out that the nurse deliberately hid the fact that it’s against my religion and just told him I wasn’t fond of the exam but would get it.

    What a freaky nurse!!!

    • That bitch sounds like a vicarious lesbian. Doing everything as if a situation is about to take place is just like talking in fixed situations- it’s a tactic to manipulate you. Jsut like saying “How many should I put you down for?” when someone is trying to make a sale.

      I also would like to ask a question, if you don’t mind: you just got an ultrasound without being pregnant or anything? I ask because it seems that it would be useful for women to be able to customize things that way. I know a lot of things can be done with scans of various sorts & blood or urine tests would work for STDs.

      • Hello, Alex!

        Yes, I received an ultrasound and it is a very viable option for all women except those that have cervical cancer. I went to the doctor for ‘monthly’ pain that could not be controlled by Tylenol. I can’t take NSAIDS because of allergies and I can’t take narcotics due to my religion.

        The ultrasound showed my female organs very clearly – better than any pelvic exam could ever do. Be careful – some doctors will try to trick you into accepting a transvaginal ultrasound – but that is the usage of a ‘male organ’ shaped long probe that breaks the hymen and is thrusted in and out. Luckily for me, the doctor automatically suggested the abdominal ultrasound.

        Actually, pelvic exams are not needed during pregnancy either. The ultrasound shows everything that is necessary to see. The only time that anyone needs to see ‘there’ is minutes before the birth. However, in some states, doctors will take legal action against a pregnant woman that refuses pelvic exams on the grounds of ‘she is putting the life of another on danger’ which results in a court ordered rape. 😦

      • Keepingitprivate and other Americans- do you know about doctors taking legal action against women refusing medical care, specifically pelvic exams? Do you know of any specific cases?

    • That’s pretty fucked-up, but then they don’t step in & block things off when doctors get coercive about things like that. The policy implementation workers seem, honestly, to be cut from the same cloth as the biological manipulators.

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