Tighten legislation regarding consent for gynaecological surgeries

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Currently in the UK, it is legal for women to be subjected to invasive intimate examinations and procedures whilst under general anaesthetic without their explicit consent - be it written or verbal. 

On 16th February 2019, I underwent a diagnostic laparoscopy (exploratory keyhole surgery described as the “minimally invasive, gold-standard” procedure in the diagnosis of endometriosis), at Norfolk & Norwich University Hospital for unexplained pelvic pain. I awoke with the translucent hospital underwear around my knees; bleeding and in relative discomfort. Four months later, I was shocked to discover that I had been placed in the lithotomy position, was given multiple internal examinations whilst unconscious, cervix dilated and a uterine manipulator inserted. No explanation of the aforementioned was given to me prior to the surgery, nor was the nature of the procedure adequately depicted on the leaflet provided and all of the above remains absent from the NHS website.

Upon asking the surgeon why I was not told anything intimate would occur (and was wrongly lead to believe the surgery was within the confines of the abdomen), I was given the response: "It slipped my mind. It would have been more painful for you if you were awake. Pre-operatively, you did not tell me of any procedure you did not wish to be undertaken." The Trust made it clear that any verbal acknowledgment to future women could not be guaranteed, given there is no formal protocol to be followed when explaining the details of a surgery (and despite the NHS website stating consent must be obtained on the basis of an explanation by a clinician). Understandably, a thorough investigation as to the issue is the primary concern. However, should this take precedent over surgeon/patient trust and transparency? Does the fact a patient is in an unconscious state remove the right one has to their liberty and autonomy in regard to their bodies? Instantly I felt a rush of concern for other girls/women who had undergone the same surgery, perhaps none the wiser to the full extent of their procedure. 

With 1 in 5 women having experienced some form of sexual assault since the age of 16, a safety net ought to be provided for these individuals in particular whereby such an event occurring could be triggering and potentially detrimental. No ethical gynaecologist would perform any examination or procedure intimate in nature without the explicit consent of a conscious patient: the same courtesy should therefore apply to women when at their most vulnerable.

I am calling on Matt Hancock to make any form of penetration known as an explicit part of the consent form process for gynaecological surgeries - as communicated by the performing surgeon via pre-surgery information - purely to avoid unnecessary shock and confusion. Relying on an individual verbalising the entirety of what a procedure entails off their own accord is a slippery slope that is often missed. In this scenario, this is simply not sufficient.

Please sign so that girls and women are aware as to what they are consenting to before undergoing general anaesthetic. #InformedConsent