Abstract：
AbstractObjective: We performed this study to examine patients\' choices to permit or refuse medical student pelvic examinations under anesthesia (EUAs) during planned gynecologic procedures.
METHODS: We conducted an exploratory retrospective chart review of electronic consent forms at a single academic medical center using contingency tables, logistic regression, and nonparametric tests to explore relationships between patient and physician characteristics and consent.
RESULTS: We identified and downloaded electronic consent forms for a census of 4,000 patients undergoing gynecologic surgery from September 2020 through calendar year 2022. Forms were linked to anonymized medical record information. Of the 4,000 patients, 142 (3.6%) were removed from analysis because consent forms were incomplete. Of 3,858 patients, 308 (8.0%) were asked for EUA consent more than once, 46 of whom were not consistent. Overall, 3,308 (85.7%) patients consented every time asked, and 550 (14.2%) refused or limited EUA consent at least once. Nine patients limited their consent to female students, and two patients refused medical student participation at all. We performed exploratory multiple logistic regression analyses exploring differences in rates of consent across patient and physician demographic groups.
CONCLUSIONS: We find that some patients are more likely than others to refuse a pelvic EUA, magnifying the dignitary harm from a nonconsensual invasion of intimate bodily integrity and perpetuating historic wrongs visited upon vulnerable people of color and religious minorities. Patients\' rights to respect and control over their bodies require that physicians take seriously the ethical obligation to inform their patients and ask them for permission.
METHODS: We conducted an exploratory retrospective chart review of electronic consent forms at a single academic medical center using contingency tables, logistic regression, and nonparametric tests to explore relationships between patient and physician characteristics and consent.
RESULTS: We identified and downloaded electronic consent forms for a census of 4,000 patients undergoing gynecologic surgery from September 2020 through calendar year 2022. Forms were linked to anonymized medical record information. Of the 4,000 patients, 142 (3.6%) were removed from analysis because consent forms were incomplete. Of 3,858 patients, 308 (8.0%) were asked for EUA consent more than once, 46 of whom were not consistent. Overall, 3,308 (85.7%) patients consented every time asked, and 550 (14.2%) refused or limited EUA consent at least once. Nine patients limited their consent to female students, and two patients refused medical student participation at all. We performed exploratory multiple logistic regression analyses exploring differences in rates of consent across patient and physician demographic groups.
CONCLUSIONS: We find that some patients are more likely than others to refuse a pelvic EUA, magnifying the dignitary harm from a nonconsensual invasion of intimate bodily integrity and perpetuating historic wrongs visited upon vulnerable people of color and religious minorities. Patients\' rights to respect and control over their bodies require that physicians take seriously the ethical obligation to inform their patients and ask them for permission.
摘要：
摘要目的：我们进行了这项研究，以检查患者在计划的妇科手术中允许或拒绝医学生在麻醉（EUA）下进行盆腔检查的选择。
方法：我们使用列联表对单个学术医疗中心的电子同意书进行了探索性回顾性图表审查，逻辑回归，和非参数检验，以探索患者和医师特征与同意之间的关系。
结果：我们确定并下载了电子同意书，用于从2020年9月到2022日历年接受妇科手术的4,000名患者的普查。表格与匿名医疗记录信息相关联。在4000名患者中，142份(3.6%)被从分析中删除，因为同意书不完整。在3858名患者中，308（8.0％）多次被要求获得EUA同意，46人不一致。总的来说,3,308（85.7％）患者每次询问时都同意，和550（14.2%）拒绝或限制EUA同意至少一次。九位病人只同意女学生,两名患者拒绝医学生参与。我们进行了探索性多元逻辑回归分析，探索了患者和医生人口统计学组之间同意率的差异。
结论：我们发现一些患者比其他人更有可能拒绝骨盆EUA，非自愿侵犯亲密的身体完整性和延续历史性的错误，放大了尊严的伤害，这些错误发生在有色人种和宗教少数群体的弱势群体身上。患者尊重和控制自己身体的权利要求医生认真对待告知患者并征求他们许可的道德义务。
方法：我们使用列联表对单个学术医疗中心的电子同意书进行了探索性回顾性图表审查，逻辑回归，和非参数检验，以探索患者和医师特征与同意之间的关系。
结果：我们确定并下载了电子同意书，用于从2020年9月到2022日历年接受妇科手术的4,000名患者的普查。表格与匿名医疗记录信息相关联。在4000名患者中，142份(3.6%)被从分析中删除，因为同意书不完整。在3858名患者中，308（8.0％）多次被要求获得EUA同意，46人不一致。总的来说,3,308（85.7％）患者每次询问时都同意，和550（14.2%）拒绝或限制EUA同意至少一次。九位病人只同意女学生,两名患者拒绝医学生参与。我们进行了探索性多元逻辑回归分析，探索了患者和医生人口统计学组之间同意率的差异。
结论：我们发现一些患者比其他人更有可能拒绝骨盆EUA，非自愿侵犯亲密的身体完整性和延续历史性的错误，放大了尊严的伤害，这些错误发生在有色人种和宗教少数群体的弱势群体身上。患者尊重和控制自己身体的权利要求医生认真对待告知患者并征求他们许可的道德义务。
