The presence of a third party during breast and pelvic examinations.

MARCH 2003 The Society of Obstetricians and Gynaecologists of Canada would like to emphasize that a complete medical examination should include a breast and pelvic examination. The following recommendations are made to physicians regarding clinical examination in the office and hospital setting: 1. It is a reasonable and acceptable practice to perform a breast and pelvic examination without the presence of a third person in the room unless the woman or health-care provider indicates a desire for a third party to be present. 2. If the health-care provider chooses to have a third person present during all examinations, the health-care provider should explain this policy to the woman. 3. If the woman desires a third party to be in the room, her wishes should be respected. She may select the person of her choice. 4. Discussion about the presence of a third person in an examination room should stress both the woman’s and the healthcare provider’s choices. That choice should be offered to the woman by one of the following means: • the health-care provider may display a sign explaining the choice within the office, • the woman may be verbally offered the presence of a third person in the examination room, or • the staff may document within the office chart the woman’s choice with respect to third-party presence, such that the health-care provider is made aware of the woman’s choice prior to seeing her. 5. In the absence of an examination room separate from the health-care provider’s office, the health-care provider should leave the room before the woman undresses. Proper gowns or drapes should be available for the woman undergoing a pelvic and breast examination. If the examination area is within the health-care provider’s office, a curtained area should be available where the woman can dress and undress in privacy within that office space. 6. The health-care provider should respect the wishes of the woman regarding privacy during history-taking and physical examination. Many women may not wish to have a third person in the examination room, so that they can discuss personal or intimate matters with the health-care provider alone. Health-care providers should be sensitive to this wish, and respect it as much as possible. However, the health-care provider should use caution at all times to avoid any potentially compromising situation. 7. If the health-care provider or the woman wishes to have a third party present, the health-care facility must provide it.