Autonomy suspended: using female patients to teach intimate exams without their knowledge or consent.

Recent reports of medical students performing pelvic exams for training purposes on anesthetized women without their consent have produced a firestorm of controversy and calls for greater regulation. Despite periodic efforts to reform the practice, such unauthorized practice is neither a recent phenomenon nor unique to the United States. Two small-scale studies published in 2003 hint at the extent of this unauthorized practice. In February, Peter Ubel and colleagues reported that 90% of medical students at five Philadelphia-area medical schools performed pelvic examinations on anesthetized patients for educational purposes during their obstetrics/gynecology rotation. Although trumpeted as proof that physicians are