How women can identify gynecologist misconduct and abuse

Women may find it challenging to distinguish between appropriate gynecological care and potential misconduct or abuse during intimate examinations. While protocols exist, many patients are unaware of their rights, such as the explanations they should receive before a physical touch, their right to refuse procedures, request a chaperone, or stop a consultation if uncomfortable. Recent incidents, including a case in Salvador, Bahia, where a gynecologist is suspected of secretly filming a patient, have reignited discussions about the boundaries of medical practice and patient rights. Experts emphasize that gynecological consultations require absolute respect for patient privacy and clear communication about every procedure. Questions and examinations should be limited to what is medically necessary, according to Lia Cruz Vaz da Costa Damásio, president of Febrasgo's National Commission for Professional Defense and Valorization. The necessity of physical exams, such as breast or pelvic examinations, depends on the patient's age, complaint, medical history, risk factors, and the consultation's purpose. Contraceptive prescription, for instance, does not automatically mandate a pelvic exam. Patients must be informed about the procedure, its indication, the body parts involved, and potential sensations before any examination. They are also entitled to privacy for changing, adequate covering, and exposure only of the area being examined. Fátima Iyetunde Oladejo, a specialist in medical and forensic expertise from USP, stresses that explanations should be clear and consent sought before each step. The ethical and technical protocols for gynecological exams are designed to protect patients, and deviations can constitute ethical violations or even criminal offenses. The Medical Ethics Code mandates respect for dignity, privacy, and patient autonomy. Key warning signs include initiating an exam without prior explanation, performing intimate touches without authorization, persisting after a patient expresses pain or fear, prolonged undressing, inadequate covering, allowing unauthorized individuals into the room, or making inappropriate sexual comments. Patients have the right to refuse unjustified exams and are not required to undergo intimate procedures to receive prescriptions or medical certificates. Recording or filming during consultations is prohibited without explicit consent. Brazilian law also guarantees the right to have a chaperone present during consultations and procedures in both public and private facilities, enhancing safety and transparency, though this does not replace patient consent. If a patient perceives a departure from protocols or suspects misconduct, they are advised to interrupt the examination if safe to do so and leave the premises. In immediate risk situations, contacting the military police at 190 is recommended.