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Are you up to standard? Informed consent and sensitive exams of minor patients

Are You Up to Standard?, July Messenger 2019, Messenger, Professionalism & Standards | Posted July 11, 2019

Standards of practice apply to patients of all ages

When performing sensitive exams on pediatric patients, many physicians will lift the front of the underwear and briefly palpate underneath the garment. This is generally done instead of having the patient disrobe completely when there is a parent or guardian in the room, to minimize the patient’s embarrassment.

However, in light of recent updates to the Health Professions Act, this technique can now have very negative consequences.

Avoid misinterpretation of legitimate medical exams

Good medical practice will usually require an appropriate physical examination, and patients may not understand the purpose or importance of an exam that involves an intimate area of their body. Reduce the risk of a boundary violation and ensure the comfort of your patients by fully explaining the nature and scope of any exam, especially those of a sensitive or intimate nature. When a minor patient is involved, it’s important that both the patient and the parent or guardian understand what the exam entails.

Explicit consent must be obtained for intimate exams

While consent may be implied, explicit consent is necessary for an intimate exam. When explicit consent is provided by the patient (or their parent or guardian), it is best practice to document it in the patient’s record. Please review our advice document on Informed Consent for Minors for more information.

Questions? Please contact Chantelle Dick, CPSA Standards of Practice Coordinator, at

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