Tuesday, April 26, 2011

Gender Wars and The Patient Modesty Debate: Sowing Seeds of Alliance

Gender wars can serve a valid purpose. Historically, socially, personally: Their seeds can grow into multi-colored displays of equity or germinate into dominant monolithic icons of power and control. It’s safe to say they will always exist, until we create a third gender to take our frustrations out on.
But are these battles expected to grow out of every situation? Can’t certain struggles simply take root in the duality of cooperation? When we find that we have a common struggle, will we always debase it to whose is worse before we agree to simply make it better for everyone?
The truth is that the “Medical Modesty” gender war has to end, or neither will reap benefits for very long. If we do not defend and help each other we will simply be considered a fad: a temporary and unique ‘genre’ in the medical arena.
A recent example: A few months ago I decided to investigate and collect data on male sexual abuse, the aftermath, and unique stress syndromes that male survivors may experience. Obviously this information would be useful in determining medical modesty preferences (if any), as well as avoidance in seeking care. It is no surprise that this problem is more rampant than generally believed. What is a surprise are the amount of people and sources who want to argue about which gender’s sexual abuse is more important. The issues of privacy, modesty, and respectful care involving abuse survivors quickly becomes a debate between genders: Why females would be/feel more threatened, why men would/wouldn’t have consideration, why would a woman investigate male sexual abuse and whose point of view was I intending to speak for.
And for this I have to ask……. “why”?
Do I really need to pick a gender side to be on? Do any of us really need to stop at the line drawn in the sand, or can we simply advocate for each other? Must we always first decide “who’s ahead” before leaving someone behind? Of course not. We need to stand together as a co-operative unit, support each other, and use our gendered talents for the benefit of each other and not for petty arguments.
*Remember: If the issues are not supported by both genders, then they become less valid for either.
It is not smooth sailing for anyone. Modesty in medicine stems from many reasons and has its unique struggles for each individual. With that, it is our responsibility is to speak up when encountering inequity or abuse. So I would challenge any woman who defends her ethical rights in healthcare to also defend those of the man beside her. And any man who stands up for his modesty/morals in healthcare to do so for the woman beside him as well.
Some issues are larger than gender. They are, instead, desperately human.

Sunday, January 23, 2011

“Sparks” are Still Flying….

Some issues stay alive simply because of the human condition. Others are slowly beaten to death, and then resurrected by new champions. And there are those whose passion seems to invoke a life of their own: filled with players at odds and unrelenting.
Then there are those issues that embody all three.
The story of Twana Sparks, an ENT in Silver City NM, seems to be one of those anomalies. Just when the controversy seems to ebb, it bobs back to the surface for redress when new opinions flare. Like it or not, and many do not, the debate storms on.
Sparks was accused of performing non-authorized genital exams on male patients without consent and while they were under anesthesia. While denying any wrongdoing, she did sign an agreed order with the Medical Board which outlines the ‘conditions which Sparks must comply with in order to continue practicing’. Some of those conditions include regular therapy sessions with a psychotherapist, polygraph exams every four months, and not performing any genital, rectal or breasts exams for any reason.
A few minutes spent traveling the blog-o-sphere will find numerous comments from both sides of the exam table, including the paper’s own comment section with over 300 comments to date. (See news story and comments) Here we find posters who regale Sparks with praise as an ‘otherwise’ trusted ENT, and others who believe her license should have been revoked. (Of course there’s some off-topic chatter from those who simply must speak to any occasion available, so be prepared for a few odd forays into weirdness.) All in all, what is interesting are the amount of people willing to acknowledge the possibility of abuse yet ignore it as a sort of collateral damage. Whether guilty or not, in their eyes the risk is worth her care.
So I have to wonder….why are people prepared to give up personal integrity in order to receive expected services? What makes some patients passive participants, either not caring or not wanting to know what happens to their bodies? Why do some find quality care and ethical treatment mutually exclusive?
Medical care already has monetary costs; does it need to have ethical costs as well? The truth is that it doesn’t. While my definition of respectful care may be different than others, most of us will probably agree that abuse is not a characterization of respectful care. Those who wish to sweep the Sparks controversy under the rug are ignorantly harming those who have trust and faith in the ethics of the medical system. Letting one doctor get away with abuse keeps the door open to the passive attitude that allows any doctor to get away with abuse.
Whatever truth lies in the Sparks controversy, no one should be willing (and ready) to trade respect for healthcare. One should certainly not believe that under anesthesia the body cannot be humiliated. No doubt many are wondering if they were part of a childish game led by a person who has no boundaries or moral compass. They may never really know, and certainly that is the scattered bones of abuse.
Hopefully the spotlight will remain on issues such as these, by a few champion posters, until ethics catches up with expectations.

© Suzy Furno-Maricle 2011

Thursday, December 2, 2010

Modesty VS Morals….The Hidden Battle

The various aspects pertaining to the issue of medical modesty can be daunting. While investigating the black and white of it one can trip over an array of gray stumbling blocks. So much so that advocates prefer to keep the subject within one hue, and simply color it “Modesty”. While that is an excellent stand with which to advocate the general subject, many people/patients/clients find that it does not truly express their views. The word ‘modesty’ may not fully convey their needs and struggles for acceptance or understanding regarding respectful care. For them, it really is a moral choice. These decisions need not be faith-based, but are still fully and ethically who and what people choose to be. Or, perhaps these convictions are based on religious edicts, and people have spent their lives protecting that “eternal” path from being carelessly shattered.
Here lies the dilemma of ‘medical modesty’. Have we condensed the modesty issue to such a degree that the significant messages of moral convictions are not being heard? If we insist that modesty be the issue’s main thrust, are caregivers given the opportunity to see the passionate side of morality and damages caused by disregarding it?
The truth is that the medical arena will not respect or defend the decisions of your body the same as you would. Most do not even feel the need to protect your ethical standards unless backed by protocols to avoid legal issues. Instead, they assume the role of psychologist stating that any mental harm while within their walls can be easily discarded. Or perhaps the role of medical pope, absolving you of any actions you deem immoral that they may inflict on you. And marriage councilor, finding any marital damage that stems from their actions to be petty and unwarranted jealousy. Their beliefs become your prison, and this self-serving attitude inflicts damage. So they send broken people home after promising “no harm”, never accepting responsibility for the tornado of emotional or spiritual damage that is now your life.
Caregivers may state that they simply do not have time to consider all of these harms. It certainly seems that if they have time to discount them then they have already found time to consider them. So let’s try to put accountability in their ethics. Let’s let them know the full range of damage that occurs while on their watch. Only when all possibilities are exposed and out of the closet will caregivers ever understand the full ramifications of their actions. Then we can truly and simply color the picture as ‘Modesty’ with full and honest understanding of all the grays.

© Suzy Furno-Maricle 2010

Monday, November 8, 2010

Yes Virginia: It’s a Prostate Exam

A holiday season or so ago I was half listening to the television while stressing over my husband’s Christmas list. What do you get a guy who needs nothing and wants even less? I was still holding out hope for inspiration when an ad with a “merry” tone caught my attention. The ad sported an attractive woman, grinning and practically winking secrets at me. I leaned forward in anticipation: She claimed to have the perfect gift for any man. She then looked directly at me through the camera and said, “Get him an appointment for a prostate exam.”
Rewind. Play again.
“Get him an appointment for a prostate exam.” Yes. That is what she said.
Seriously and what the heck? For Christmas?
Cringing, I envisioned the reaction Christmas morning of men opening small holiday boxes only to find “Happy Prostate Exam” written on appointment cards. What a terrible marketing scheme, unless a pap smear actually made it to her Christmas list.
Nevertheless I started thinking. How many women really think about Men’s Health? How many women know the issues, pitfalls, concerns, drawbacks, and needed reform? Who of us knows hype from help, and why men really avoid healthcare? Although many women just do not talk about it, you and I are going to.
Recent studies have shown that 46-49 percent of males do not seek healthcare. We’ve all read it; we all know it. The simple truth is that this is a healthcare crisis and but for a few changes and choices these men might choose care. Frightening? Think of the top ten men in your life and consider that roughly half of them are not getting medical attention. Perhaps your man is one of the many not seeking care and you find this startling and unacceptable. But before you rush to the phone to make an appointment he will undoubtedly not keep, have you asked him ‘why’ he doesn’t go? Now be prepared because modesty just may be on his list.
*Let’s consider that: The safe feeling you get enveloped in the arms of mostly female staffers may well pose a humiliating problem for him. The ocean of females you encounter in just one visit may seem normal to you, but the intrusion of privacy and modesty may well be the barrier he faces to choosing care. Be willing to listen to his concerns without judgment. His anxiety and preferences are just as real as yours. (How many of you prefer a female OB-GYN?) Stand by his decisions to seek same gender care if it is his preference. Be as involved as you possibly can in the search for choices that he can accept. If it involves making a few phone calls then do it.
*Or: Suggest he make his own appointments. He will get a better idea of who and what to expect, and become more assertive about what he considers respectful and dignified care. Remember, even a male doctor may also mean a series of female techs and support staff.
*And together: Petition the medical community for options that would allow men the same vast choices as women. If we are talking about saving lives then don’t worry about saving face. Be bold. Support him. Stand up and be a Woman.
*Don’t forget: Talk to your female friends and gain support for men facing modesty issues. I’m sure he supports your healthcare preference. It’s extremely helpful to bring this issue up with friends who are caregivers. You will gain insight as to how they view this issue and whether they do/don’t want to change male circumstances.
*Down to Earth: Men aren’t really from Mars Ladies. Nor are they babies, children, or little boys. If they ask us to respect their bodies then that is what they deserve. No chastising, belittling, coercion or bullying. We all have issues that are at core…human.
*Intimacy: No one ever says this one out loud! Some men want to keep intimate exposure between only one woman (you) and them. It forms a bond and strengthens trust. What woman would not want that sort of value and respect placed within their relationship?
*As always: Emergencies happen. Know his preferences. Know his wishes in healthcare situations and don’t forget to tell him yours.
Couples need to be their own best advocates. No one knows your spouse/significant other better than you. No one cares as much and has a more personal stake in each other’s health and lives. Be a team. Be supportive. Show real support for each other’s health by showing real respect for each other’s needs.

© Suzy Furno-Maricle 2010

Thursday, October 28, 2010

Are Women Ready to Sexually "Come Out" Of The Medical Cultural Closet?

Women seek equality, gender equity, and/or equal societal standards. Whatever terms we use, it is certain that we want to be seen for our unique strength and accountable for our weakness. This is the attitude that makes us girls of perserverance and later women of character. But how much truth is involved in equity? Are we willing to set aside cultural norms to achieve raw honesty? Are we willing to be seen as the gender who uses the truth when it is handy only to discard it when it's not?
There are those who seem to see women that way. We say we want all things equal, until equality becomes tough. We want the big jobs as long as they are not too messy. And with the topic at hand, we love the options that allow medical modesty to be easier for us, but are a big part of why it is so difficult for men. Afterall, 94% of nurses are women, and many do not support men's modesty issues or consider it a strong healthcare issue.
Are these people correct? Is this who we are? Or maybe...
Female nurses have always taken care of men, so why the "big deal now" with modesty and embarrassment? We are not a sexual threat. Nudity means very little to us. No need to feel humiliated in front of us.....right? Why does it even matter?
So we ask ourselves why. Why are we the exception? Why are women often considered the sexually benign one in the room? And more importantly, why is this alright with us?
The medical arena often tells us that men are visually stimulated (women not so much) and they must therefore exercise some control over intimate situations involving the opposite gender. We see this attitude often when explaining why females can be used for either gender in intimate situations, and chaparones should be used for female patients involving male care. However, recent studies on female sexuality are finding women to be as visually stimulated as men involving the nude form with physical arousal times virtually the same.
Perhaps it is time for society to reconsider female sexuality and stop the outdated stereotypes that women are physically maternal and only emotionally sexually stimulated. Stop the notion that women only find nude men attractive if they are dipped in chocolate and carrying gifts of strappy shoes. We are sexual. We are neither the neutral or invisible gender in the room, and we will give the same respect to everyone that we deserve ourselves. We are not so different after all.
Men might have a better chance at modesty issues if society were honest about both genders.
Are we ready to be that honest? Or did the big job suddenly become too messy....

Saturday, May 15, 2010

Let's Talk...

Modesty is becoming a controversial topic of discussion, both in the medical arena and patient culture. We seek solutions to questions. Answers for the most common of concerns. The right to be respected in the most basic of human needs.
Let's figure it out together. Let's talk.....