A policy that patients are free to make a request for a chaperone should be established in each health care setting. From the standpoint of ethics and prudence, the protocol of having chaperones available on a consistent basis for patient examinations is recommended. ![]() The Council recommends the following guidelines: Furthermore, their status affirms the formal nature of the examination.” Health professionals are held to standards for safeguarding patient privacy and confidentiality. Unless specifically requested by the patient, family members should not be used as chaperones. The preferred type of chaperone: “Whenever possible, authorized health professionals should serve as chaperones rather than office clerks or family members.Whatever the social custom, it is important that patients from all demographic categories feel comfortable requesting a chaperone.” Custom has dictated that chaperones are most commonly offered to patients of the opposite sex, and more frequently to female patients of male physicians. The nature of the physician/patient relationship: “For a new visit or first-time examination, patients should be apprised of the availability of chaperones.However, there is a general consensus that an examination of reproductive organs (i.e., a pelvic, testicular, or breast exam) or an examination of the rectum heightens the importance of a chaperone.” The perceived intimate nature of the exam: “A sense of invasiveness towards different features of the physical exam can vary among individual patients.To evaluate the need for a chaperone, the Council on Ethical and Judicial Affairs (CEJA Report 10-A98), American Medical Association (AMA) suggests weighing the following considerations: With no chaperone to support the provider, it becomes a “he said/she said” battle. Very often these types of salacious allegations “make the news” and can be detrimental to a provider’s reputation even if the provider successfully prevails against the allegations. Providers can potentially face medical malpractice claims, assault/battery claims, and disciplinary actions by State Boards. The risks to the provider who chooses not to have a chaperone during a sensitive examination are significant. The easiest way to avoid confusion is to ask the patient whether he/she/they would prefer a chaperone who is male or female? Today, consideration must be given to the sexual orientation/identification of the patient and whether he/she/they are/have transitioned. Historically, chaperones were offered when patients were of the opposite sex of the provider and most often when a male provider was performing a sensitive examination on a female patient. Likewise, the chaperone must understand the purpose for being in the room during the examination and stand at a vantage point that would prevent later claims that he/she could not view what the provider was doing. Having this discussion may also increase the patient’s comfort with the presence of a chaperone. Equally important is providing the patient with information about the various types of examinations and the details of what to expect, which can alleviate anxiety and help prevent a misunderstanding as to the appropriateness of certain actions during the examination. It also allows the patient to assume ownership of his/her/their care. Taking steps to help a patient feel comfortable during a physical examination is helpful in building a solid and trusting relationship. it offers advantages in convenience and time efficiency when authorized health professionals serve as chaperones and can assist with procedures such as gynecologic examinations. ![]()
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