Samantha Seybold

The pelvic exam is used to assess the health of female reproductive organs and so involves digital penetration by a physician. However, it is common practice for medical students to acquire experience in administering pelvic exams by performing them on unconscious patients without prior authorization. In this article, we argue that such unauthorized pelvic exams (UPEs) are sexual assault. Our argument is simple: in any other circumstance, unauthorized digital penetration amounts to sexual assault. Since there are no morally significant differences between UPEs and other instances of digital penetration, UPEs are sexual assault. So, insofar as one is against sexual assault, one should be against UPEs.

Medical students commonly learn how to administer pelvic exams by practicing on unconscious patients, often without first obtaining explicit consent from patients to do so. While twenty-one states currently have laws that require teaching hospitals to obtain consent from patients to participate in this educational experience, opposition from the medical community has stymied legislative progress. In this paper, I respond to the two most common reasons offered to oppose legislation, which appeal to (1) the educational benefits of these exams, or (2) protecting institutional autonomy. Kantian ideas about autonomy help to illuminate the problematic ways in which these arguments supplant the importance of women’s choices over how their bodies are used while seeking medical treatment. Ultimately, neither argument offers sufficient reason to oppose laws that require explicit consent before administering training pelvic exams.

This paper poses a series of objections to Sofia Jeppsson’s hard-line reply to Pereboom’s four-case manipulation argument. According to Jeppsson, the compatibilist can resist Pereboom’s argument by disregarding facts about what caused an agent to act (the ‘causal perspective’) and focusing primarily on the agent’s own perspective of their action (the ‘agential perspective’). Jeppsson argues that we have an obligation to disregard the causal perspective. This is for two reasons: (I) we must disregard the causal facts of the agent’s action, including whether they have been manipulated, since the agent has reason to disregard them; and (II) the causal perspective is not obviously relevant to judgments of moral responsibility. In this paper, I show that both (I) and (II) can be undermined because the causal perspective provides information that is necessary for moral deliberations. This is because it would seem that at least one necessary condition for an agent to be considered morally responsible is that the agent’s actions are not fully controlled by someone else. Since this is information that we can only obtain via the causal perspective, we do not have an obligation to disregard this perspective and so need not accept the compatibilist’s hard-line account.