All medical consultations, examinations and investigations are potentially distressing. Patients can find examinations, investigations or photography involving the breasts, genitalia or rectum particularly intrusive (these examinations are collectively referred to as “intimate examinations”). In addition, consultations involving dimmed lights, the need for patients to undress or for intensive periods or being touched may make a patient feel vulnerable.
For most patients, respect, explanation, consent and privacy take precedence over the need for a chaperone. The presence of a third party does not negate the need for adequate explanation and courtesy and cannot provide full assurance that the procedure or examination is conducted appropriately.
A formal chaperone implies a clinical health professional, such as a nurse, or a specifically trained non-clinical staff member, such as a receptionist.
Protecting the patient from vulnerability and embarrassment means that the chaperone would usually be of the same sex as the patient. Therefore, the use of a male chaperone for the examination of a female patient or of a female chaperone when a male patient was being examined could be considered inappropriate.
The patient should always have the opportunity to decline a particular person as chaperone if that person is not acceptable to them for any reason.
In all cases, where the presence of a chaperone may intrude in a confiding clinician-patient relationship, their presence should be confined to the physical examination. One-to-one communication should take place after the examination.
Procedures which are Generally Regarded as Being of a Sensitive Nature:
- Cervical cytology
- Gynaecological
- Testicular
- Breast examination
- Rectal examination