Chamber: Any form of sexualized behavior during gynecological examinations is a particularly serious form of violence against women

Any form of sexualized behavior in gynecological examination situations represents a particularly serious form of violence against women, because it relies on the asymmetry of power, abuse of the profession, and the vulnerable position of the patient, the Commission for Ethical Issues and Deontology of the Medical Chamber of Montenegro announced today.

The commission issued a statement regarding the arrest of gynecologist P. J. by the Podgorica police, suspected of illicit sexual acts.

The Commission for Ethical Issues and Deontology of the Medical Chamber of Montenegro said that they had received a report from a patient who stated that a doctor "touched her inappropriately after completing a gynecological examination at a private health institution" in Podgorica.

"According to the documentation, it is concluded that the patient experienced unwanted physical contact of a sexual nature, verbal comments and behavior that could have caused feelings of fear, confusion and humiliation at a time when she was completely exposed, vulnerable and in a dependent relationship with the doctor. As it was later learned, the case has since been reported to the competent Basic State Prosecutor's Office for further action," the statement states.

The Commission for Ethical Issues and Deontology of the Medical Chamber of Montenegro added that accordingly, they do not prejudge the outcome of the proceedings, and that they fully respect the presumption of innocence, and that they will not comment on the criminal and legal aspects of this case.

"However, given the gravity of the allegations made, the Commission for Ethical Issues and Deontology believes that it is necessary to react in a timely and principled manner from the sphere of professional ethics and deontology, given that, if the competent institutions determine the accuracy of the allegations, the described conduct would represent one of the most serious violations of medical ethics, patient rights, and international professional and human rights standards," the statement reads.

The Commission for Ethical Issues and Deontology of the Medical Chamber of Montenegro states that The Code of Medical Ethics and Deontology of the Medical Chamber of Montenegro clearly stipulates that a physician is obliged to respect the rights, freedoms, autonomy and human dignity of every patient, as well as to be guided in his work by the principles of beneficence, causing the least harm and the principles of fairness.

"A physician is also obliged to use all his or her abilities to preserve the reputation and dignity of the profession, as well as the noble tradition of the medical profession, maintaining high standards of professional work and ethical behavior towards the patient. In addition, the code prohibits any abuse of the medical profession, stipulates that doctors' decisions must be based exclusively on procedures that alleviate suffering and achieve health, while respecting the rights, freedoms, autonomy and dignity of each patient, and that the professional relationship of doctors towards the patient must not be conditioned by any unethical reason. The provisions of the Code of Ethics are binding for all members of the Chamber, and disciplinary liability is provided for violations of the provisions of the Code of Ethics, including more severe measures," the Commission said.

They also state that the Law on Patients' Rights guarantees respect for human dignity, physical and psychological integrity of the patient and protection of these rights, the right to safety during medical procedures, as well as the patient's right to freely decide on everything concerning his or her life and health.

"Acting without medical purpose and without consent, in the intimate context of an examination, represents a direct violation of these norms," ​​the statement from the Commission for Ethical Issues and Deontology of the Medical Chamber of Montenegro reads.

The commission also said that the Criminal Code of Montenegro prescribes the punishment of acts against sexual freedoms, in terms of illicit sexual acts, as well as sexual harassment, and that it particularly emphasizes the inadmissibility of abusing one's position in this context in a relationship of subordination or dependence, as can be perceived in the relationship between a doctor and a patient.

"The International Code of Medical Ethics and the Declaration on the Rights of Patients of the World Medical Association oblige physicians to adhere to appropriate professional boundaries, and emphasize that a physician must never engage in abusive, exploitative, or other inappropriate relationships or behavior with a patient, and must not engage in sexual intercourse with a current patient. The patient's right to dignity, autonomy, and privacy must be respected at all times, and the physician is obligated to respect all other human rights of patients, as well as all other highest standards of professional and ethical conduct, and must especially avoid acting in a manner that may undermine public trust in the medical profession," stated the Commission for Ethical Issues and Deontology of the Medical Chamber of Montenegro.

The statement also states that the Istanbul Convention (Council of Europe Convention on preventing and combating violence against women and domestic violence), which Montenegro has ratified, and is also a binding document – ​​clearly recognizes sexual violence against women in healthcare institutions as a form of gender-based violence, emphasizing the obligation of institutions to protect, empower and refer victims to adequate services.

"Given the nature of a gynecological examination, strict respect for the boundaries, purpose of each medical procedure, and informed consent is crucial. Any physical procedure outside of a medically justified action and without explicit informed consent falls outside the scope of legal and ethically permissible procedures," said the Commission for Ethical Issues and Deontology of the Medical Chamber of Montenegro.

The Commission for Ethical Issues and Deontology concludes that, in the context of a gynecological examination, where patients are predominantly women, any unwanted touching of a sexual nature represents not only a violation of ethical norms, a violation of the law and a potential criminal offense, but also a gender-based violation of dignity, autonomy and safety, which is in direct conflict with obligations under national and international ethical and professional codes and standards.

"Any form of sexualized behavior in gynecological examination situations represents a particularly serious form of violence against women, as it relies on power asymmetry, abuse of the profession, and the vulnerable position of the patient. Abuse of power in such a space can have long-term consequences for mental health, lead to distrust in the healthcare system and avoidance of healthcare. The Commission emphasizes that healthcare institutions must be an absolutely safe environment for all patients, especially female patients, and every doctor must be a person of unwavering professional and ethical integrity," the statement reads.

The Commission for Ethical Issues and Deontology of the Medical Chamber of Montenegro emphasizes that any form of sexual violence, sexual harassment or sexualized behavior towards patients is absolutely unacceptable, and that it strongly condemns any form of gender-based violence, especially in the context of gynecological examinations.

They also stated that they insist on zero tolerance for the abuse of professional power and that they respect the presumption of innocence, but emphasize that such allegations - if proven - deserve the strictest condemnation.

The Commission for Ethical Issues and Deontology of the Medical Chamber of Montenegro said that it is considering the report of this case, which relates to a potential violation of the Code of Medical Ethics and Deontology, and that, upon assessment, it will submit its opinion to the competent body of the chamber.

The commission said they guarantee that they will take all measures to protect patients' rights and the integrity of the medical profession.