Allegations of sexual abuse in an intensive care unit

Abstract

Objectives 

To describe misperceptions of sexual abuse by critically ill, sedated patients undergoing routine perineal care in an intensive care unit and to offer suggestions for addressing patient allegations of sexual mistreatment in this setting.

Design 

Case reports and discussion.

Setting 

Intermediate care unit extension of a medical intensive care unit at a university teaching hospital.

Patients 

A 57-yr-old man who misperceived rectal intubation as sexual assault while receiving intravenous lorazepam for sedation; a 31-yr-old woman who misinterpreted a perineal bed bath as sexual abuse while receiving lorazepam and fentanyl.

Interventions 

None.

Conclusions 

Under the influence of commonly used psychotropic drugs, some acutely ill, hospitalized patients misperceive routine perineal care as sexual abuse. Because the care that gives rise to mistaken allegations of sexual misconduct is often given in private, and because sexual abuse of patients sometimes actually occurs in hospitals, institutional investigation of these complaints is both sensitive and difficult. Some inpatient allegations of sexual abuse may not be resolvable by any means. Awareness of the potential for misinterpretation of perineal care may help prevent this disturbing phenomenon and promote fair, reasoned investigation when patient complaints of sexual abuse do arise in acute care hosptials. (Crit Care Med 1999; 27:437-440)