{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:26:18Z","timestamp":1791347178136,"version":"4.3.1"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T00:00:00Z","timestamp":1607126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australas J Ultrason Med"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The intimate examination is an important component of the assessment of a patient presenting with obstetric or gynaecological concerns. Ultrasound practitioners, like any other medical practitioner, are in a unique and privileged position. During the examination, the sonographers engage in a very close and personal interaction with an individual whom they have likely never met. They are also most likely unfamiliar with their social situation, cultural background, previous experiences with the healthcare profession and more importantly, any history of sexual trauma. It is an extremely sensitive area of practice which places a great deal of responsibility on the clinician to ensure that they not only protect their patient from psychological distress, but also themselves, from the threat of litigation arising from such distress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This paper highlights the current governance requirements for sonographers and makes suggestions to support them in safeguarding their patients and themselves from allegations of unprofessional conduct, until such a regulatory body exists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A wide\u2010ranging review of the literature exploring the perceptions of female patients regarding intimate sonographic examination was performed using standard search engines. Additionally, grey literature was searched for policy statements and government regulatory documents for guidance on the topic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Although much research has been undertaken in this field across diverse cultures and knowledge in this area is ever increasing; however, the guidelines for sonographers appear to be site specific and variable. At present, there is no overarching governance for sonographers, as there is with practitioners registered with the Australian Health Practitioner Regulation Agency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>While there are practice standards for the purposes of Medicare set out by the Diagnostic Imaging Accreditation Scheme, there is no regulatory professional standard that sonographers are held accountable to. This is problematic and has the potential for inadvertent boundary transgression by the practitioner, as there is also no existing framework for management of such incidents in an equitable manner.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The intimate examination is generally well tolerated; however, there is a subset of the population who are vulnerable to psychological distress arising from the examination. The sonographer must be astute to signs of distress and act in accordance with the intimate examination guidelines set out by AHPRA, for the dual purpose of protecting their patients against harm and also themselves from the threat of litigation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajum.12234","type":"journal-article","created":{"date-parts":[[2020,12,6]],"date-time":"2020-12-06T02:43:57Z","timestamp":1607222637000},"page":"5-12","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Dangers in the dark: Calling for a safer practice of transvaginal ultrasonography"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4399-3167","authenticated-orcid":false,"given":"Kelly","family":"Collins","sequence":"first","affiliation":[{"name":"Wesley Hospital Auchenflower Queensland Australia"},{"name":"University of Queensland St Lucia Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3773-8132","authenticated-orcid":false,"given":"Tina","family":"Hamlyn","sequence":"additional","affiliation":[{"name":"Redcliffe Hospital Redcliffe Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6961-0902","authenticated-orcid":false,"given":"George","family":"Bruxner","sequence":"additional","affiliation":[{"name":"University of Queensland St Lucia Queensland Australia"},{"name":"Metro North Mental Health Service Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9816-3734","authenticated-orcid":false,"given":"Alka","family":"Kothari","sequence":"additional","affiliation":[{"name":"University of Queensland St Lucia Queensland Australia"},{"name":"Redcliffe Hospital Redcliffe Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,5]]},"reference":[{"key":"e_1_2_15_2_1","unstructured":"Australian Heath Practitioner Regulation Agency.Sexual boundaries in the doctor\u2010patient relationship.2020. Available from:https:\/\/www.medicalboard.gov.au\/Codes\u2010Guidelines\u2010Policies\/Sexual\u2010boundaries\u2010guidelines.aspx. [Accessed January 20 2019]"},{"key":"e_1_2_15_3_1","unstructured":"Association AS.Code of Conduct for Sonographers 2014. Available from:https:\/\/www.sonographers.org\/public\/12\/files\/Our_Profession\/ASA_Code_of_Conduct_2015.pdf."},{"key":"e_1_2_15_4_1","unstructured":"Health TDo editor.The Diagnostic Imaging Accreditation Scheme (DIAS) 2020."},{"key":"e_1_2_15_5_1","unstructured":"Association AS.Standards of Practice Australasian Sonographers Association;2014. Available from:https:\/\/www.sonographers.org\/publicassets\/44e8b2a1\u20101c6f\u2010ea11\u201090fb\u20100050568796d8\/ASA_Standards_of_practice\u20102015.pdf."},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1742271X16676223"},{"key":"e_1_2_15_7_1","unstructured":"Public Statement and Statement of Decision in relation to Mr Samir Ishak 2019. Available from:https:\/\/www.hccc.nsw.gov.au\/Hearings\u2013\u2010decisions\/Public\u2010statements\u2010and\u2010warnings\/Public\u2010Statement\u2010and\u2010Statement\u2010of\u2010Decision\u2010in\u2010relation\u2010to\u2010Mr\u2010Samir\u2010Ishak."},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.1983.2.3.r26"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.48.5.385"},{"key":"e_1_2_15_10_1","unstructured":"PalmerJBC ChildA HaslamA LongE CongM McPhersonJ RobertsonA SandersK ShawI WaltersW.The RANZCOG code of ethical practice.Australia:The Royal Australian and New Zealand Obstetrics and Gynaecology Bioethics Working Group;2006."},{"key":"e_1_2_15_11_1","unstructured":"General Medical Council.Intimate examinations and chaperones content 2020. Available from:https:\/\/www.gmc\u2010uk.org\/ethical\u2010guidance\/ethical\u2010guidance\u2010for\u2010doctors\/intimate\u2010examinations\u2010and\u2010chaperones. 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