A new report suggests that medical students are sometimes encouraged to breach informed consent guidelines by their supervisors.
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Academics from the University of Auckland surveyed 93 final-year students - just over a third of the final year.
The peer-reviewed study, published in the New Zealand Medical Journal, indicates the respondents were representative of the entire student population, matching age and gender distribution.
Most students admitted that they were not always compliant with consent guidelines.
The study focused particularly on sensitive procedures like breast, rectal, or genital examinations. Across all of those procedures, except for one, the majority of respondents admitted to noncompliance.
The sole exception was in the case of non-birth related pelvic examinations, which 85 percent of respondents said they always performed with proper informed consent.
During breast exams, on the other hand, only 17 percent said they always sought consent.
Students noted that their clinical decisions were strongly influenced by their supervisors. Some said they were pressured to forgo informed consent, with one student noting that they were coerced into performing an unconsented rectal exam on an unconscious patient.
Students described some supervisors as indifferent and unsupportive of the consent process. "I explained the University policy, but he wasn't concerned," wrote one student.
The report also points towards power imbalances, with respondents noting that they felt unable to challenge their seniors.
"I often felt unable or unwilling to question seniors even though I was aware the consent process was not followed," wrote another.
The journal's authors have suggested a review of the survey's findings to provide a safer environment for students and their patients.
*This article has been edited to clarify that the survey was carried out by University of Auckland staff.