A GP is being asked to apologise to a teenager who underwent a circumcision because he did not act in a respectful or culturally sensitive way.
The 15-year-old underwent the procedure for cultural reasons.
Following the procedure and aftercare, the boys mum lodged a complaint about his care, as well as comments made about her son's weight which were upsetting.
Deputy Health and Disability Commissioner Dr Vanessa Caldwell found the GP made several breaches, including giving the patient the right to information and the right to make a choice and give consent.
On November 1, 2020 the boy arrived at a medical centre for his circumcision with his parents and grandmother.
His family heard the GP, named in the report as Dr B, remark that the boy had not shaved as requested and asked if he'd managed to lose any weight. In an initial consult, they were told the procedure is more difficult in overweight children.
The boys mum said she was troubled by the comment about weight loss, adding that her son was saddened by the comment. She also said he was shy and very nervous about exposing his genitals to the doctor.
Dr B said he did ask whānau to leave the room before he started the procedure for safety reasons due to two recent episodes of fathers fainting.
However, the boy's mum said Dr B did not tell them this until after the procedure had been completed.
She also said that during the procedure, where whānau waited in the corridor area, they could hear the boy grunting in discomfort but Dr B was using humour and laughing during this. Dr B acknowledged that on reflection, a better course of action would have been to invite his parents in to help to settle him.
After the procedure, Dr B said it took so long because the boy's "thighs are so big" and because he was "freezing up".
Then, about 20 minutes after the surgery, Dr B reached out and opened the boy's sarong without any explanation or asking for consent to examine his penis.
"Given the teenager's vulnerability as a young person, the intimate nature of the post operative examination and the presence of the teenager's whānau in the room at the time, I find the GP opening the teenager's sarong without consent unacceptable," Dr Caldwell said in a statement on Monday.
"In my view, although the teenager had consented to undergo circumcision, this did not mean the GP could continue further physical examinations without explicitly gaining consent for each follow up examination.
"The teenager had the right to be informed about the GP's intention to examine his postoperative site, and the reasons for that examination, and he had the right to give or withhold his consent and indeed to request this examination occur more privately.
"Consenting is an ongoing process and care must be taken to protect the privacy and dignity of consumers."
Dr B apologised for having appeared abrupt or rude following the procedure, as well as for any hurt or disrespect felt because of his conduct. He also apologised to the boy's parents for care that fell below the standards he usually sets for himself.
Dr B has since made changes to the way he communicates with patients and will provide more information about consent and what to expect for this kind of procedure.
However, Dr Caldwell made further recommendations including that Dr B make a formal written apology to the boy and his mum, complete a module about giving consent and review guidelines on how to address weight issues in young people and families.
"I encourage the GP to use sympathetic and thoughtful language in the future when advising his patients on sensitive matters including weight loss," she said.
