(NEW YORK) -- Opening statements in the federal trial of a Manhattan, New York obstetrician/gynecologist charged with sexually abusing female patients highlighted a rare but devastating type of sexual misconduct -- that of a patient by a medical professional.
Robert Hadden, a former obstetrician/gynecologist at Columbia University and New York-Presbyterian Hospital, pled guilty to abusing patients in 2016, but avoided jail time in a controversial deal with the Manhattan District Attorney's office.
Now, he's on trial over federal charges. He pled not guilty to the federal charges, which accuse him of enticing women to cross state lines in order to sexually abuse them. His defense called it a "technical crime."
Obstetricians and gynecologists regularly perform sensitive examinations when patients are emotionally and physically vulnerable. Those exams are medically important, which is why experts say abuse during such procedures is an egregious breach of trust -- in addition to violation of physician ethics and also a criminal act.
"Although sexual misconduct is uncommon in clinical care, even one episode is unacceptable," Dr. Kavita Shah Arora, chair of the American College of Obstetrics and Gynecology (ACOG) committee on ethics, said in an email to ABC News.
Health care providers should always fully explain all medical exams and only perform them with the patient's consent, ACOG said in its position statement on sexual misconduct. Providers should use the minimal amount of physical contact necessary for the exam and a chaperone should always be in the room for all breast, genital and rectal examinations -- regardless of the gender of the patient or health care provider, the group said.
The American Medical Association code of medical ethics recommends that health care providers make chaperones available during exams.
"In my entire career I never examined a patient without my nurse in the room," says ABC News chief medical correspondent Dr. Jen Ashton, who is also a board-certified obstetrician and gynecologist. "That is for both the patient's and the doctor's protection."
Patients can always ask to see a doctor or care provider of the gender they're most comfortable with, the Rape, Abuse & Incest National Network (RAINN) says in its guidelines on sexual abuse by medical professionals. They can also ask for a friend or family member to stay in the room during any type of exam, not just gynecologic exams, RAINN says.
RAINN says that it's unacceptable for providers to refuse to answer questions, conduct exams without gloves, prevent others from coming into the room with a patient, insist on seeing body parts they're not examining, or ask questions that make a patient uncomfortable.
Patients can also end an exam at any time and leave the room, Ashton says.
"If it feels wrong, trust your instincts and sit up -- and end the exam," Ashton says. "Gynecological exams, done properly, take seconds, not minutes -- and they definitely don't feel sexual."
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