Here’s the news story. It’ll turn into a free-registration-required archive page in a couple of days, so here’s the summary:
Woman has obstetrician. Obstetrician believes strongly in current effort to limit damage awards from medical malpractice suits. Pressures woman to agree with him using pamphlets and other means. Eventually asks woman to sign petition. Woman refuses. Obstetrician says, You’re not my patient any more, I’ll provide a referral to another obstetrician and emergency care for 30 days, but otherwise don’t come back.
Kosher?
Note that this is not a debate on the merits of the issue of limiting malpractice damages. If you want to argue that, take it elsewhere.
This is about a doctor who refuses to treat a patient because of a difference in political beliefs. If you’re getting hung up on the medical-malpractice issue, just imagine it’s something else: a peacenik doctor who drops a patient because he sees all the flags and yellow ribbons on the patient’s car, or a pro-life doctor who drops a patient because of the patient’s NARAL t-shirt, or a doctor who drops a patient because the patient won’t sign up for the Sierra Club or the NRA; pick your political poison.
The basic question: Can a doctor lobby his/her patients for or against political issues while they’re in the medical office for care? And if the patients disagree, can the doctor dump them?
In this case, the doctor didn’t dump every one of his patients who refused to sign the petition; he retained the patients who declined but expressed sympathy to the case. This patient argued with him, so he booted her.
Discuss.
(If you want to Google up other news links, the doctor’s name is Mulholland, the patient’s name is Chavez, and the city where this happened is Richland, Washington.)
Doctors are not slaves; they should be free to treat whomever they please. There are some exceptions as regards protected classes: doctors cannot exclude based on race, for example. But the peacenik doctor should be free to refuse his warmongering patients and the HCI doctor free to drop hia NRA patient.
Now, I think those doctors are foolish in the extreme, utter idiots. But I wouldn’t legally compel them to treat people under the conditions described in the OP.
Some people can’t be discriminated against while others can? I lump “all humans” as a protected class. The doctor is wrong. Certain professions require that you not refuse to serve people arbitrarily, this is one.
Do you believe that anyone who wants to practice medicine should be free to do so without having to complete medical school, residency, and the boards?
(I admit that individual states may have licensing requirements that impose duties on doctors beyond this basic requirement, and so in some states, it’s possible you may be right). But as a general proposition, legally speaking, you’re wrong.
You may claim that morally, you’re right.
I disagree.
Since there is no source of moral authority and direction that we can both agree upon as authoritive, we will simply have to leave it as a disagreement.
Provided he is an independent doctor (that is, not directly employed by a clinic/hospital/HMO), I don’t see that it would be unethical - provided that other, adequate health care is available for the person and the doctor assists with the transition (transfer of files, etc.). While I believe that there is an additional burden on medical professionals than there would be for most businesses, telling a doctor he must serve everyone (outside of emergency situations) regardless of his personal feelings toward them is an abridgement of his right to freedom of association.
The situation is obviously different if the patient’s medical resources are limited (only doctor in a remote Alaskan village, only qualified specialist, etc.).
As far as the lobbying - I would think it has no place in the examination room, where the patient is in a vulnerable position. Distributing literature or asking to sign a petition in the waiting room would be acceptable, because the patient would be able to respond on an equal footing.
In the specific case referenced, I believe the doctor is in breach of his duties because the client is experiencing a medical issue (pregnancy) that requires consistent monitoring, and passing off to another provider in the midst of caring for that issue for non-critical reasons is neglectful.
Once the doctor has accepted the case, I see the point that he has a strong obligation to finish it. And it’s not like he’ll be tying himself down for years. He can swallow his ire for the remainder of the pregnancy and treat her, since he undertook the case in the first place. I agree with that.
What precisely does that question have to do with the ability of a licensed medical doctor to pick and choose whom he will treat on a normal, non-emergency basis?
The doctor may indeed be a flaming jerk, but rights-wise, why should doctors in private practice be compelled to treat someone they don’t want to treat? If he was in an HMO or something similar where he legally contracted to service a specific cohort of patients, his rights to pick and choose would probably be more circumscribed, and I would imagine tossing patients for political beliefs would be frowned upon by the HMO and might get him removed as service provider.
Personally, I think doctors should be free to pick their patients. In this case, at least the guy offered to treat her for a reasonable time until she found another doctor. I didn’t see where it said the woman was pregnant, btw. And if she was, there’s no reason that another doctor couldn’t pick up the case once that doctor had her medical records (assuming of course that there wasn’t something highly unusual about her pregnancy).
Bricker has addressed the legal questions, but what about any extra-legal requirements to Medical Board* would have that could decertify* the doctor for this type of behavior? Any medical experts around?
*not sure if there is such a board, but I’m assuming there is some governing body…
I had a doctor tell me she didn’t treat “my kind” and that if I didn’t leave her office, she would call security. The religious pamphlets scattered around her waiting room should have been a tip-off before I even saw her.
I left quietly and reported her to the AMA. Don’t know if they took any action, but at least I did file a complaint.
Perhaps if he was the only doctor in the world, I might agree with you.
But look at it this way. Why would you WANT a doctor to treat you if you knew he didn’t want to? If I was a Black guy living in the 1940s, I’m not sure I’d want to have doctors required to treat Blacks. Why put your life in the hands of someone who hates you for the color of your skin? (I pick the 1940s because racism was much more “respectable” back then, and it wouldn’t be as uncommon as it is today to find a highly racist doctor.)
TI have to agree with JerH and Bricker. He has accepted the patient and is therefore oblidged to finish treatment. Doctors do have a right to refuse patients however I think that using the treat of withholding treatment or actually withholding treatment to lobby their political beliefs is morally wrong and should be a punishable offense.
While I believe that Bricker is correct, in that the law imposes no duty to refrain from such discrimination (in general; some jurisdictions may impose such a duty, but I’m not an expert on medical regulation), but I am equally convinced that it is immoral for a doctor to place conditions on whom he treats beyond those forced by economic reality.
I don’t think it should be illegal for a doctor to refuse treatment to anyone, for any reason (including sexual orientation, religious belief or lack thereof, race, etc.), except in emergencies where not acting would result in death.
I prefer my bigots to be upfront about their beliefs, and would much rather a doctor say “Sorry, I don’t treat racial epithet” then have his prejudices manifest themselves in more subtle and potentially harmful ways.
That is a very good point. You don’t want to mess with the hand holding the scalpel. On the other hand, if things went sour medically, at least you’d have no misgivings about suing the pants off him. There are some cases where the lack of alternatives could be an issue in more remote areas. If the only doctor in town won’t take you and you need to drive 50 miles to deliver a baby, is it reasonable for the doctor to force that on you?
The various licensing requirements to practice medicine are barriers to market entry, and as such they are a boon to those who have been able to invest the necessary time and money to become a doctor. No one is “free” to practice without jumping through the hoops. You ask why doctors should be compelled to treat someone they don’t want to treat. The fact that only those with licenses are legally allowed to do what they do might, in certain circumstances, be cause for such compulsion.
What if we’re talking about a small town with only one obstetrician and a mother who can’t afford to seek treatment in another location? Should the mother employ an old fashioned midwife? Would the midwife be compelled to refrain from practicing because s/he doesn’t have a license?
The talk of not interfering with a doctor’s right to contract seems overly-simplistic given the legally restricted market. I’m in favor of medical licensing, but the market advantage given by licensing should be balanced by certain responsibilities, and this might be one of them. I’m not really sure of that (Metacom and John Mace have brought up good points), but when deciding this issue, it’s worth considering the market advantages that doctors enjoy.
No, and I wouldn’t think much a someone who did, assuming he just couldn’t physically handle your. OTOH, just because the guy is a doctor, is it reasonable for **you **to force him to treat you? Again, the guy is not your slave.
Suppose the doctor purposely moved to a smal town because he only wanted to work part time. Suppose he engages in research and only has a few hours a week that he devotes to treating patients.
There are two sides to this issue, and I just find it hard to accept that once you become a doctor, you suddenly take on a moral burden that others don’t share. Not everyone is a doctor, of course, but why doesn’t Bill Gates have a moral responsibility to set up a scholarhip fund and recruit doctors to go and live in remote areas where doctors are nonexistent? He could do this with minimal effort. Hell, he could afford to hire someone to do it for him, full time!
Fortunately for us, I think there are very few people who become doctors who aren’t predisposed to wanting to help people. That’s part of the job.