Dealing with a racist patient
CVK
Interesting dilemma, from the New York Times Magazine’s Ethicist column:
I am an anesthesiologist at a metropolitan hospital. A patient scheduled for an operation one day requested a female anesthesiologist, a request we were inclined to honor. When the anesthesiologist’s name was given to the patient, she wondered if the anesthesiologist was African-American. When told that she was, the patient demanded a white anesthesiologist. It was 7 a.m., too early to contact hospital lawyers or the ethics board. What should we have done? D.W., Texas
I admire your inclination to honor a request that would put a patient at ease, but such requests are not exempt from moral scrutiny. If a patient told you she would be more emotionally prepared for surgery if she could go out to the hospital parking lot and drive over a couple of puppies, you would not lend her your car. Similarly, you should have rejected her racist request, explaining that the hospital does not consider race when making assignments. (If it did, the hospital could face legal claims from rejected anesthesiologists.)
More after the jump…
Despite your honorable intentions, you were wrong even to grant her request for a female anesthesiologist. We rightly consent to some such demands but not to all and not unthinkingly. Most of us would accommodate a woman’s desire for a female gynecologist, deferring to the patient’s sexual modesty. But few would honor her request for a female clerk in the hospital gift shop. Because an anesthesiologist’s task does not intrude on sexual modesty, it was illegitimate to make sex a factor here. Surely other members of the surgical team were men but were not subject to patient veto.This is an ethically ambiguous area: notions of sexual modesty vary. Even as we become a more egalitarian society, situations remain in which sex has its claim, but these should be few and as time passes, fewer still.
UPDATE: Despite finding the patient’s request objectionable, the doctors decided to grant it.
Anonymous wrote:
http://www.andrologyjournal.org/cgi/content/full/25/2/178
http://cavalierdaily.com/CVArticle.asp?ID=17149&pid=1057
A similar thing happened right near Philly (Abington Hospital) - it’s a huge medical complex with tons of offices in a fairly diverse middle-upper class area. A white couple comes in for delivery of their child and insist that only white doctors, nurses, and orderlies attend the mother and the child.
Personally, I would have told the racist couple to go see how the parking lot could accomodate their labor and delivery, but the hospital caved, at least initially, and faced law suits as a result from AA staff.
Posted 07 Jul 2006 at 3:52 pm ¶
Lyonside wrote:
Crap… that was me…
Posted 07 Jul 2006 at 3:54 pm ¶
Merq wrote:
uhh… lyonside?
i don’t get it.
Posted 07 Jul 2006 at 5:04 pm ¶
Ann wrote:
Anoymous:
“…but the hospital caved, at least initially, and faced law suits as a result from AA staff.”
Serves ‘em right that they were sued by the AA staff.
Who the hell are you most responsible to in matters of medical competency?
Some racist piece of s++t couple or your own employees?
I vote we go with the respectful (and intelligent, non-litigation sanity) treatment of the staff working at the hospital who know what they are doing.
I mean, hell, the staff had at least 8-10 years of medical schooling, internship/first-year residency.
Who the hell are you going to be afraid of the most?
Racist white couple?
Or AA staff?
“Nurse! Nurse! Get a gurney, and get it stat! We need to transport these creatures out to the back alley behind the wastewater treatment plant where they belong!
“Sorry AA staff. We acknowledge your intelligence, your competency and your feelings.
“Don’t wanna be part of no lawsuit!”
Posted 07 Jul 2006 at 7:16 pm ¶
Rachel S wrote:
This cases are not that infrequent. There was a high profile case in Detroit when I lived there. Hospital staff put up a sign saying no Black nurses were to care for a particular patient because that patient suffered delusions about Blacks. They were bascially trying to defend racism as a sort of mental illness.
Posted 08 Jul 2006 at 12:51 am ¶
Meg wrote:
but if a ‘non-white’ was the only one capable of helping in an emergency i’d bet there’d be no objections. If their house was burning down do u think these white patients would say, “sorry fellas, only the white ones can help put it out.” Are there actual ethical guidelines on this - as in official ones from state registration boards, ama or something. If it’s set down that patients have the final say in their treatment then change may have to come from there and not the individual hospitals.
Posted 08 Jul 2006 at 3:32 am ¶
Lyonside wrote:
Merq: I’m “Anonymous” because my computer at home doesn’t remember my username, evidently… my work one, however, does…. hrm. Wonder if that’s a security risk…
Posted 08 Jul 2006 at 10:25 am ¶
Lyonside wrote:
Meg: There are no rules by law as to what a patient can demand. If a patient objects to something in the hospital that is not related to the type of care and competence (provable), then they are free to move to another place, but the hospital is not liable. Especially in today’s managed care setting, the standards of care are usually written out or otherwise the same from patient to patient. Basically, you have to exhaust the normal channels and treatments before moving on to something more radical.
The ONLY way I could ever see either scenario playing out in favor of the bigot AND the staff is this way: There is a verbally or even physically abusive patient. Maybe s/he picks on minorities, or women, or people under 30, whatever. As a worker, I’d probably appreciate the management telling the staff that this person had a problem, that it may cause offense, that because of the Hippocratic oath the hospital was treating them anyway, but that the staff has the right to have someone else do the work if they felt uncomfortable or offended. If they wanted to still work with the patient, then that would also be their right (hell, it might be BETTER for the patient). But then at least control wouldn’t be with the patient, but would remain with the staff providing necessary care.
Posted 08 Jul 2006 at 10:31 am ¶
the joy princess wrote:
remember that episode of the Jeffersons?
Posted 08 Jul 2006 at 8:18 pm ¶
Ann wrote:
the joy princess:
‘remember that episode of the Jeffersons?”
Oh yeah.
Mr. White Racist and Son, LLP/INC., went to the CPR class at the apartment building where Weezy and George lived. George, Weezy and Florence were in the class as well as various racial groups.
The CPR instructor had everyone take turns on the CPR dummy for practice. Mr. Racist did not want to put his mouth on the dummy, after George and Florence took their practice session.
Mr. Racist stormed out of the class, taking his son with him.
Later on that night Mr. Racist had a heart attack, while dining out with his son. (Unbeknownst to Mr. Racist, so was George and Weezy.) Since Mr. Racist’s son left the class with dear old dad, he did not know what to do. Young Massa Racist In-Training cried out: “Help! My dad is having a heart attack! And I don’t know what to do with him since his racist, hateful self took me out of the CPR class and therefore I did not learn anything!) Or something of that effect.
So, George, who went to the CPR class, and passed it with full-colors, reluctantly got up to perform CPR on Mr. Racist. Well, he was kinda still angry over being dissed by Mr. Racist earlier.)
Anyheck, George performed CPR on Mr. Racist, brought him back from the brink of death, and saved the day.
Looking up from the floor where he fell,Mr. Racist saw that George had saved his life. He looked over at his son, and realizing that a black man had saved his life, said to his son: “You should have let me die.”
Anywho, while the paramedics were wheeling Mr. Racist out on the gurney to the hospital, the son, now an enlightened person to the destruction of racist thinking, throws the racist tracts his father was passingout earlier to white people,into the garbage can, and probably vows to free his mind (so his ass will follow) from the pernicious clutches of racism.
While the medical people are taking Mr. Racist to the hospital, George stands there, feeling very down and despaired and says:
“I should have inhaled.”
But, Weezy takes him on home.
Moral of the Story:
You never know who might be in the room who can save your life.
So, when you start choking on that piece of French baguette, and you have loudly and ignorantly proclaimed to the world that you are a racist, and no one comes to your aid, well,you damn well better know how to perform the Heimlich Manuver on your own little ‘ol self.
The rest of the world ain’t having it anymore from your Piltdown Man antideluvian antics.
And unless you know how to perform the self-procedure Heimlich Manuver on yourself, be prepared to choke on that piece of bread.
And keep on choking, until your racism chokes you to death.
Posted 08 Jul 2006 at 10:37 pm ¶
Lyonside wrote:
Ann:
Thanks for the episode recap. Just to remind folks, George Jefferson himself was pretty much a racist on the show (which adds to, rather than detracts from, the irony/humor of the episode).
I saw a little of All In The Family and The Jeffersons (the spinoff) as a small child in reruns, and as a grownup I can appreciate not only the patriarchal mirror but the damn balls of the shows to do what they did when they did it. We can’t GET this kind of stuff on the air today.
Posted 10 Jul 2006 at 6:37 am ¶
eric daniels wrote:
Who cares, I can’t even pick up my medicines because people think I am a drug dealer (I quess having a prescription with shoulder length locks who scare most folks) So If the lady wanted a white Prep person so be it, I am tried of having to convince people that Black Folks are human beings. Just don’t deny me my right not to trust you because you are white (because white folks want the right to be trusted without challenge) I think due to my expeciences in this country, I should look at white folks (and others) with a degree of mistrust and If that gets me called a racist bastard so be it. I think I have earned the right to say that most non- black (and quite a few blacks) have to earned the right not trust this country and If they get angry, they can kiss why the sun don’t shine.
Posted 12 Jul 2006 at 7:30 pm ¶