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Choosing health care providers by race

Some of you may have read about the situation that arose in a Detroit hospital where a father requested that no black nurses touch his newborn child and on the surface it appears that the hospital tried to comply with his wishes. To my surprise, the news report says that it is an ‘open secret’ for requests to be made that treatment not be provided by doctors and nurses of a different race and for those requests to be accommodated as much as possible.

“In general, I don’t think honoring prejudicial preferences … is morally justifiable” for a health care organization, said Dr. Susan Goold, a University of Michigan professor of internal medicine and public health. “That said, you can’t cure bigotry … There may be times when grudgingly acceding to a patient’s strongly held preferences is morally OK.”

Those times could include patients who have been so traumatized — by rape or combat, for instance — that accommodating their request would be preferable to forcing on them a caregiver whose mere presence might aggravate the situation, she said.

The article went on to suggest that this kind of request happens more often in emergency situations.

Paul-Emile’s research cited a 2007 study at the University of Michigan Health System and others on how physicians respond to patients’ requests to be assigned providers of the same gender, race or religion.

The survey of emergency physicians found patients often make such requests, and they are routinely accommodated. A third of doctors who responded said they felt patients perceive better care from providers of shared demographics, with racial matches considered more important than gender or religion.

Of course if the tables had been turned, and a doctor or nurse said that they would not treat a person of another race (or because of any other criteria), that would be utterly inexcusable and the hospital would be justified in terminating their services.

Perhaps the medical code ‘do no harm’ pushes hospitals to give a patient’s wishes greater weight than in other situations. But even here, there seems to be a paradox. If there is no emergency, as was the case of the Detroit hospital, then why accede to such an unreasonable and prejudiced request? If there was an emergency, then surely it is more important to get the best people who are at hand to take action rather than scrambling to meet irrelevant criteria of race? Why make the baby suffer because of the father’s prejudices?

I tried to think of cases where acceding to such types of requests might be acceptable. What if a person is so psychotic or traumatized that not complying with the request would make the situation worse? What about situations where people request treatment by health care providers of the same sex? Some religious people, especially Catholics, often like to have a priest pray with them when they are near death. If a person requests a priest of a specific race in such a situation, should the church try to accommodate that?

To my mind, in the specific case in the news report, there seems little doubt that the father’s request was out of line. When you go to a hospital, you are implicitly accepting the entire package and cannot then pick and choose. If you want to be treated only people of your own race, then you should go to a hospital that employs only such people. It would be no different than going to a restaurant and requesting that your food be cooked and served only by people of your own race. No restaurant should feel obliged to honor such requests, so why do hospitals seem to be willing to accommodate them?

Comments

  1. says

    That’s really freaky. I would think that a good return question would be: “Would you mind a doctor who’s a bit less experienced but is part of your preferred race, or would you prefer to get the best medical care we can provide?”

  2. raymoscow says

    This reminds me of the MASH episode in which the wounded patient asked to only be given white-people blood, so they pretended that they gave him ‘black blood’ by mistake, darkened his skin with iodine while he was unconscious, and pretended that he was turning black, which terrified him. Eventually they let him know that it was a practical joke, played because his request was stupid. (They might have told him that up front, but then there wouldn’t have been a joke.)

  3. TGAP Dad says

    I can relate to a concept that I first read in Michael Moore’s Stupid White Men: every harm visited upon me was perpetrated by white men. In Stupid White Men, Moore notes

    White people scare the crap out of me. …I have never been attacked by a black person, never been evicted by a black person, never had my security deposit ripped off by a black landlord, never had a black landlord… Never been pulled over by a black cop, never been sold a lemon by a black car salesman, never seen a black car salesman, never had a black person deny me a bank loan, never had a black person bury my movie, and I’ve never heard a black person say ‘We’re going to eliminate a thousand jobs here – have a nice day!’

  4. left0ver1under says

    Here’s an idea: Anyone who doesn’t want “another race” to provide medical care should get a medic alert bracelet saying so.

    That way, if an ambulance attending a scene finds that the injured person doesn’t want aid from “one of them”, his wishes will be obeyed and no treatment will be given. A different ambulance will be despatched containing attendants of the “right race”. That may mean the person will have to wait longer to get to the hospital, but at least they won’t have to worry about who’s helping them. Protecting the person’s wishes not to be touched by “them” is the most important thing.

    We could even extend this to firefighters or police. The person in need of aid won’t be touched by anyone “undesirable”, they can be rescued or protected only by those they want to help them.

  5. Corvus illustris says

    Evidently the father in the Detroit story didn’t realize that a large part of child care for the slaveholding class in the, er, ante bellum Confederacy was supplied by enslaved women–who probably had children of their own to care for as well.

    That said, I’d still go along with the practice of accomodating the prejudices of trauma patients in an emergency situation. The last thing you’d want to do would be to push the physiological reactions of somebody who is near going into shock by having a possessor of the wrong paint job or accent scare them. At the time of the assassination attempt on Reagan, it was reported that one of the surgeons who treated him said that he had asked whether there were any Democrats on the surgical team. The response was “we’re all Republicans here, Mr President.” Even if the story was a fabrication, I think the response was right.

  6. sc_770d159609e0f8deaa72849e3731a29d says

    There was an alarming instance a few years ago in the UK where a dying man would allow his organs to be transplanted, but he and his family insisted they went to people of the ‘right’ race. In the end, it was agreed to acccept his turns because there is a shortage of such organs.

  7. sc_770d159609e0f8deaa72849e3731a29d says

    Whoops!
    In the end, it was agreed to acccept his terms because there is a shortage of such organs.

  8. says

    This is an excellent article. I also believe that health care and care givers are an important topic when it comes to seniors and those people who are suffering from a disease or illness. Thankfully, there are now some options which are very effective and affordable too. I am talking about a virtual companion, which will help senior citizens to live a happier life and to stay at home as well.
    Feel free to look at http://www.gerijoy.com for more information

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