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?