How to Respond to a Patient's Discriminatory Request for a Different Clinician
ASCO Post (April 10, 2018)
9 Pages Posted: 21 Jun 2018
Date Written: April 10, 2018
The ASCO Post, in partnership with the American Society of Clinical Oncology (ASCO), communicates news of evidence-based multidisciplinary cancer care to a broad audience of 30,000 oncology professionals and ASCO members. Professor Pope authors a monthly Law and Ethics in Oncology column that explores the legal and ethical issues oncologists must be aware of in this era of precision medicine and changing health-care policy, both to protect patients’ rights and to safeguard against potential legal jeopardy.
Some patients may make discriminatory requests for a diffrrent clinician for their health care. These individuals may want to avoid treatment with clinicians of a certain race, religion, gender, sexual orientation, or national origin. Oncologists are not exempt from this type of patient behavior. Clinicians may confront fewer discriminatory requests in the outpatient setting, because patients can normally avoid conflict by selecting clinicians whom they prefer. But clinicians in hospitals and other medical institutional settings may confront discriminatory requests more often. Recent studies suggest that 20% to 40% of physicians have personally experienced or know someone who has experienced rejection by a patient based on their race or ethnicity. These rates are substantially higher among minority clinicians.
Furthermore, discriminatory requests may be rising. First, the health-care workforce is slowly becoming more diverse. ASCO, for example, is implementing its Strategic Plan to Increase Racial and Ethnic Diversity in the Oncology Workforce to promote the development of an oncology workforce that is culturally competent and equipped to care for a diverse population of patients with cancer. Consequently, there are more and more racial and ethnic minority health-care providers in a position to potentially confront a patient’s discriminatory request. Second, there are not only more “targets” of discriminatory requests, but there may also be more patients likely to make them.
Few professional societies have issued applicable guidelines or policy statements to provide clear guidance in these situations. Only recently have hospitals begun adopting policies to confront patient discriminatory requests, but even those remain limited. Here, we provide some recommendations on how to respond to a patient’s discriminatory request for a different clinician.
Note: Reprinted from The ASCO Post, with permission from Harborside. © 2018.
Keywords: invidious discrimination, bias, Title VII, racist, bigoted
JEL Classification: I18, K13, K32
Suggested Citation: Suggested Citation