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Legal Commentary

: Prawfs

Law, politics, and medicine

By Dan Markel, Ethan Leib, Rick Garnett, Matt Bodie, Paul Horwitz , Steve Vladeck, and Orly Lobel

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I found this story really disturbing and a bit disgusting, although I am not entirely sure why. A urologist near Orlando posted a sign on his office door reading "If you voted for Obama, seek urologic care elsewhere. Changes to your healthcare begin right now. Not in four years.?

I just do not get the stridency. One supporter of the doctor is quoted as saying "You?re going to see this more and more . . . People are very angry.? Really--so angry that you are not going to treat someone? I was no fan of Bush II, but I never thought of not doing business with someone who voted for Bush or supported his decision to take the country into war with Iraq. And I certainly never thought of asking my doctor about his views on the matter or making my medical decisions based on those views. Nor would I have expected him to ask me about my views or base his decision whether to treat me on those views.

Unfortunately, The Times was blase to the point of jokey about the story--"If we have red and blue states and red and blue counties, why not red and blue doctors' offices?"--in a way that is not helpful.

Of course, customers/patients/clients have a First Amendment right to decline (even in a very public manner) to engage in business with someone because of their political views or positions. If Dr. Cassell had somehow been involved in the HCR debate, I might choose not to go to him for that reason. So some turnabout certainly seems fair play.

The medical ethics of the situation obviously stand out here. Even the broadest conscious clauses would not apply here--no one is asking Dr. Cassell to perform a procedure to which he has moral, ethical, or religious objections, unless Democratic prostates are somehow morally different than Republican prostates (there is a joke in there somewhere, but this is a family blog).

Dr. Cassell insists that he never would refuse to treat a patient because of her politics because that would be unethical. But is there really an ethical difference between a flat refusal to treat someone and a strong and public statement discouraging people from coming to her in the first place? If the only (or the best or the only one on my HMO) urologist in town places a sign on his door with the intent of keeping certain people from availing themselves of his care, hasn't he, in effect, refused them treatment. Health law or medical ethicists, help me out on this. At some level, if Dr. Cassell is serious about this, I would respect him more if he stuck to his guns and really and truly flat refuse to treat any Democrats.

Full post as published by Prawfs on April 04, 2010 (boomark / email).

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