Saturday, April 3, 2010

Dr. Cassell sparks debate over health care with signage

An urologist in Florida is sparking debate over a sign posted outside his office door. Jack Cassell posted, "If you voted for Obama…seek urologic care elsewhere. Changes to your health care begin right now, not in four years" (http://www.huffingtonpost.com/2010/04/02/jack-cassell-doctor-refus_n_523076.html). At first glance one may think that Cassell's sign is unethical as it goes against the Hippocratic Oath that medical professional uphold. In an interview with the Orlando Sentinel Cassell explained that "I'm not turning anybody away -- that would be unethical. But if they read the sign and turn the other way, so be it" (http://www.orlandosentinel.com/news/local/lake/os-mount-dora-doctor-tells-patients-go-aw20100401,0,658649.story).

Many, including Rep. Alan Grayson (D-Fla.), question the behavior of Cassell. William Allen, a professor of bioethics, law and medical professionalism at the University of Florida's College of Medicine, sees Cassell's sign as "pushing the limit" as patients cannot be refused based on race, gender, religion, sexual orientation or disability. In an interview with MyFoxOrlando.com, Cassell responded to the potential unethical situation his sign created with, "I do not see why, as I am not denying care. I have an opinion."

I came across this article from a Facebook friend that commented, "this doctor is being allowed to continue his practice based on a political view. In fact, this is almost as bad if he had a sign that said "whites only" on his door." Does putting a sign outside the door, as Cassell did, resonate in the same manner that "whites only" signs did? Or is it okay for the doctor to air his views in this manner? My question to the Facebook crew was, "Okay, we still live in the USA right? I think it's a bit short sighted by the Doctor but he has every right to provide his service to who we wants to. Is so far as long as we still in the USA where freedom of choice reigns." I recognize that in a free society, a truly free society, discrimination will exist to varying degrees.

Does Cassell's sign discriminate? Has political ideology or affiliation become a protected class? As Dr. Cassell stated in his interview, he is not denying care to those that enter his office; rather he is simply protesting health care. A lot of interesting facts have come out since the Senate and House "fix it" bills were signed into law. A number of new taxes have been created, constitutional objection has been raised and companies are reporting the effects of these changes. All of this has President Obama campaigning again to "inform" the nation of what is really in the bill.

4 comments:

  1. Political affiliation is NOT a protected class. However, as a Dr. that is licensed by the state, you take an oath to treat all patients equally. Refusing service to someone because of political affiliation would be a breach of that oath and potential for revocation of the license.

    Personally, I think he fell off the wrong side of the cabbage truck and is a li'l left of nutty which is why I wouldn't want him as my doctor, but if he provides a service that someone needs, he cannot discriminate against them and uphold his oath to provide medicine.

    What happens if paramedics show up at a car accident and see the "pro-obama" bumper sticker on the car and refuse to treat them? While that's a bit more extreme, certain professions cannot refuse service.

    Now if he was a bartender, he's got every right to refuse service.

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  2. Kevin,
    Except he's not refusing care to anyone. So you're little story about paramedics refusing to treat someone has nothing to do with the point of the article. Same with your bartender analogy, it has nothing to do with it.

    He's not refusing care, end of story.

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  3. It's an implicit refusal. By stating "if they read the sign and turn the other way, so be it." you are implicitly refusing service. Just because you don't verbally tell them to go away, doesn't mean that you didn't force them to self-select that fact based upon your discriminatory behavior.

    Therefore, it's more than splitting semantic hairs to make your point.

    It's no different than putting a sign on your door as a Dr. stating "whites only". It's not explicit refusal of service, but it's certainly implicit. By that fact, the analogy fits, I'm sorry you can't see it.

    And therefore, as I said, the difference between a bartender who refuses service (implicitly or explicitly) and a Dr. is that bartenders aren't licensed by the state (although their bars are) and I can choose to go elsewhere. Neither of those are necessarily true of doctors.

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  4. Why cannot doctors be allowed to turn away patients they don't feel they want to help? Set aside the Oath for a moment. Lawyers are rewarded with Pro Bono work; yet our Doctors are not - do not both professions have similar and equal ethical standards to live up to?

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