…and this is a 
No church-going doctors for me, please
Category: Religion
Posted on: February 27, 2007 6:00 AM, by PZ Myers
Here I've been thinking of getting a nice tattoo (something discreet and subtle, like an octopus someplace you'll never see it), and then I learn that for the sake of my health, I better not. After all, some good Christian doctor might refuse to help me when I'm sick. Dr Gary Merrill, who proudly proclaims his Christian faith, turned away a little girl with an ear infection because her mother had a tattoo.
…Dr. Gary Merrill wouldn't treat her daughter for an ear infection because Tasha, the mother, has tattoos.
The writing is on the wall—literally: "This is a private office. Appearance and behavior standards apply."
For Dr. Gary Merrill of Christian Medical Services, that means no tattoos, body piercings, and a host of other requirements—all standards Merrill has set based upon his Christian faith.
Way to represent your faith, doc! He ought to read the Gospel of Luke—there's an obscure story in there about some guy beaten up and left to die by the road, and a priest and a Levite, the people Dr Merrill must model his life after, walk by and leave him there to die. He can stop reading right there, though…there's some other bit that follows with a fellow from Samaria that isn't all that important.
Hey, I just had a liberating thought—I think I'd rather die than ask for help from some sanctimonious jerkwad who calls his clinic "Christian Medical Services," so maybe I can go ahead and get that tat after all! Maybe I can get a little more flamboyant, too—how about keeping most of it under the shirt, but with one tentacle reaching up and wrapping around the neck?
Comments
A Christian not liking body piercings? Makes the crucifixion a tough gig.
Posted by: Peter McGrath | February 27, 2007 6:05 AM
hippocratic oath? what's that?
Posted by: djlactin | February 27, 2007 6:07 AM
Shouldn't he be sued an disbarred (or whatever they do to doctors) for this? Is anyone doing anything about it?
Posted by: kirkmc | February 27, 2007 6:08 AM
Less 'suffer the little children' and more 'let the little children suffer'. This beggars belief. As you point out, a good Christian would have treated the child - after all, Jesus ministered to all sorts of undesirables, right? But the thing that really gets me is the attitude that it's OK for a doctor to allow a child (or any patient, for that matter) to suffer needlessly because they don't like tattoos. This attitude seems to be shared by the AMA spokesman quoted. To say that it's only in life-threatening situations that there are ethical requirements on the doctor is mind-boggling. This is a consequence of viewing medicine as being like any other business. In another country, this would be a serious offence against professional codes of ethics.
Posted by: iain | February 27, 2007 6:09 AM
Is this what Tony Benn was implying when he told Dawkins "Science doesn't tell you how to live?"
http://www.bennites.com/TONYBENNRICHARDDAWKINS.html
Posted by: Mike Haubrich | February 27, 2007 6:31 AM
hippocratic oath? what's that?
/lurk
the hypocritic oath takes precedence
lurk
Posted by: blorf | February 27, 2007 6:48 AM
Perhaps he also gives out that old-timey penicillin instead of those godless new antibiotics that have been 'intelligently designed' to deal with newer, resistant bacilli that have evolved. (a recent Doonesbury strip)
Posted by: Ocky | February 27, 2007 6:48 AM
PZ
come and join the tattooed aquatic science crew.. once you start, you won't want to stop!
other aquatic ink (many from fellow scientists) at:
http://www.lovelab.id.ucsb.edu/Tattoos.html
Posted by: FishBwoy | February 27, 2007 6:52 AM
*** He said if they don't like his beliefs, they can find another doctor
*** Morton said certain ethics apply if a person's life is in danger, but besides that, there is no requirement to serve anyone they don't approve of.
Is the doctor kind of an ass? Probably. I'm not sure that holding the kid responsible for the behaviour of the parents is fair.
Is the doctor a doctor I'd want? Definitely not, I'm not paying him to judge my lifestyle.
Is the doctor right? Yes, absolutely. He is a businessman and is within his rights to reduce his customer base subject to law and medical ethics.
It doesn't say how freaky-looking the parents are, but this is a topic I've been on about for years. If you have tattoos and piercings and look generally like some kind of freak, you should EXPECT this kind of negative attention... that's why you got the tattoos and piercings isn't it - any attention FTW? It is unfortunate that this incident occurred, and I can't blame the child, but I find it very difficult not to put some blame on the parents. They made the bed, and their kid now lies in it.
And just maybe the onus is on you to choose your doctors more carefully.
We all assume that doctors are utterly selfless people, but that's not the case... they're people just like you and me. Nobody's life was in danger, and I highly doubt that in the phone book under "pediatrician", Dr. Morton was the only entry. How much time did these people spend bitching about tattoos and how much time did they spend moving on to the next doctor? In the article, I didn't see where they went to another doctor. This last bit is important because it would have lent a lot of credibility to the seriousness of the daughter's condition.
I also noticed this:
*** "I have tattoos, actually, and no, nothing's ever been said about it," Brandi Stanley said, Merrill's patient.
This leads me to believe there's a bit more to this story than meets the eye.
In any case, there's a good lesson in this for young people everywhere: If you dress like a freak, you will judged and treated accordingly. That's the way of things.
I've heard all the "I have tattoos and piercings and I'm not a freak" arguments. They're beside the point. I'm sure you're all great people - Nobel Peace winners just waiting for the chance. But nobody can see that for looking at you and the world reacts first on how you look. And apparently, so do some doctors...
Posted by: Evolving Squid | February 27, 2007 7:01 AM
I think your idea about getting the tatoo is great PZ!
Let us know when you get it.
Posted by: Thoburn | February 27, 2007 7:04 AM
Considering that Jesus Christ Man himself has a "666" tattoo and urges his followers to get ones for themselves, I fail to see how Christianity could be the motivator of this healer's alleged discriminatory policy.
Posted by: brtkrbzhnv | February 27, 2007 7:14 AM
This is one of those stories which makes me wish christianity were _true_, just so I could look forward to the day when Jesus gets hold of this "doctor" and shakes some sense into him.
Posted by: csrster | February 27, 2007 7:17 AM
So, this guy hides behind some scripture in order to behave unethically?
I would challenge this physician to point to any part of the California code of ethics for physicians, to any ethical code of the American Pediatric Association, to any part of scripture, the Better Business Bureau code, or anything else, which justifies such asinine, Sodomous* behavior.
* Wha? Sodomous? Yeah, take a look at Ezekial. It explains that the behavior of the Sodomites that got God's dander up was their inhospitality (nothing to do with sex, and especially nothing to do with homsexuality). So, why not call a self-proclaimed Christian Sodomite, a Sodomite?
Posted by: Ed Darrell | February 27, 2007 7:32 AM
Evolving squid:
"Is the doctor right? Yes, absolutely. He is a businessman and is within his rights to reduce his customer base subject to law and medical ethics."
Maybe this wasn't clear to you: this doctor's behaviour was unethical. What he did was morally wrong.
Maybe the written code of conduct he works under doesn't say so, but that is a flaw in it, not an excuse for him.
I'll leave aside your frankly weird points about people with tattoos and how they should expect to be treated. The point is:
the little girl had a painful condition
the doctor could have helped her
he refused for no good reason
so his action was wrong
Maybe he's within his rights to turn away adult patients whose looks he doesn't like. I still would have problems with that, and it certainly isn't very Christian. In this case, however, there is no ambiguity.
Posted by: iain | February 27, 2007 7:32 AM
I wouldnt go to a physicians office called "Christian Medical Services" any more then I would go to "Jesus Saves Tire and Lube", for reasons unrelated to my atheism.
If you have to put "Christian" and "Jesus" in the name of your business to drum up customers and get people to trust you (cause only trustworthy people are Christians), then odds are, you suck.
Posted by: ERV | February 27, 2007 7:38 AM
There are 34 pediatricians I find listed for Bakersfield. Surely the mother could have found someone to take care of her kid's ear problems.
Which doesn't excuse Dr. Merrill in any way.
Posted by: Ed Darrell | February 27, 2007 7:42 AM
Yeah, I just asked my German teachers here in Freiburg what would happen if a doctor refused to treat a girl based on these specific grounds. They said it just would never happen. Ever. Not unless the doctor's office was entirely full for a week and the mother had no health insurance.
Posted by: Fatmop | February 27, 2007 7:44 AM
In any case, there's a good lesson in this for young people everywhere: If you dress like a freak, you will judged and treated accordingly. That's the way of things.
Conform or we'll let your kids suffer from treatable infections!
Posted by: NBarnes | February 27, 2007 7:46 AM
All the way to the seventh generation, eh? No comment.
A situation difficult to get into in Germany, of course.
Posted by: David Marjanović | February 27, 2007 7:58 AM
What the hell?
Doctors refuse patients all the time for lack of MONEY or INSURANCE.
Who ya kiddin?
Posted by: Cocky Bastard | February 27, 2007 8:00 AM
OK, cocky bastard, I'll add 'the doctor was going to be adequately recompensed' to my list of salient factors. I was assuming it could go without saying...
Posted by: iain | February 27, 2007 8:04 AM
"In any case, there's a good lesson in this for young people everywhere: If you dress like a freak, you will judged and treated accordingly. That's the way of things."
Of course, the question of what constitutes a "freak" is an open one. I would point out that 40 years ago (and even today in some benighted places), my wife and I would have been judged "freaks" in many parts of the country because we happen to be of different races. I would also note that, technically, this doctor would refuse service to one of my elderly coworkers- he is a veteran (Korean War, I think), and has a prominent anchor tattoo on his forearm from his time in the military. A couple of the older Buddhist monks attending my local temple for Loy Krathong also had rather prominent tattoos, but they are freaks by definition- they aren't Christian- and would hopefully never be unlucky enough to have to depend on this worthless disgrace to the medical profession.
Posted by: MJ Memphis | February 27, 2007 8:09 AM
I'll leave aside your frankly weird points about people with tattoos and how they should expect to be treated.
Please don't. It's important to this whole issue. I think people who make spectacles of themselves do so in an attempt to draw negative attention upon themselves and have no ground to complain when they get it. You dress weirdly, you should expect to get treated weirdly, irrespective of what kind of person you are deep down. It's not cosmically fair, I'll grant that, but it IS the way the world usually works.
Now, the doctor is an independant business man. In the US, as I understand it, he has the freedom to pick and choose his clients within certain limits. It's necessarly to qualify that with "In the US" because in other places that's not the case and doctors have to deal with whoever walks in.
I'm pretty sure, although anyone who can demonstrate otherwise is welcome to do so, that a doctor in most of the US is not required to treat anyone who asks for it unless there is an imminent danger to life. In this case, there was not.
So it really boils down to "Mom didn't get the service she wanted and bitched to the paper rather than going somewhere else", and "The doctor doesn't have a practice that most people would send their kids to."
I think the doctor's actions are distasteful, but not unethical.
Posted by: Evolving Squid | February 27, 2007 8:13 AM
Doctors refuse patients all the time for lack of MONEY or INSURANCE.
Which is an interesting ethical question in itself. Especially given all the clap-trap we've been hearing lately about how much more charitable and ethical religious people are supposed to be.
Posted by: baldywilson | February 27, 2007 8:13 AM
How would you like a surgeon who visits you just before your operation and suggests that the two of you spend a little time praying? After all, wouldn't you want to accept Christ immediately before going under the knife, just so you could go to heaven if the doctor makes a boo boo? See more here.
Posted by: Zeno | February 27, 2007 8:18 AM
"Maybe he's within his rights to turn away adult patients whose looks he doesn't like. I still would have problems with that, and it certainly isn't very Christian."
On the contrary, it seems very Christian to me. It's certainly not moral, but the words "christian" and "moral" are not interchangeable.
Posted by: abeja | February 27, 2007 8:22 AM
"And the sign said,
Long-haired freaky people
Need not apply..."
How dare anyone express anything with their personal appearance (other than pure conformity, of course)?? I absolutely agree that the penalty for looking like "some kind of freak" ought to be denial of health care, hopefully leading to pestilence and death. And of course the "sins" of the mother should be visited on her children. [/snark]
You know, the recent Julie Amero case proved (if nothing else) that we have a very tough and broadly applicable statute on child endangerment here in CT; if Dr. Good-God lived here, I know of a couple overzealous prosecutors we could send his name to!
E-Squid, medicine is not just a business; it's a profession, and its practitioners are responsible to professional standards. Being a doctor is also a position of public trust, subject to state licensing and oversight. It p!sses me off when doctors deny care based on personal whim, regardless of whether that whim is motivation by religious conviction (e.g., Plan B) or mere personal crankiness (as this case appears to be, regardless of the Good Dr.'s protestations of divine mandate).
This is all just another argument for a universal health care system: I assume one peripheral benefit of such a system would be that patients would be guaranteed access to care without regard to their -- or their parents' -- superficial aesthetic characteristics.
Posted by: Bill Dauphin | February 27, 2007 8:28 AM
Evolving squid:
Is the doctor right? Yes, absolutely. He is a businessman and is within his rights to reduce his customer base subject to law and medical ethics.
iain writes:
Maybe this wasn't clear to you: this doctor's behaviour was unethical. What he did was morally wrong.
You're talking past Evolving Squid's point. He/she/it is arguing that the doctor has the right to apply, or refuse to apply, his skills for whatever reasons he deems good. You are arguing that the doctor should be forced to apply his skills for reasons you deem good. It's pretty easy to see which position is more consistent with individual freedom.
Yes, the doctor is an ass. The fact that he is an ass should be widely publicized. People who disagree with his views should choose other doctors, and refuse their services to him ("I'd like to fix your plumbing, mister, but I've got these tattoos, so you don't want me in your house.").
Forcing him to do what you want instead of what he wants is the definition of immoral.
Patrick
Posted by: Patrick | February 27, 2007 8:38 AM
You dress weirdly, you should expect to get treated weirdly, irrespective of what kind of person you are deep down. It's not cosmically fair, I'll grant that, but it IS the way the world usually works.
If it were the parents seeking medical attention for themselves, then you may have an interesting point; but the parents were seeking medical attention for their child. The child did not choose to have parents with tattoos, and should not have been denied access to prompt medical care because of the lifestyle choices of her parents.
In the US, as I understand it, he has the freedom to pick and choose his clients within certain limits. It's necessarly to qualify that with "In the US" because in other places that's not the case and doctors have to deal with whoever walks in.
Whilst this is true, and certainly the AMA position appears to reflect this, that is not sufficient for determining whether what the doctor did was ethical.
This is a doctor that is explicitly stating "I am a christian doctor, and I run a christian surgery", in an area where, most likely, most people will regard christianity as the pinnacle of morality and ethics. It is therefore right and proper to examine the question, not in light of "is it legal?", but "is it ethical?". Two very different questions.
This doctor has effectively said that it is ethical - and more to the point, has stated that it is ethical by the highest standards he can think of - to refuse to treat a child because of the appearance and lifestyle choices of its parents: a decision that the child has no influence over, and no responsibility for.
It is simply one more example of members of a religion stating that what is ethical according to their religion would be considered abhorrent to most people.
Posted by: baldywilson | February 27, 2007 8:43 AM
PZ, you mean you DON'T have a tat yet?
I thought that having a tatoo of your "study animal" was pretty much REQUIRED for marine biologists ;)
Posted by: dorid | February 27, 2007 8:52 AM
Dear Evolving Squid,
Where, exactly, did the article say that the parents were making spectacles of themselves?
So it's OK to discriminate based on appearance? Tell me - would you deny treatment to women who wear trousers, or men who wear pink? Immigrants from African countries with tribal scars, or who wear traditional robes? Sikhs because of their turbans? Ted Haggard because he just looks freaky?
I think that says it all. Thank goodness I don't live in the US, and have free access to state-employed doctors who receive and treat patients according to need.
Posted by: Peter Barber | February 27, 2007 8:53 AM
So it really boils down to "Mom didn't get the service she wanted and bitched to the paper rather than going somewhere else"
Yes, it's not like parents of small children have anything better to do than go around all day searching for a doctor that approves of their appearance.
Posted by: windy | February 27, 2007 9:09 AM
I don't think iain and I are "talking past" ES's point: It's not always true that thinking someone is wrong means you don't understand them; occasionally people really are wrong.
The current issue is not about "individual freedom": This guy could've exercised his freedom by choosing another career... but the free choice to become a doctor carries with it the obligation to treat patients ethically. I'm neither a trained medical ethicist nor a lawyer, but if arbitrarily denying minors medical treatment based on their parents' aesthetics constitutes treating patients ethically, I'll eat my hat.
I tire of these whines about "individual freedom." Yes, freedom is a core value, perhaps the core value of our society... but it's not an absolute value: It's constrained by the rights of the other people you live among, and it's constrained by the requirements of contracts you freely enter into and roles you freely accept. Medical care -- even when it's for non-life threatening conditions -- is not the same as a can of soda or a candy bar: Denying access to it matters.
And BTW, even people in "regular" businesses don't have complete freedom to select their customers. If you think otherwise, try opening a retail store that refuses to sell to African-Americans or Jews... or even that fails to provide reasonable access to the wheelchair-bound. (And before you jump on me, yes, I know that getting tattoos is a matter of choice, not directly comparable to ethnicity or cultural heritage or disability. But it's also just as irrelevant to a person's "fitness" to receive services as those other things.)
Posted by: Bill Dauphin | February 27, 2007 9:14 AM
Evolving Squid,
I understand that you feel it is OK to judge people by their appearance; I think that makes you a narrow minded bigot, but I don't care because I'll never have to meet you.
I understand that you think it is OK for practicing physicians to prioritise their business model over their ethical obligations; I think that makes you amoral, but that's OK because I'll never have to meet you.
But can you get this into your evolving brain: the patient did not have a damn tattoo. The patient didn't even have a choice whether or not to have a tattoo. The patient was a child in pain, who had no responsibility whatever for her mother's tastes. And in the face of this you continue to justify this quack.
You, sir, are beneath contempt.
Posted by: chris y | February 27, 2007 9:17 AM
I hate people who dress like freaks too... those idiots, walking around all day with utterly useless and constricting pieces of cloth knotted around their necks.
Posted by: Craig | February 27, 2007 9:27 AM
Bill Dauphin writes:
The current issue is not about "individual freedom": This guy could've exercised his freedom by choosing another career... but the free choice to become a doctor carries with it the obligation to treat patients ethically.
This is entirely about individual freedom. You are talking about forcing the doctor to behave as you believe he should. The doctor is choosing to abide by different standards. You may consider his standards poorly thought out and not in accordance with the religion he claims to follow, and I would agree with you. As soon as you talk about forcing him to behave as you wish, though, you are the one in the wrong.
Your claim that he somehow agreed to follow your view of morality when he became a doctor is vacuous. It is no more right to prevent someone with different views from becoming a doctor, assuming they have the ability, than it is to impose your views on them after they have become one.
I tire of these whines about "individual freedom."
The cry of every would-be tyrant.
The bottom line is that you consider it acceptable to force this person to act against his beliefs, even though he has neither threatened nor used force against anyone else. Regardless of the fact that this man is a jerk, that puts you in the wrong.
Patrick
Posted by: Patrick | February 27, 2007 9:30 AM
Yeah, because those standards are objective, universal, and absolute.
Posted by: Caledonian | February 27, 2007 9:34 AM
Yes, it's not like parents of small children have anything better to do than go around all day searching for a doctor that approves of their appearance.
I would think that arranging for medical care is something a responsible parent does sometime before their child desperately needs it, so yes, it's probably fair to say that parents of small children do not have anything better to do than go around all day searching for a doctor that they can deal with. More correctly, they should be doing that before their child needs help.
Maybe that's just me. I didn't wait until I was sick to find a doctor, and I think a responsible parent should do the same. This issue did not have to come up while their daughter was sick.
I'm not saying that I think what the doctor did was "cool" in some way. I find it distasteful, but I find it so because, like so many people, I tend to hold doctors to a higher standard of behaviour than other people, and that's perhaps a bit unfair. To me, the concept of Christian doctors is strange to begin with, but that's beside the point. Distasteful doesn't mean unethical. I think the medical code of ethics requires that doctors treat life-threatening issues and endeavour not to make situations worse. If that's the code of ethics, then I'm not sure the doctor has broken them, even if people find his actions inappropriate.
It's also good that the doctor's practices are out in the open, so people are aware and can make a better call on whether or not to seek services from that physician.
Now, the doctor is an independant[sic] business man.
I also have difficulty spelling "independent" as someone else noticed, and I get treated accordingly.
So it's OK to discriminate based on appearance? Tell me - would you deny treatment to women who wear trousers, or men who wear pink? Immigrants from African countries with tribal scars, or who wear traditional robes? Sikhs because of their turbans? Ted Haggard because he just looks freaky?
The better question is: Would you want to be treated by someone who had such distaste for your appearance? I'm not sure I'd want to go to a doctor who had a thing for pudgy white guys but had to treat me because they were forced to accept me.
Posted by: Evolving Squid | February 27, 2007 9:40 AM
Who forced him to become a doctor in the first place?
I make no such claim... but I do claim that when he became a doctor he "somehow agreed" to be a damn doctor! And not to arbitrarily punish children for his moral objections to their parents.
Hmmm... that I want my fellow citizens to respect each others rights, and my own, makes me a nascent tyrant? That I want people to live up to the implicit obligations of their own freely chosen professions makes me a tyrant?
If that's the definition of "tyrant," I guess I'll have to rethink my disapproval of tyrants. ;^)
Look, it's not about forcing anything on people; it's about expecting people to know what they're getting into: If you can't eat bugs, don't try out for Survivor; if you can't treat kids who have parents you disapprove of, don't become a pediatrician.
Posted by: Bill Dauphin | February 27, 2007 9:47 AM
A friend of a friend uses possession of a Jesus fish on the truck to vet contractors. Anybody with the fish is an instant DQ. Same with any other general cues about religious faith.
In general if they need to "faith-up" their services... their services can't get by on their own. Just as any belief which requires faith to be believed is undoubtedly false.
Posted by: Tatarize | February 27, 2007 9:48 AM
It's also worth noting that the article has a quote from someone else who has tattoos and who gets treatment from that doctor.
That leads me to believe that the article may not be covering the situation fairly. Was there some other issue happening that might have led to refusal of treatment? That would seem relevant to the whole situation.
Posted by: Evolving Squid | February 27, 2007 9:53 AM
Just so it's absolutely clear, is this a fair summary the moral and ethical opinion of the denizens of this blog:
A doctor must treat anyone who shows up, for whatever their condition, irrespective of the personal beliefs of the doctor.
If it is, then it goes well beyond the medical code of ethics.
Posted by: Evolving Squid | February 27, 2007 10:02 AM
Bill Dauphin writes:
>> You are talking about forcing the doctor
>> to behave as you believe he should.
>
> Who forced him to become a doctor in the first place?
Non-sequitur. Why should your views on how a doctor should behave have greater weight than his? What gives you the right to define how doctors should behave, and force them to do so?
>> Your claim that he somehow agreed to follow
>> your view of morality when he became a doctor
>> is vacuous.
>
> I make no such claim... but I do claim that
> when he became a doctor he "somehow agreed" to
> be a damn doctor!
You contradict yourself in the course of a single sentence. You are claiming that your definition of what it means to be a doctor is the one that should be enforced.
>>> I tire of these whines about "individual freedom."
>>
>> The cry of every would-be tyrant.
>
> Hmmm... that I want my fellow citizens to respect
> each others rights, and my own, makes me a nascent
> tyrant?
You don't respect the doctor's right to choose who he will and will not treat.
> That I want people to live up to the
> implicit obligations of their own freely
> chosen professions makes me a tyrant?
No, it's the fact that you reserve to yourself the right to decide that those "implicit obligations" actually exist and that your views of what they are should be enforced.
> Look, it's not about forcing anything on people;
Then let's be clear. Would you or would you not legally require the doctor to treat the child in these circumstances?
If the answer is yes and the doctor refused, would you or would you not use the legal system to prevent the doctor from practicing medicine in the future?
Patrick
Posted by: Patrick | February 27, 2007 10:10 AM
In any case, there's a good lesson in this for young people everywhere: If you dress like a freak, you will judged and treated accordingly. That's the way of things.
Since when did the way of things justify or excuse the choices of people?
Posted by: Raging Bee | February 27, 2007 10:12 AM
I think we should sic MC Router on him...
Posted by: Geoff Arnold | February 27, 2007 10:17 AM
I read about this case last week.
A couple of salient points:
* According to an interviewer, other parents of this doctor's patients have obvious tattoos or piercings, yet have never had their kids turned down for treatment. So the doctor is inconsistent at applying his own standards.
* The mother was referred to this pediatrician by her insurance company, probably an HMO. So she didn't just pick him randomly out of a phone book...the insurance picked for her. Seems to me that maybe doctors who have special "standards" for their patients ought to let their participating insurance providers know ahead of time, before they send unsuspecting patients into situations like this.
Posted by: Adrienne | February 27, 2007 10:19 AM
Don't have kids, do you? For your sake, I pray (in a completely nontheist sort of way, of course) you never have to learn what a fantasy it is to think you can ever have all your kids' healthcare ducks in a row.
I have great health insurance and a family doctor I trust implicitly... but on the day my daughter passed through the hands of a neurologist, a pediatric ophthamalogist (sp?), an ER radiologist, and finally a brain surgeon within the span of 8 hours (and into the care of a pediatric oncologist a few days later), I did not have any opportunity to investigate her (new) doctors' religious backgrounds and prejudices. Suppose one of those doctors had refused to care for my daughter because he (as it happened, they were all men) disapproved of my facial hair, or of my wife's weight? (BTW, my daughter is healthy and happy now, more than 5 years post-diagnosis and 4 years after her last treatment.)
No matter how diligent a parent you are, you just can't be 100% prepared for every medical emergency. And yes, a child's ear infection can be an emergency, albeit (usually) a non-life threatening one. This is why it's important that we can count on doctors to be doctors, for all of their patients, whenever they're on duty. Your apparent belief that it's no big deal to have to go hunting for another doctor in the middle of your child's suffering shows about as much human compassion as Joe Lieberman's comments on hospitals denying Plan B to rape victims ("It's only a short drive to another hospital" OWTTE).
IMHO, taking a "strict constructionist" approach to codes of ethics is inherently not particularly ethical: The point of a code of ethics is to do the right thing; doing just as much of the right thing as the strict letter of the code forces you to and not a jot more amounts to, for my money, not doing the right thing at all. YMMV.
Posted by: Bill Dauphin | February 27, 2007 10:20 AM
Evolving Squid said:
"Just so it's absolutely clear, is this a fair summary the moral and ethical opinion of the denizens of this blog:
A doctor must treat anyone who shows up, for whatever their condition, irrespective of the personal beliefs of the doctor.
If it is, then it goes well beyond the medical code of ethics."
Provided that the doctor is suitably qualified to treat the condition presented, then yes, he does have a duty to treat to the patient. The fact that he may not like the patient, or approve of their lifestyle is not a relavent consideration.
Should he patient have issues with paying, or be disruptive the doctor may decide that he will not treat PROVIDED he makes sure that will not mean the patient goes without treatment. The will normally mean a referral to another doctor. I would point out I live in the UK say payment issues are not really pertinent. Any doctor in the UK acting as this moron did would soon find themselves facing a standards hearing.
It is pretty simple really. How come some people seem to have trouble understanding ?
Posted by: Matthew Penfold | February 27, 2007 10:24 AM
Thank Dog for the evil, amoral atheists of Doctors Without Borders and the Haight-Ashbury Free Clinic, who commit to helping their patients despite--or maybe even because of--their personal and cultural differences from the societal norm.
Posted by: RedMolly | February 27, 2007 10:25 AM
Patrick, E.S.,
At what point did I suggest that the doctor should be forced to do anything? I said that his action was unethical. That doesn't mean that I think he should be forced to behave ethically in cases like this. People often make this mistake: they assume that if something is wrong, it should be against the law. But there are plenty of ways in which we can fail to act as morality requires without breaking the law.
I also didn't say that doctors have an absolute duty to treat anyone regardless of their beliefs. I said that *in this case* the doctor had no good reason to refuse treatment to a *child* who was wholly innocent of offending against him.
ES wants to insist that the tattoos are important, and that if 'You dress weirdly, you should expect to get treated weirdly'. He ignores the central point here, which is that it was a child who was treated badly, because of her mother's appearance. In other words, even your own argument could not possibly justify this action.
Posted by: iain | February 27, 2007 10:29 AM
What's hilariously ironic about this is that, just a few years ago, this same "doctor" would probably have refused to give the mother contraception, and would probably have refused to perform an abortion.
Now, in typical right-wing asshattery, she's out of the womb ... and on her own.
Posted by: Warren | February 27, 2007 10:30 AM
Various commenters upset with Evolving Squid wrote things like:
...ought to be...
...I understand that you feel it is OK to judge people by their appearance...
AFTER Evolving Squid had written (emphasis added by me):
In any case, there's a good lesson in this for young people everywhere: If you dress like a freak, you will judged and treated accordingly. That's the way of things.
I've heard all the "I have tattoos and piercings and I'm not a freak" arguments. They're beside the point. I'm sure you're all great people - Nobel Peace winners just waiting for the chance. But nobody can see that for looking at you and the world reacts first on how you look. And apparently, so do some doctors...
Why do so many people confuse "I see that the world is this way" with "I think that the world ought to be this way"?
There is an important difference between those two statements.
The impression I got from E-Squid's comments (I may be mistaken) is that E-Squid is not surprised by this Doctor's behaviour, based on a perception of wide-spread unease with tattooing (i.e. lots of people don't like tattoos). At what point did E-Squid say "and the status quo is exactly the way I think is best"? At what point did E-Squid say "I hate non-conformists"?
I think that makes you a narrow minded bigot, but I don't care because I'll never have to meet you.
If you're going to sling around strong terms like "bigot", please check your sources first. You know, actually READ the relevant comment. Also, clearly you do care, because you went to the (minimal) trouble of posting a comment.
As for the issue at hand - tempest in a tea-pot is my opinion. The Doctor is a jerk, not just for refusing to treat a sick child, but also for making the statement that he only treats christians, by naming his practice "Christian Medical Services". As has been pointed out above, if you have to market your business by including a reference to the dominant local religion, perhaps you don't have the competence to compete openly based on skill and talent. The mother is a media-mongering fool, who perhaps would have been better off simply going to another, less jerkish, Doctor, and then telling her friends and relatives about the poor service she got at Dr. Merrill's place. Screaming "persecution!" to the local TV network affiliate seems somehow counterproductive.
BUT, we're not presented with much information here, are we?
Posted by: TheBrummell | February 27, 2007 10:31 AM
Squid, it seems like you're ignoring the gist of the comments against your position--at least, I don't see where you've addressed the main objection.
No one is claiming that it's ethical to force the doctor to treat a patient; the claim is rather that he accepted the responsibility to treat all patients when he became a doctor, and that he's now choosing to abrogate that responsibility.
You're skirting around the issue, saying that there might have been other factors, and that if the mom looked like a freak, it's her own fault--but you haven't addressed the underlying question of the doctor's apparent practice of treating only the patients he likes.
Posted by: Robert M. | February 27, 2007 10:33 AM
I like that some of the posters above think it's immediately obvious that "individual freedom" is preserved when a doctor refuses to treat a patient in need, and that it's equally obvious that it's not threatened when getting a tattoo means that your child has less access to non-emergency medical care.
Posted by: Brainslug | February 27, 2007 10:35 AM
Yes, let's do be clear: Doctors, like other professionals, are licensed by the state and certified by their fellow professionals. Being a licensed medical practitioner is not a civil right: It comes with both privileges and duties. All I'm saying is that people who are unwilling to perform the duties of a profession in a sensibly nondiscriminatory fashion should not be licensed, nor sanctioned by their peers. What I'm really saying is that if they know they can't perform the duties of a given profession for all comers with a clear conscience, they should probably pick a different profession in the first place, and avoid the whole regulatory question.
How that position makes me some sort of jackbooted thug is mysterious to me... but it's sure been entertaining watching you try to make the case. Thanks. Gotta go now; I need to get my brown shirt pressed. ;^)
Posted by: Bill Dauphin | February 27, 2007 10:40 AM
Since noone else has done so yet, I reproduce here the Principles of Medical Ethics, taken from the AMA website at http://www.ama-assn.org/ama/pub/category/2512.html
Principles of medical ethics
1. A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.
2. A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
3. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
4. A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.
5. A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
6. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.
7. A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
8. A physician shall, while caring for a patient, regard responsibility to the patient as paramount.
9. A physician shall support access to medical care for all people.
Item 6 certainly seems to cover the case in question. The claim that he accepted the responsibility to treat all patients is, I am afraid, false. He may be a jerk, and I wouldn't go to him for treatment, but he did not act unethically.
Posted by: Frelghra | February 27, 2007 10:43 AM
I too would rather die than ask for any "Christian Medical Services". As for the ink, I strongly suggest you keep it off your neck.
Posted by: sally | February 27, 2007 10:45 AM
"6. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care."
Seems to conflict with
"9. A physician shall support access to medical care for all people."
Did the doctor provide a referral to another doctor ? If he did not then it seems he was acting unethically.
Posted by: Matt Penfold | February 27, 2007 10:48 AM
Where in the bleeping New Testament does Jesus condemn people with tattoos or piercings? Aside from his general assholery, this doctor is making up his christianity as he goes along.
Posted by: Rugosa | February 27, 2007 10:50 AM
Frelghra,
One of the things I don't like about codes of practice and suchlike is that people start thinking that as long as they obey the code, their conduct must be ethically acceptable. I think that the doctor didn't do anything contrary to principle 6, but I still think that his actions were unethical.
Posted by: iain | February 27, 2007 10:50 AM
No one is claiming that it's ethical to force the doctor to treat a patient; the claim is rather that he accepted the responsibility to treat all patients when he became a doctor, and that he's now choosing to abrogate that responsibility.
Yes, I understand that is the gist of the comments, and no, I do not agree that a doctor accepts that responsibility when he becomes a doctor - even though, if I became a doctor, I would do so.
The impression I got from E-Squid's comments (I may be mistaken) is that E-Squid is not surprised by this Doctor's behaviour, based on a perception of wide-spread unease with tattooing (i.e. lots of people don't like tattoos). At what point did E-Squid say "and the status quo is exactly the way I think is best"? At what point did E-Squid say "I hate non-conformists"?
Yes, that is correct. I will say that I think non-conformists get exactly what they should expect to get. Being non-conformist comes with a price. Being non-conformist is hard work. When you are non-conformist, I don't think you have room to complain about the hardships.
Obviously, I'm non-conformist compared to many people in this thread, and that hacks off some people. I'm prepared for that.
No one is claiming that it's ethical to force the doctor to treat a patient;
I disagree. By calling the doctor's actions unethical, and knowing that doctors are subject to a code of ethics, it is necessarily saying that the doctor is acting outside the code of ethics. If not treating the child is unethical, then the code of ethics forces treatment.
you haven't addressed the underlying question of the doctor's apparent practice of treating only the patients he likes.
You're right. To me there is no question. Doctors treat only the patients they deem acceptable except in life-threatening situations. That's all I expect of my doctor, or any doctor. Despite this, if I was a doctor, I would probably treat anyone who walked in the door - but I must say probably, because I am not a doctor and honestly can't envision every possible situation.
I'm overweight. If my doctor said "lose weight or I won't treat you", should I:
1. Whine to the media?
2. Find another doctor?
3. Lose the weight?
Posted by: Evolving Squid | February 27, 2007 10:55 AM
I'd like to see what a physician has to say about this, but it seems to me that once you make an appointment and the Doctor agrees to see you, he's under some obligation to provide a service. After all, in most offices if you miss the appointment, you have to pay a fee. There's an agreement between the doctor and patient that they will meet at a specific time for one to perform a service in exchange for monetary compensation.
I think it's perfectly ethical, if not moral or nice, for the doctor to say "okay, don't ever come back here again," but I think once he's agreed to their appointment and visit, and once they're in the office, he's under some obligation to provide the service to which he agreed.
The article says that the AMA supports the right to turn away patients, but I was under the impression that in the United States, most businesses face severe penalties for refusing to serve people based on things like color, creed, religion, national origin, and whatnot. Are there acceptions to anti-discriminatory laws that allow for religious-based discrimination?
Posted by: Tom Foss | February 27, 2007 10:58 AM
Bill Dauphin writes:
Yes, let's do be clear: Doctors, like other professionals, are licensed by the state and certified by their fellow professionals. Being a licensed medical practitioner is not a civil right: It comes with both privileges and duties. All I'm saying is that people who are unwilling to perform the duties of a profession in a sensibly nondiscriminatory fashion should not be licensed, nor sanctioned by their peers.
That doesn't add clarity, nor does it answer the questions I asked. The questions are quite straightforward, requiring only very simple responses:
Would you or would you not legally require the doctor to treat the child in these circumstances?
If the answer is yes and the doctor refused, would you or would you not use the legal system to prevent the doctor from practicing medicine in the future?
I'm very interested in your response.
Patrick
Posted by: Patrick | February 27, 2007 10:58 AM
"I'm overweight. If my doctor said "lose weight or I won't treat you", should I:
1. Whine to the media?
2. Find another doctor?
3. Lose the weight?"
You missed an option. The doctor, if he think you should loose weight, should provide support for doing that. Ie, access to a dietician, refferal to specialised treatment if you are morbidly obese etc. Any doctor who just says go away and loose weight else I will not treat you is not acting professionally or ethically.
Posted by: Matt Penfold | February 27, 2007 11:01 AM
Bow to our prejudice! Bow or suffer!
It's not hard to reduce this argument to absurdity. "I'd like to prevent that guy from murdering you, but I've got these tattoos...", or worse, "I'd like to stop your house from burning down, but *you've* got these tattoos..."
Assuming that you accept that there is a line here, why is it ok for plumbers to do this but not police officers or firemen? Because somebody's health could be in danger when police officers and firemen refuse their services.
This is not a painter or a mechanic or a restaurant owner we're talking about here. (Whether or not such behavior is or ought to be illegal for any of those businesses is a separate argument.) This is a doctor, and furthermore, one who refused service to a child because he disapproved of the parent. I really don't see how anyone can consider his behavior defensible in the slightest, let alone meeting the standards we ought to expect from the medical profession.
Maybe you think medical licenses shouldn't be mandatory or regulated, but they are, and that means that practicing medicine is a privilege, not a right. I definitely believe he should be reprimanded by the appropriate licensing agency, and if he persists in denying care based on his personal prejudices, his license should be revoked. (Note: not "he should be jailed".)
Posted by: Chris | February 27, 2007 11:01 AM
iain writes:
At what point did I suggest that the doctor should be forced to do anything? I said that his action was unethical. That doesn't mean that I think he should be forced to behave ethically in cases like this. People often make this mistake: they assume that if something is wrong, it should be against the law.
You are correct and I apologize for the unwarranted inference. I encounter so many people who automatically leap from "I think that's wrong." to "There ought to be a law." that I failed to give you the benefit of the doubt. I'm sorry.
Patrick
Posted by: Patrick | February 27, 2007 11:02 AM
"I'm overweight. If my doctor said "lose weight or I won't treat you", should I:
1. Whine to the media?
2. Find another doctor?
3. Lose the weight?"
I see. Because not treating a childs illness because of your attitudes about their parents sense of personal atire is exactly like a doctor telling you that if you don;t take his medical advice, he'll stop giving you medical advice.
um, no.
Lose weight or I won't treat your daughter.
Nope... that's not even it. He'd still be an ass, but its still on the basis of YOUR health, supposedly.
"I won't treat your daughter because I'm a Christian and you're a Jew."
"I won't treat your daughter because you're black and my Christian religion says the races should be seperated.
"I won't treat your daughter because you're gay."
"I won't treat your daughter because you're not wea