In the Soviet Union, party membership was everything. Your job, your access to food and other consumer goods, and your apartment all depended on your standing with the party. And votes were simply a tool to provide a patina of legitimacy. No one who liked warm weather voted against the Party.
One of the many advantages of the protections provided by the U.S. constitution is that we generally cannot be hired or fired based on our personal or political beliefs. We also get to elect our leaders frequently. So it should be with a great sense of irony that various teabagger groups shout and stomp about the US becoming a socialist regime, while simultaneously threatening armed rebellion for not getting their way in an election. And it is with disgust and disdain that I view professionals punishing others based on their vote or their political views.
When a physician fired an employee for voting for Obama, that was—I assume—a clearly illegal act. It was also immoral. But it has nothing to do with medical ethics.
But when a doctor refuses to see patients based on their politics, this is a gross violation of medical ethics. In fact, it’s hard to think of a precept of medical ethics not violated by this sort of behavior.
This has become an issued due to the widely-publicized story of Dr. Jack Cassell, a Florida urologist who posted a sign on his office door which said, “If you voted for Obama…seek urologic care elsewhere. Changes to your healthcare begin right now, not in four years.” The doctor claims that he hasn’t turned anyone away, but that is irrelevant. The only person’s needs being served by the sign are his own—whether it is to make a political point, humiliate others, or who-knows-what-else. (The statement that he hasn’t turned anyone away is irrelevant for a number of reasons: first, he can’t know this, as the sign acts as his proxy, and second, even if no one leaves, they can be made to feel very uncomfortable.)
As a physician, Dr. Cassell’s first duty is to serve his patients. He should not be forced to see any particular patient, but neither should he abandon patients or turn them away for arbitrary reasons. Dr. Cassell is well within his constitutional and professional rights to choose whom he treats and what he says, but using patients to satisfy one’s own needs is both unethical and pathetic.
Basic medical ethical principles, such as beneficence, non-maleficence, and dignity dictate that we not use patients to make our own political statements. Dr. Cassell’s sign may deter current and future patients from seeking needed care, and may lead to abandonment, as patients of his who see the sign may feel unwelcome. This may lead to feelings of humiliation and delay of needed care.
Behavior such as Cassell’s is unconscionable. He should save his political activism for the ballot box and teabagger meetings. Punishing patients for their vote seems so—-Soviet.