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Thread: Some patients don't want nurses of other races

  1. #1
    Super Moderator cougarnurse's Avatar
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    Some patients don't want nurses of other races

    Of course, this story has been mentioned on the web lately (Michigan). http://news.yahoo.com/patients-wont-...194714831.html
    DETROIT (AP) -- It's been called one of medicine's "open secrets" — allowing patients to refuse treatment by a doctor or nurse of another race.
    In the latest example, a white man with a swastika tattoo insisted that black nurses not be allowed to touch his newborn. Now two black nurses are suing the hospital, claiming it bowed to his illegal demands.

    The Michigan cases are among several lawsuits filed in recent years that highlight this seldom-discussed issue, which quietly persists almost 60 years after the start of the civil rights movement.

    The American Medical Association's ethics code bars doctors from refusing to treat people based on race, gender and other criteria, but there are no specific policies for handling race-based requests from patients.

    "In general, I don't think honoring prejudicial preferences ... is morally justifiable" for a health care organization, said Dr. Susan Goold, a University of Michigan professor of internal medicine and public health. "That said, you can't cure bigotry ... There may be times when grudgingly acceding to a patient's strongly held preferences is morally OK."

    Those times could include patients who have been so traumatized — by rape or combat, for instance — that accommodating their request would be preferable to forcing on them a caregiver whose mere presence might aggravate the situation, she said.

    Tonya Battle, a veteran nurse at Flint's Hurley Medical Center, filed the first complaint against the hospital and a nursing manager, claiming a note posted on an assignment clipboard read, "No African-American nurse to take care of baby." She says the note was later removed but black nurses weren't assigned to care for the baby for about a month because of their race.

    That case is now a federal lawsuit. In a statement earlier this week, Hurley President Melany Gavulic denied Battle's claim, saying the father was told that his request could not be granted. Gavulic said the swastika tattoo "created anger and outrage in our staff," and supervisors raised safety concerns.

    Hospital officials said they planned to make a statement about the matter Friday evening but offered no details.

    Multiple email and phone messages left for Battle through her attorney were unreturned, and a listed number for her had been disconnected. She told the Detroit Free Press she "didn't even know how to react" when she learned of her employer's actions following her interaction with the father.

    She said she introduced herself to the man and he said, "I need to see your supervisor." That supervisor, Battle said, told her that the father, who was white, didn't want African-Americans to care for his child and had rolled up his sleeve to expose the swastika.

    "I just was really dumbfounded," Battle said. "I couldn't believe that's why he was so angry (and) that's why he was requesting my (supervisory) nurse."
    Attorney Tom Pabst, who is representing nurse Carlotta Armstrong in a second lawsuit, said the hospital's actions left nurses in the neonatal intensive care unit "in a ball of confusion."

    "She said, 'You know what really bothered me? I didn't know what to do if the baby was choking or dying. Am I going to get fired if I go over there?'" Pabst said.
    The Michigan cases follow a 2010 decision by the 7th U.S. Circuit Court of Appeals, which held that the federal Civil Rights Act prohibits nursing homes from making staffing decisions for nursing assistants based on residents' racial preferences. The ruling stemmed from a lawsuit filed by a black nursing assistant who sued her employer for racial discrimination.

    In another federal lawsuit filed in 2005, three black employees of Abington Memorial Hospital near Philadelphia claimed they were prevented from treating a pregnant white woman by her male partner, who was a member of a white supremacist group. The man used a racial slur when forbidding any care by any African-Americans.

    The complaint alleged that supervisors honored the man's request. The case was settled confidentially before going to trial, and the hospital admitted no liability. Frank Finch III, the attorney for the employees, said hospital officials also cited employee safety in their defense.

    "That defense doesn't fly under the anti-discrimination law," Finch said. "Hospitals cannot use that as a defense in nonemergency situations."

    He said every hospital has a policy against discrimination and "undoubtedly acquiescing to such a demand is a violation of a written, internal policy in addition to being a violation of the law."

    Fordham University law professor Kimani Paul-Emile said she suspects nurses file more discrimination suits than doctors.

    "With nurses and other sorts of staff, the hospital is telling them they can or cannot do something," she said. "That might go to why you might see more lawsuits brought by nurses."

    She wrote an article last year in the UCLA Law Review titled "Patients' Racial Preferences and the Medical Culture of Accommodation." It was the source of the "open secrets" phrase.

    Paul-Emile's research cited a 2007 study at the University of Michigan Health System and others on how physicians respond to patients' requests to be assigned providers of the same gender, race or religion.

    The survey of emergency physicians found patients often make such requests, and they are routinely accommodated. A third of doctors who responded said they felt patients perceive better care from providers of shared demographics, with racial matches considered more important than gender or religion.

    "The notion of white patients rejecting minority physicians for bigoted reasons in emergency departments and other hospital settings is deeply troubling and uncomfortably reminiscent of the type of discrimination that the civil rights statutes were designed to eliminate," Paul-Emile wrote in her article.

    Another study she cited found that patient requests for care by a physician are most often accommodated when made by racial minority patients.

    Lance Gable, a law professor at Wayne State University in Detroit, said he believes such requests "are made more often than we'd like to think about" even if they aren't frequently agreed to by hospital management. He suspects a supervisor might honor them but not say anything explicit to employees and only in rare instances would signs be posted as alleged in the Flint case.

    "Maybe their explanation is an accurate description of what happened — the supervisor was scared of the father of this patient and made a decision that was ill-advised," Gable said. "It might have been the right thing to do for the safety of the staff, and it still might be a violation of anti-discrimination laws."





  2. #2
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    Sadly, there are elderly who as a result of disease lose their filters and then go on to express racially intolerant feelings. This is an unfortunate legacy that our "honored" citizens are leaving which bears heavy consequences on the quality and consistency of their care in LTC centers. If those elders are lucky, they are cared for by conscientious, forgiving and loving professionals who look past the slurs and insults and continue to do provide excellent care day by day. I ask you all, do you believe that we will we as a race of beings, ever rise above our difference and see our commonality?

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    Patients/families etc. can pick and choose their providers. I've seen many times, where men and women don't want male nurses.
    Is that prejudice? I don't know, but, I've seen pt.s refuse care by staff based on color...I've heard elders yell out slurs....
    it's very uncomfortable. I feel for the nurse in the above article.

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    A second nurse has reportedly filed another lawsuit against the hospital.
    I'm betting there will soon be more plaintiffs coming forward.

    The first lawsuit was moved from state court to federal court. You can find a copy of the original complaint and removal notice here (PDF).

    Some patients may make these requests but there is absolutely no good reason for a hospital to honor them under any circumstances. Reading the court documents, I was surprised this was allowed to continue for so long even after the hospital's in-house counsel became aware of it.

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    It appears that the main theme today is patient satisfaction and alot of times that goes too far.
    Wonder what other administrators of other hospitals would have done.
    Also, what does hospitals anti discrimination policy mean?
    Job hiring? Job advancement?

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    I think there are two standards here; the first being nondiscriminatory management of staff and the second being honoring patients' wishes. Kdog pointed out the priority of pursuing patient satisfaction which seems to be universal but where does that cross lines with anti-discrimination laws?

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    it crosses a line when a message is posted stating exact race not allowed,as in this case discussion.... this is a tough situation

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    Regulations notwithstanding, tough or not, does it fall within a patient's right to decide who cares for him/her? For the record, I'm in the camp that states that qualified staff is qualified staff regardless of race, gender, sexual orientation or astrological sign.

    Quote Originally Posted by Kdog View Post
    it crosses a line when a message is posted stating exact race not allowed,as in this case discussion.... this is a tough situation

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    While patients generally do have the right to select a health care provider and make decisions about their medical treatment, I believe it is perfectly reasonable to refuse to accommodate a request that would infringe on the rights of others or that would endanger patient health and safety. A patient's limited right to legally discriminate does not require anyone else to illegally discriminate.

    Yes, there are still quite a few people who select their doctors and other healthcare providers on the basis of criteria (such as race, religion, nationality, age, sex, gender and sexual orientation) that could not be legally considered in many other settings. Allowing the communication of such requests should not result in others being required to illegally discriminate or to endanger patient health and safety. I also think health care facilities should have a right to limit the time, place and manner for the communication of such requests on their private property. It also makes sense to penalize facilities that accommodate such requests just as we would if they accommodated a request from a patient or anyone else to do anything else illegal.

    Even ignoring any moral and ethical concerns, discrimination is generally bad for business. Management and staffing is difficult enough without adding the burden of developing the logistical procedures and business processes to accommodate individual requests for illegal discrimination and developing a system to hide the accommodations. When that system fails (as it almost inevitably will), legal costs and judgments can result in liabilities that will bankrupt a company; negative publicity can dramatically reduce revenue and it often increases staff turnover and decreases staff morale. Successful claims will often result in the increase of liability and malpractice insurance premiums not only for the facility itself but those practicing there. There can also be resulting Workers' Compensation claims that increases Workers' Compensation insurance premiums (or increases other costs if self-insured). The funds to cover these additional costs have to come from somewhere and regardless of where they come from (profits or budget cuts), a group of people will be economically harmed. If resulting budget cuts directly affect patient health and safety, the result could be non-economic harm that could result in exponentially higher liability. This would be in addition to the direct harm to patient and staff safety and health that might be caused by accommodating an illegal discrimination request.
    Last edited by Peter; 02-25-2013 at 08:05 AM.

  10. #10
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    Peter,

    Outstanding post! Your eloquence on the subject makes me wonder what your background is. Have you considered replying to the OP in Yahoo News?

    R

    Quote Originally Posted by Peter View Post
    While patients generally do have the right to select a health care provider and make decisions about their medical treatment, I believe it is perfectly reasonable to refuse to accommodate a request that would infringe on the rights of others or that would endanger patient health and safety. A patient's limited right to legally discriminate does not require anyone else to illegally discriminate.

    Yes, there are still quite a few people who select their doctors and other healthcare providers on the basis of criteria (such as race, religion, nationality, age, sex, gender and sexual orientation) that could not be legally considered in many other settings. Allowing the communication of such requests should not result in others being required to illegally discriminate or to endanger patient health and safety. I also think health care facilities should have a right to limit the time, place and manner for the communication of such requests on their private property. It also makes sense to penalize facilities that accommodate such requests just as we would if they accommodated a request from a patient or anyone else to do anything else illegal.

    Even ignoring any moral and ethical concerns, discrimination is generally bad for business. Management and staffing is difficult enough without adding the burden of developing the logistical procedures and business processes to accommodate individual requests for illegal discrimination and developing a system to hide the accomodations. When that system fails (as it almost inevitably will), legal costs and judgments can result in liabilities that will bankrupt a company; negative publicity can dramatically reduce revenue and it often increases staff turnover and decreases staff morale. Successful claims will often result in the increase of liability and malpractice insurance premiums not only for the facility itself but those practicing there. There can also be resulting Workers' Compensation claims that increases Workers' Compensation insurance premiums (or increases other costs if self-insured). The funds to cover these additional costs have to come from somewhere and regardless of where they come from (profits or budget cuts), a group of people will be economically harmed. If resulting budget cuts directly affect patient health and safety, the result could be non-economic harm that could result in exponentially higher liability. This would be in addition to the direct harm to patient and staff safety and health that might be caused by accommodate an illegal discrimination request.

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