A tricky ethics question

16 Dec
2003

Robert Prather writes:

I have a question. I don’t know if you read this post: Regulation Through Litigation but a friend went to a surgeon’s office and the doctor won’t provide service to plaintiff’s attorneys or their employs. In a political / philosophical sense I agree with it since you could make a good argument that these guys have been enemies of the healthcare industry.

However, I’m wondering if it’s ethical. Any thoughts?

What a great ethical dilemma! I will cheat on this one and give two answers.

For elective care, i.e., normal office consultation, physicians have no obligation to accept any patient. The physician can elect to see only private insurance, only indigent patients, or only patients who live in their town. If one assumes that the potential patient pool is large enough, then these are legitimate decisions.

Physicians can even fire patients for any variety of reasons.

Physicians should not abandon patients. Thus, if a patient has an ongoing relationship with this physician and then goes to work for the lawyer, he/she should continue the doctor patient relationship.

All discretion ends when emergencies arise. If the surgeon is on call for the emergency room, and the lawyer comes in with an emergency, then the only ethical standard that I know would require the surgeon to provide the emergency care.

There are probably more intelligent ethicists who could expand on this quick and dirty analysis.

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5 Responses to A tricky ethics question

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Insults Unpunished

December 16th, 2003 at 8:44 pm

Medical Ethics
I posed a question to db, who is a doctor, about the ethical implications of refusing to accept patients because they are plaintiffs’ attorneys or the employees of same. I’m not a doctor and am inclined to say a doctor…

Avatar

Ross

December 16th, 2003 at 9:46 pm

Interesting question. In general, a physician has the right to refuse to see a patient, so long as there is not an emergency or critical ongoing relationship (that would be abandonment), ample notice and/or opportunity to get a new physician has been given by the doc, or there are no additional contractual responsibilities to which the physician has agreed (e.g., a contract to treat a certain class or group of people or employees of a particular business, in which case there may be a colorable breach of contract case).

I don’t think the physician would have any problem getting representation should the plaintiffs’ attorney or his employees decide to sue, however. After all, we lawyers have no consciences and will represent anybody.

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John Anderson

December 17th, 2003 at 8:43 am

Cute. But while I can certainly sympathise, ethically I don’t think it has any standing. Legally, it just may squeak by, though I doubt it, but ethically it seems equivalent to a vegetarian doctor refusing to see a patient who may include meat in his diet or a doctor using an Atkins-style diet refusing to treat a vegetarian.

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Chris Rangel

December 17th, 2003 at 9:49 am

Generally I don’t think it’s a good idea to piss-off the lawyers and I don’t think that refusing to treat trial lawyers would be effective if we were actually trying to send a message this way (the lawyers would just draft the “lawyer antidiscrimination act”).

However I have to wonder if it ever does really happen that a lawyer can’t get regular health care. There is an infamous trial lawyer down in South Texas who has sued tons of doctors and won millions and every doc in the valley knows this guy. I really wonder if he ever has any trouble getting him or his family seen by a physician? Don’t burn your bridges . . eh?

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Anonymous

December 17th, 2003 at 7:14 pm

I see the problem of treating a plainiff’s attorney as being somewhat similar I suppose to treating John Gotti, Al Capone, or any other mobster/extortionist. As a physician, you may not want to treat, but the consequences of denial of treatment (broken bones, cement overshoes, or devastating lawsuit) is potentially the same. Many physicians would not refuse treatment simply out of fear.