Medical Ethics

This story seemed so fringe I thought it would evaporate. Dr. Jack Cassell, a Florida urologist put a sign on his office door, ‘If you voted for Obama… seek urologic care elsewhere.’ He claims this does not amount to turning anyone away. I claim that he doesn’t have the cojones to acknowledge the plain meaning of what he wrote. I hate it when they do that–it debases the language.

Anyway, there may be a court case around it, so here’s a nursing perspective.

In the twenty years I’ve been an RN, I’ve cared for many wonderful people and it’s a privilege to make a living this way. I have also cared for people who were rude to me, and worse, rude to the aides I supervised. On rare occasions I’ve done a risk assessment for potential danger to myself or staff, but never left anyone without access to care. Most times I saw the patient with no cover except an escape plan. So far, so good.

Tell me if this hypothetical is far-fetched. An elderly patient shows up at the office of Dr. Jack Cassell for a painful and debilitating urinary problem. He has waited weeks for this specialist appointment and is hoping the doctor can help him. He sees the sign on the door and walks away.

If I saw a sign like that, I would question the doctor’s ethics, judgment, and competence. Doctors need to have enough humility to listen to their patients, to not pre-judge, and to be willing to change course when the treatment isn’t working. Arrogance is a handicap. And a doctor who can’t stand by his own words as they would be commonly understood is dangerous. That’s the kind of doctor who writes deliberately vague and incomplete orders thinking he’s protecting himself from lawsuits.

On very rare occasions I’ve had to give nursing care to seriously bad people. I did my job. I’m not going to get sued or lose my license because some offender caused me to lose my cool.

I hope this doctor loses in court. If medical people have the right to refuse services at whim then the whole basis for respecting the profession is gone.

MORE ON THIS: At Buzzflash. Good post that sounds like it was written by a nurse.

SECOND THOUGHTS: I do a lot of elder care, and older men are probably the majority of patients who visit a urologist. Urinary problems can be extremely painful and really interfere with your life. Patients can find another urologist, it’s true, but that means a call to the primary doctor, insurance hassles, and more waiting. When you have a tube up your urethra and a bag strapped to your leg I’ll bet you count the days until you can see that specialist. Scaring patients away like that is cruel.