DETROIT – It has been called one of the “open secrets” in the U.S. medical world — 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 the seldom-discussed issue, which 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 care 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.” Battle 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.
Hurley Medical Center President Melany Gavulic said in a statement that the swastika tattoo “created anger and outrage in our staff,” and that supervisors had raised safety concerns. Gavulic said the father was told his request could not be granted.
Battle told the Detroit Free Press that 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 blacks 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 the neonatal intensive care nurses “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.
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 blacks.
The complaint alleged that supervisors honored the man’s request. The case was settled confidentially before going to trial. Frank Finch III, the attorney for the workers, said hospital officials also cited employee safety in their defense. “That defense doesn’t fly under the antidiscrimination law,” Finch said. “Hospitals cannot use that as a defense in nonemergency situations.”