Michigan Pediatrician Refuses to Treat Lesbian Couple's Baby

[jdh71]

Yeah, you don't mean thought crime, except you do. You're not getting the issue. It is not about thoughts--it is about actions, particularly discrimination and speech.

What action actually happened?? Where is the actual harmed party. Point to the damages. There were not actual "actions". Just thoughts.

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[jdh71]

Exactly! you are not getting it. Discrimination in the provision of medical treatment and speaking about why you did it is not a thought. Read that again slowly.

You would have a point if the patient actually didn't get seen. Except that is not what happened. I get it fine. It's you that are unable to think straight about this.

 

[fishingboat]

What action actually happened?? Where is the actual harmed party. Point to the damages. There were not actual "actions". Just thoughts.

Your confusion deepens. What happened was that she refused to see a patient because the patient's parents were lesbians. Damages, though relevant in a civil suit, are not relevant to this. These were actual actions, not just thoughts.

 

[fishingboat]

You would have a point if the patient actually didn't get seen. Except that is not what happened. I get it fine. It's you that are unable to think straight about this.

There is certainly epistemic closure in this thread, but it is entirely yours. You are the one who cannot acknowledge what is right before you...that discrimination itself is an act, and speaking about it is an act. These were not thoughts (that is, some private process occurring within the doctors head--these were acts that were witnessed and heard).

 

[charmiedermie]

That's a different scenario. Nor is it an answer the question I posed.

Fine, I will answer. Your hypothetical scenario to @touchpause13 is not unethical bc a patient-physician relationship has not been severed, unlike in this case.

 

[jdh71]

Your confusion deepens. What happened was that she refused to see a patient because the patient's parents were lesbians. Damages, though relevant in a civil suit, are not relevant to this. These were actual actions, not just thoughts.

There is no confusion. This is just the same as if I can't see a patient in clinic because I don't have time or I'll be busy with a procedure and my partner sees the patient instead at the same time. I have not made any action toward that patient directly to not see them if they actually get seen. I've not been "unethical". This is essentially the same scenario presented here and the only difference is the thoughts of the physician in question.

 

[jdh71]

There is certainly epistemic closure in this thread, but it is entirely yours. You are the one who cannot acknowledge what is right before you...that discrimination itself is an act, and speaking about it is an act. These were not thoughts (that is, some private process occurring within the doctors head--these were acts that were witnessed and heard).

So thoughts are only "ok" as long as you never say anything about them?? That seems to be a bit convenient and disingenuous. What are thoughts if not expressed?? How would one ever be punished for a thought crime if it were only living in a mind??

 

[jdh71]

Fine, I will answer. Your hypothetical scenario to @touchpause13 is not unethical bc a patient-physician relationship has not been severed, unlike in this case.

How was a patient-physician relationship severed? It never started.

 

[fishingboat]

So thoughts are only "ok" as long as you never say anything about them?? That seems to be a bit convenient and disingenuous. What are thoughts if not expressed?? How would one ever be punished for a thought crime if it were only living in a mind??

I think you are coming around, finally. Yes, that is exactly what I am saying. When you express a thought, that is an act. The act is often speech, or perhaps it is a decision with real world implications, like refusing to see a patient and telling the patient why you refused. To act on a thought is often, and to speak on it is almost certainly your right. It is other people's right to react to those acts, and that reaction might include negative social consequences. Which is why it is fatuous to talk about "thought crimes" here--because these are not thoughts, they are actions.

 

[charmiedermie]

The free market PUNISHING her for her opinion. Yes.

I think you have to be more than a little obtuse or perhaps intellectually dishonest not to see the punishment here, even if you agree it's justifiable or a naural consequence. It's happening. You brought up karam. What is karma after all if not the recompense for the life lived, some to positive ends and some to negative ends. I don't think it's that hard even for medical students to see that negative karma is really just punishment of one form.

No one cares about her opinion. She used her opinion to actively discriminate against giving medical care to a patient once a physician-patient relationship was established. You are being a little intellectually dishonest if u think she is being punished just for the thoughts in her head. This case is medical professionalism at its core.

 

[jdh71]

I think you are coming around, finally. Yes, that is exactly what I am saying. When you express a thought, that is an act. The act is often speech, or perhaps it is a decision with real world implications, like refusing to see a patient and telling the patient why you refused. To act on a thought is often, and to speak on it is almost certainly your right. It is other people's right to react to those thoughts, and that reaction might include negative social consequences. Which is why it is fatuous to talk about "thought crimes" here--because these are not thoughts, they are actions.

I'm not coming "around". I've been here the whole time. You've been stuck in an outragegasm.

Thoughts unless expressed are meaningless. It's the sound of one hand clapping. A "thought crime" (in quotes for a reason, don't get pedantic) is being punished for that thought being expressed. You can't actually punish anyone for THINKING anything (yet). And the bigger point here regarding "thought crime" is no untoward action was actually taken by anyone involved at all at any time. The only way the thought was known was because it was written, therefore what is being punished here is the thought. I mean I AM taking crazy pills in here today. Just admit it. This doctor "thinks bad" and you don't like it.

 

[jdh71]

No one cares about her opinion. She used her opinion to actively discriminate against giving medical care to a patient once a physician-patient relationship was established. You are being a little intellectually dishonest if u think she is being punished just for the thoughts in her head. This case is medical professionalism at its core.

Her opinion is the only thing anyone cares about. There isn't a medical issue here, at all, not in this case. If there is a medical issue, point to it.

 

[fishingboat]

I'm not coming "around". I've been here the whole time. You've been stuck in an outragegasm.

Thoughts unless expressed are meaningless. It's the sound of one hand clapping. A "thought crime" (in quotes for a reason, don't get pedantic) is being punished for that thought being expressed. You can't actually punish anyone for THINKING anything (yet). And the bigger point here regarding "thought crime" is no untoward action was actually taken by anyone involved at all at any time. The only way the thought was known was because it was written, therefore what is being punished here is the thought. I mean I AM taking crazy pills in here today. Just admit it. This doctor "thinks bad" and you don't like it.

I just love this thing where you say "I'm not talking about thoughts!" then you explicitly say you are talking about thoughts. I think you are, in fact, taking crazy pills. Either way, you are the only one talking about thought crimes. The rest of us are talking about discrimination and speech used to justify discrimination.

 

[Shikima]

I'm not coming "around". I've been here the whole time. You've been stuck in an outragegasm.

Thoughts unless expressed are meaningless. It's the sound of one hand clapping. A "thought crime" (in quotes for a reason, don't get pedantic) is being punished for that thought being expressed. You can't actually punish anyone for THINKING anything (yet). And the bigger point here regarding "thought crime" is no untoward action was actually taken by anyone involved at all at any time. The only way the thought was known was because it was written, therefore what is being punished here is the thought. I mean I AM taking crazy pills in here today. Just admit it. This doctor "thinks bad" and you don't like it.

It's ok, OP is wanting to use guilt for social control purposes under the guise of martyrdom.

 

[charmiedermie]

How was a patient-physician relationship severed? It never started.

Sorry, but you're wrong.
www.uthsc.edu/medicine/legaledu/UT/ factsheets/PhysicianPatientRelationship.pdf

The time to do that was not accepting that patient on your schedule, before they are in your patient room.

 

[DoctwoB]

Based on my understanding of the law, what she did was (unfortunately), not illegal. The federal civil rights act makes it illegal to discriminate based on race, religion, color, or national origin. The ADA added disability to that list. Some states have passed separate laws adding sexual orientation to that list, but apparently that is not the case in this state.

Hopefully this case gets enough attention to add sexual orientation to the list of classes that are illegal to discriminate against. In the mean time, the internet trolls shall exact their vengeance. The problem ends up being that when a wrong but forgivable act becomes a national sensation like this, the punishment always far exceeds the crime. For example, see this nytimes article about one lady who wrote an offensive tweet and basically had her life ruined. Use times like this to raise awareness, not for massive public shaming of someone whose views are no longer politically correct.

http://www.nytimes.com/2015/02/15/magazine/how-one-stupid-tweet-ruined-justine-saccos-life.html?_r=0

 

[jdh71]

I just love this thing where you say "I'm not talking about thoughts!" then you explicitly say you are talking about thoughts. I think you are, in fact, taking crazy pills. Either way, you are the only one talking about thought crimes. The rest of us are talking about discrimination and speech used to justify discrimination.

When did I say I wasn't talking about thoughts?

And it is true that I am the one talking about "thought crime" because that was what this was, no matter you'd like to characterize it so you feel like you don't need to address the point. The bottom line is she is being "punished" for discriminatory thoughts.

 

[jdh71]

Sorry, but you're wrong.
www.uthsc.edu/medicine/legaledu/UT/ factsheets/PhysicianPatientRelationship.pdf

The time to do that was not accepting that patient on your schedule, before they are in your patient room.

Incorrect. A relationship was never started. Just being on a schedule does not make a patient mine, or anyone else's. The relationship begins when you meet.

 

[fishingboat]

When did I say I wasn't talking about thoughts?

And it is true that I am the one talking about "thought crime" because that was what this was, no matter you'd like to characterize it so you feel like you don't need to address the point. The bottom line is she is being "punished" for discriminatory thoughts.

I've addressed this again and again, but I'll keep doing it until you comprehend it. Can you really be an attending? How can you not understand this?

The bottom line is that she is being punished for an act of discrimination and her speech about why she did it. This is not a thought.

 

[Shikima]

When did I say I wasn't talking about thoughts?

And it is true that I am the one talking about "thought crime" because that was what this was, no matter you'd like to characterize it so you feel like you don't need to address the point. The bottom line is she is being "punished" for discriminatory thoughts.

One could argue that there is reverse discrimination against her religion.

 

[fishingboat]

When did I say I wasn't talking about thoughts?

And it is true that I am the one talking about "thought crime" because that was what this was, no matter you'd like to characterize it so you feel like you don't need to address the point. The bottom line is she is being "punished" for discriminatory thoughts.

You said you were talking about thoughts when you said I wanted to punish the doctor for her thoughts. It is right there in print.

 

[jdh71]

I've addressed this again and again, but I'll keep doing it until you comprehend it. Can you really be an attending? How can you not understand this?

The bottom line is that she is being punished for an act of discrimination and her speech about why she did it. This is not a thought.

You like the last word. I can see that. So do I. Maybe this goes on and on until you can . . . comprehend it . . .

Of course it's a thought. If not expressed thoughts are nothing. You wouldn't know the thought if not for the expression. Therefore you are actually punishing the thought.

And can I get a ruling from anyone on the Burnett's law on this quote??

 

[PL198]

No one is stopping you from exercising your free speech and talking about someone acting like a jerk. It's well within your rights to point out if someone is being a dingus. Yes the doc had the right to do what she did, but so do the parents. They don't have any legal case, so it only makes sense that they would go for the "tell everyone that Dr. whatherface was a jerk" route.

right but trying to change policy based on public sympathy is a joke. it's like taking a rape case public when it fails in court. can't get your desired outcome(doc seeing your baby) so you attempt to ruin them socially.

 

[jdh71]

One could argue that there is reverse discrimination against her religion.

Would that really be "reverse"?

Though, I don't think in most of the cases of outrage here is anyone mad because the physician is a Christian per se (I'm assuming Christian). Most folks are mad because the doctor arranged for another doctor to see a patient because the patient's parents were gay.

 

[charmiedermie]

Her opinion is the only thing anyone cares about. There isn't a medical issue here, at all, not in this case. If there is a medical issue, point to it.

She allowed her opinion to influence her actions which were after the Contreras family interviewed several pediatricians, they chose Dr. Roi bc of her treatment approach and knew then they were lesbians, then allowed them to make an appointment under her, have them show up for their visit for her, and then pull the rug from under them.

 

[jdh71]

You said you were talking about thoughts when you said I wanted to punish the doctor for her thoughts. It is right there in print.

I know. I've been talking about thoughts. And their punishment.

I'm just not sure if we are agreeing or not here.

 

[Ost3oclast]

I've never seen the word "thought" so much in an SDN thread....

In other news, I doubt God told the doc NOT to treat a child. That's just ridiculous.

 

[jdh71]

She allowed her opinion to influence her actions which were after the Contreras family interviewed several pediatricians, they chose Dr. Roi bc of her treatment approach and knew then they were lesbians, then allowed them to make an appointment under her, have them show up for their visit for her, and then pull the rug from under them.

The parents aren't the patient though.

 

[jdh71]

I've never seen the word "thought" so much in an SDN thread....

In other news, I doubt God told the doc NOT to treat a child. That's just ridiculous.

inohrite?

 

[charmiedermie]

The parents aren't the patient though.

The patient was a 6 day old baby at the time. The primary medical decision makers are her parents. I'm sure you know this or are being "more than a little obtuse".

 

[PL198]

can you imagine the outrage though if the doc had just said outright " I chose to not treat the baby" compared to saying god told her to do it? That would be like current outrage squared because for some reason people accept religion as a justification

 

[jdh71]

The patient was a 6 day old baby at the time. The primary medical decision makers are her parents. I'm sure you know this or are being "more than a little obtuse".

The baby wasn't born when physician met with parents. Doctor and patient never actually met. There was never a "relationship".

 

[jdh71]

can you imagine the outrage though if the doc had just said outright " I chose to not treat the baby" compared to saying god told her to do it? That would be like current outrage squared because for some reason people accept religion as a justification

Well. I think it gives people something to at least get their brains around to understand a WHY even if they strongly disagree.

Besides a pediatrician simply declaring not not see one particular baby arbitrarily wouldn't make a lot of sense. I don't know if people would be more outraged, or more confused.

 

[charmiedermie]

Incorrect. A relationship was never started. Just being on a schedule does not make a patient mine, or anyone else's. The relationship begins when you meet.

She interviewed with both parents and knew at that time they were lesbians. This wasn't just a calling in and making an appointment.

 

[jdh71]

She interviewed with both parents and knew at that time they were lesbians. This wasn't just a calling in and making an appointment.

I know. Still NOT the patient.

 

[charmiedermie]

The baby wasn't born when physician met with parents. Doctor and patient never actually met. There was never a "relationship".

So now you're just arguing semantics when u know children can't make medical decisions for themselves and their parents do make those decisions on their behalf. We don't know when the interview happened - before or after birth.

 

[charmiedermie]

can you imagine the outrage though if the doc had just said outright " I chose to not treat the baby" compared to saying god told her to do it? That would be like current outrage squared because for some reason people accept religion as a justification

If the doctor had said during her interview with the parents that she was uncomfortable, i don't think it would be as huge of a deal. The family interviewed pediatricians to specifically try to avoid this type of situation, as they would want someone who would be comfortable with a lesbian parent family.

 

[jdh71]

So now you're just arguing semantics when u know children can't make medical decisions for themselves and their parents do make those decisions on their behalf. We don't know when the interview happened - before or after birth.

Parents make decisions but they are still not the patient. When I have a patient sick on a ventilator, I may have the spouse making medical decisions, but I am in no way confused about who the patient is.

This isn't "semantics". idontthinkyouknowwhatthatwordmeansmeme.jpg.

The parents are NOT the patient. Period.

 

[oldanddone]

ok first .... al jazeera pro lgbt article...interesting!

in the article, it seemed that the parents were very upset with the idea that they had done a lot of research on which pediatrician to see...their midwife had reccomended this one as 'holistic', they had a handful ready to interview, and they were so impressed that they chose this one. they saw her with a lot of time to spare before the birth. as parents, they want a lot of say over what practitioner they are going to work with.

on the day of the newborn exam, they are given a different doctor - unknown, unvetted, and untimely being a bit of a bait-and-switch at the last minute. for parents who seem so rigourous, i can see why they didn't like now needing to depend on an unknown entity.

i wonder whether things might have gone better if there had been discussion well in advance, and help hearing what kind of practitioner they were looking for in order to tailor suggestions of, for instance, three other names that the pediatrician knew might be a good match.

of course, then there is the broader issue of whether a physician should be able to deny service based on a person's sexuality/family constellation. or whether just certain procedures/advice (birth control, abortion). these topics are all contested ground with many things at stake - justice and equality for communities, acting from conscience and when it is 'allowed'. what is at stake. whether a person must confront their prejudices, or when it is considered part of diversity to have differences that cannot be overcome. when a patient can refuse care based on prejudices towards a physician. when it is important to recognize that care is being compromised and what to do about it...lots of things. who gets to decide. who has the power to mandate. etc. etc. the makings of a great debate.

it's the lesser-recognized outcomes that i'm interested in. i was a member of lgbt community in the past, and knew what it felt like to experience homophobia in healthcare - the kind that gets to fly 'under the radar'. at the same time, i'm interested in the over-arching push to 'mandate' professionals into a particular practice style which goes against autonomy and other principles. just lots of different angles. and who uses them. when there is the right to physician-assisted suicide, it is the religious doc orgs that are using the right to practice based on conscience. and yet, there is something interestingly humanistic there too..the right to be a human being with similarities and differences, foibles and excellences, and recognizing when one's ability to care is compromised...and not just a doctor-bot, replaceable on the assembly line. who says what, with what power behind them, to what ends...that's what interests me. and that isn't always straightforward i.e. this to me is not just an access to care and homophobia issue.

 

[charmiedermie]

Parents make decisions but they are still not the patient. When I have a patient sick on a ventilator, I may have the spouse making medical decisions, but I am in no way confused about who the patient is.

This isn't "semantics". idontthinkyouknowwhatthatwordmeansmeme.jpg.

The parents are NOT the patient. Period.

Your scenario of a spouse making medical decisions for a patient who is mechanically ventilated is different from that of a parent making medical decisions for their child who is 6 days old, who is below the age of legal consent, and can't effectively communicate their thoughts and decisions to the pediatrician.

 

[jdh71]

Your scenario of a spouse making medical decisions for a patient who is mechanically ventilated is different from that of a parent making medical decisions for their child who is 6 days old, who is below the age of legal consent, and can't effectively communicate their thoughts and decisions to the pediatrician.

No. It isn't. Someone is making decisions for a patient who cannot. The decision maker is still NOT the patient.

 

[VA Hopeful Dr]

Your scenario of a spouse making medical decisions for a patient who is mechanically ventilated is different from that of a parent making medical decisions for their child who is 6 days old, who is below the age of legal consent, and can't effectively communicate their thoughts and decisions to the pediatrician.

Yeah, there was no doctor-patient relationship formed. We can argue all day about whether this was a dick move (it was) and whether this could have been handled better (it could have) but there was no patient abandonment here.

 

[charmiedermie]

No. It isn't. Someone is making decisions for a patient who cannot. The decision maker is still NOT the patient.

Good luck with that in a malpractice lawsuit where a parent sues bc of something that happened to a child. I guess you can use the claim that they have no standing bc they're not the patient. lol.

 

[charmiedermie]

Yeah, there was no doctor-patient relationship formed. We can argue all day about whether this was a dick move (it was) and whether this could have been handled better (it could have) but there was no patient abandonment here.

I never said there was patient abandonment and I never said what they did was illegal.

 

[jdh71]

Good luck with that in a malpractice lawsuit where a parent sues bc of something that happened to a child. I guess you can use the claim that they have no standing bc they're not the patient. lol.

One thing has nothing to do with the other really. Though the context here is still the actual patient. Unless something happened to the pediatric patient himself, no one can sue anyone. The patient. The actual patient. The person who is the patient.

Look. It's ok to admit you were wrong and just stop.

 

[oldanddone]

i thought in peds, it's the child and caregiver that is a dyad/family constellation. much like any patient that doesn't have capacity, there's an extension of a patient in the form of the person who makes the decisions?

also - the initial visit, where there was an agreement for care, didn't that initiate the infant/caregiver as a patient/person who makes decisions for patient as attending that particular clinic?

 

[charmiedermie]

One thing has nothing to do with the other really. Though the context here is still the actual patient. Unless something happened to the pediatric patient himself, no one can sue anyone. The patient. The actual patient. The person who is the patient.

Look. It's ok to admit you were wrong and just stop.

Your entire argument rests on the premise that bc the child was not born yet when parents were interviewing, there was no physician-patient relationship there, when u don't know if the interview happened before or after the daughter's birth.

I know u like to argue and tweak the scenario to fit your argument, but u should stick with what happened here.

 

[charmiedermie]

i thought in peds, it's the child and caregiver that is a dyad/family constellation. much like any patient that doesn't have capacity, there's an extension of a patient in the form of the person who makes the decisions?

also - the initial visit, where there was an agreement for care, didn't that initiate the infant/caregiver as a patient/person who makes decisions for patient as attending that particular clinic?

And that agreement for care was after they interviewed her and selected her.

 

[jakeislove]

Yeah, there was no doctor-patient relationship formed. We can argue all day about whether this was a dick move (it was) and whether this could have been handled better (it could have) but there was no patient abandonment here.

This is why I hate political correctness. We're obligated to say/write "it's a dick move" and similar platitudes so no one chimp-screams about homophobia.

We're losing the ability to honestly debate topics.

 

[VA Hopeful Dr]

This is why I hate political correctness. We're obligated to say/write "it's a dick move" and similar platitudes so no one chimp-screams about homophobia.

We're losing the ability to honestly debate topics.

You know, I actually debated whether or not to even include that. I don't condone the behavior, obviously, but neither am I going to really do anything more about it. I don't think its an ethical violation, legal violation, or anything like that. I wouldn't have done it, and I think it was mean to do it (though I don't think it was mean-spirited), but that's about it.