A doctor's everyday ethics

Randy Cohen is a writer with an ethics column (“The Everyday Ethicist” or “The Ethicist,” depending on what source you get the column from). Last week, a doctor wrote in with a difficult situation he was presented with.[1] The short of it is that the doctor is Muslim, and a patient came into the emergency room and refused to be seen by the Muslim doctor. At the time, there was only one other doctor available, who also happened to be Muslim. The first doctor tried to reach the patient’s primary care physician but was unable to. The physician’s assistant offered to complete the exam, but the doctor refused to allow this and discharged the patient without a complete evaluation. The first doctor wondered if he did the right thing.

I found myself wondering what I thought was the ‘most right’ thing to do in this situation. Certainly, the doctor as an individual is allowed to feel indignant if not downright angry in the face of senseless bigotry. But as a doctor, his Hippocratic Oath leads him to ‘first, do no harm,” and to keep the good of the patient as his highest priority. These two things are in conflict for this doctor.

Finally, we don’t know anything about what the patient came into the ER for. If it were a life-and-death emergency, the answer might be different than momentary discomfort, and we do not have information as to which this situation is closer.

In this case, does the right of one individual outweigh the rights of the other? Does the doctor, given his oath to society, have to treat the bigot, regardless of the way he is treated in turn? And in fact, can this doctor treat this patient against his will? Which takes precedence, the patient’s desire to be treated by a non-Muslim, or the patient’s need to be treated?

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[1]Cohen R. Patient Prejudice. The New York Times, 14 Oct 2007. Found at: http://query.nytimes.com/gst/fullpage.html?res=9C07E3DD163EF934A35753C1A9619C8B63