Managing medically complex patients from around Maryland and the world is a practice that physicians at Johns Hopkins Medical Institutions regularly handle. However, the experience of caring for patients with openly alternate or even bigoted viewpoints regarding matters of race, ethnicity, gender or religion can be difficult. We can look back at the February 2016 issue of the New England Journal of Medicine article: "Dealing with a Racist Patients" for practical perspective and guidance. This article discusses providing care in situations where a patient might have a serious medical condition, but refuses care and how this raises “thorny ethical, legal and clinical issues—and can be painful, confusing and scarring for the physicians involved.” It also explores how providers and health systems might manage race-based reassignment demands that are expected to increase as the U.S. populations becomes more diverse. In addition, the authors put forth a framework (see it here) for addressing these demands in context of informed consent rules, common law, EMTALA and employee rights. We plan to address these issues more directly in a future Journeys in Medicine forum.
Read the full article here: http://www.nejm.org/doi/full/10.1056/NEJMp1514939#t=article
-Thomas K.M. Cudjoe, MD, MPH, fellow in Geriatrics