Lots of patients end up at our doorstep its what keeps us working and pays the bills.  Have you ever stopped to take inventory of personal bias? Yesterday I wrote about “fat shaming” which to a certain degree we need to discuss weight with people who have a BMI over 28. We need to make sure that there are healthy choices out there for them they are willing to engage in or at least provide them with the information, you do not have to be an asshole about it.

But let’s talk about real bias and passing of judgment.  Shortly after taking office the President worked on rolling back or freeze LGBT friendly rules.

A regulation that would have allowed transgender HHS staff more protections when using the department’s bathrooms and other facilities.

New proposed regulations that would have further banned discrimination in Medicare and Medicaid.

Section 1557 of the Affordable Care Act, which banned sexual-orientation-based discrimination in healthcare and extended those protections to transgender individuals for the first time.

And earlier in the year, the administration issued a proposed rule that would provide new protections for healthcare workers who have moral objections to treating patients. Supporters of the proposal say it promotes religious freedom, but critics argue it’s simply “paving the way for discrimination.”

This critic agrees.  You went to school to care for all humans, not just the ones you can tolerate.  There are very few cases that I would say could warrant your refusal:

A family member, someone you may have had a violent encounter with, the list is very limited; And it should be. You chose this path to care for patients and first “do no harm” not pick and choose who I moral object with.

As a provider, you must take inventory.  What things do you object to? Gays? People of Color? White people? A woman who wants an abortion? The woman who has had an abortion? Criminals? Child Molesters?  I can be pretty out there or tame, what about someone of a different religion? Or who is homeless?

Will you be able to treat them, fairly and work with their needs, not yours?  If you answer no, do you realize the obligations that you have to assist that person to a competent provider that will be able to meet their needs? While that requirement was also minimized by the new administration, it is part of your nursing or Hippocratic oath.  I am going to say this now.  The Trump administration has been horrible for healthcare in terms of rolling back reforms and attempting to destroy the ACA (also known as Obamacare).  We as providers must rise above politics and act ethically and appropriately.

An example; a pharmacist is Catholic and is morally against birth control pills.  He refuses to fill a script and sends the patient away without any idea who close by might fill it (even one of his colleagues in the store). Wrong dude.  Also, why the hell are you a pharmacist if you are refusing to do your job? I get it Catholics hate birth control, but who are you to force your moral view on ANYONE. If you absolutely can’t get past it I have 2 comments; One, find the patient a quick and close pharmacist and offer to transfer the script to save the time she has wasted with your moral issues and two, consider another line of work.  Seriously if you can’t serve all patients why bother? I have also seen pharmacists refuse to fill HIV medications for patients based on their bias towards homosexuals. As PCPs we are guilty of the same thing. We are also not obligated, nor should we give the patient an opinion about their choices based on our morals. The worst part is we don’t look at are our colleagues and tell them this is not right. We owe it all the way around to “police” our ranks and call out this kind as well as other “bad’ behaviors.

Ok, Karen, fuck that, Micaela, this does not give you license to falsely report someone because you do not like them.  This does not further healthcare or nursing.

It’s up to us! Hospital administration only cares about the bottom line. They could give a rats ass about our issues, and when they do “handle” them, they mishandle them badly.

Take moral inventory and decide how you are going to act, ethically.  I do not care what your bias is you need to overcome it or have a plan for those patients that allows them to keep their dignity.

Yeah, I should not have to say this to health care professionals. If this is you, correct your behavior. You know you are grossly in the wrong and really despite what you think everyone doesn’t need to look at morals the same way you do.

Bottom line, we are obligated to care, so really care and save your religion and morals for church on Sunday.