Discrimination in the Doctor-Patient Relationship

By Holly Fernandez Lynch

Nir Eyal’s post below has teed up the issue of doctors refusing to accept patients for reasons that seem to be pretty questionable.  The latest example has to do with obesity, but there are plenty of others having to do with vaccination status, sexual orientation, and the like.  Sometimes these refusals can be clearly categorized as conscientious objections (religious or otherwise).  And other times they are  a bit fuzzier, such as when the refusals are rooted in attempts to drive changes in behavior  (e.g., “get vaccinated or you can’t be my patient”) or when they stem from having inadequate staffing or equipment.  But for the patient, all of these refusals can feel discriminatory.   And that raises the obvious question: can doctors legally discriminate against patients?  The answer: it depends.  Sometimes yes, and sometimes no.

First, bear with me while I make the obligatory pitch for my book, Conflicts of Conscience in Health Care, which is now a few years old, but the issues are still very much live.  In that book, I delve deeply into the question of how to balance provider conscience and patient access.  In general, I argue that it is important to protect provider conscience, to a point (or points) – and those points have to do with burden on the patient and avoidance of invidious discrimination.   Read More

Meet the Editors – Holly Fernandez Lynch

Next, meet Holly Fernandez Lynch (hlynch at law dot harvard dot edu).

Holly is the Executive Director of the Petrie-Flom Center, where she was previously an academic fellow. Her scholarly work focuses on the ethics of human subjects research and issues at the heart of the doctor-patient relationship, such as conflicts of conscience in health care. Holly practiced pharmaceuticals law at Hogan & Hartson, LLP in Washington, DC (now Hogan Lovells), and worked as a bioethicist in the Human Subjects Protection Branch at NIH’s Division of AIDS. She also served as Senior Policy and Research Analyst for President Obama’s Commission for the Study of Bioethical Issues. Holly graduated from the University of Pennsylvania Law School, and earned her Master of Bioethics from the University of Pennsylvania School of Medicine.  She is currently an IRB member at The Fenway Institute in Boston.

Some of Holly’s representative work includes: