Health Care Law Blog
In a recent decision, the Michigan Court of Appeals held that a physician can be liable for discrimination under Michigan law for refusing to provide artificial insemination services to a single woman. Moon v Michigan Reproductive & IVF Center, PC.
A woman contacted a physician at a clinic about in vitro fertilization services. When the physician learned that the woman was single, he advised her that the clinic did not offer insemination services to single women. Afterwards, the woman sued the clinic for discrimination based on marital status.
The Court of Appeals rejected the clinic’s argument that a physician could refuse to enter into a physician-patient relationship with an individual for any reason at all. The court agreed with the general principle that the physician-patient relationship is “contractual and may only be established voluntarily and through the consent, express or implied, of both the doctor and patient.” However, the court ruled that a physician may not refuse to enter into a physician-patient relationship based on discriminatory factors in violation of the Elliott-Larsen Civil Rights Act. The statute prohibits discrimination “because of religion, race, color, national origin, age, sex, height, weight, familial status, or marital status.” Liability can be imposed if one of the listed classes is “at least one of the motivating factors” in the decision to decline a patient.
This case raises concern about the “gray areas” where medical decision-making is affected by factors that are protected under the civil rights act. Some cases are easy. A gynecologist could not be sued for declining a male’s request for services. A physician could easily be held liable for refusing a patient based on race. The more difficult cases will arise when a prospective patient’s age, height or weight is considered. Those factors can be legitimate physical conditions that affect a physician’s clinical judgment as to whether medical services should be provided. On the other hand, they could also be the basis of allegations of discrimination by an individual who is unable to obtain desired services.
Physicians, health care professionals and health care facilities would be well advised to carefully document the clinical support for declining patients or services. It would also be prudent to discuss any questionable cases with your attorney.
If you have any questions about the case or other similar matters, please feel free to contact me.
