The larger point is not about tattoos but about his deciding who he is willing to see and not see. In a private practice setting, it is pretty much his choice. He doesn’t have to give any notice except to say he won’t be seeing the patient. He actually doesn’t even have to give a reason why. And the board of medicine has no say in the matter either, except to field a complaint if there is one; they can’t make him see patients he doesn’t want to see in his private practice (and what is the “state board of medical examiners” anyway? I never heard of them.) So no, just because you think he ought to tell potentially excludable patients up front does not mean he actually has to do that at all.

This issue has been addressed in the courts already, namely by the U.S. Court of Appeals, 5th Circuit, which has affirmed a doctor’s right to refuse to see a patient in a private setting.

Unknowledgable people believe they can’t be refused service for peculiar reasons or even for no given reason at all, but that simply isn’t the case and never has been. These stories are odd and probably rare, but they are not a deviation from allowed practices.

If that was the case, they may have judged correctly. How are we hearing about this? Is our learning of this a result of the would be patient trying to embarass a person with whom she never actually did business. Most people without a conflict oreintation would just shake the dust of his office off his feet, go somewhere else, and complain to their friends.

Medical ethics are clear: except in an emergency, a physician is free to choose whom he shall serve.

But he has the obligation to tell patients up front, when they are making appointments, that he does not see that kind of patient. No hiding his preferences. Full and complete disclosure of his practice’s policies. And a notice posted in his waiting room about his preferences. As well as a policy notice on any website that he maintains for his practice, or any hospital website that lists him in their physician directory.

I wonder what he does when an established patient or their parent, previously sans tattoo, goes out and gets one. Does the doctor fire that patient? Would the state board of medical examiners view that as a valid reason to fire a patient?

The doc thinks tattooed parents are not the kinds of people he wants around his private practice. That is his right and his choice. Showing up displaying a tattoo can get you refused service, just like wearing inappropriate clothing or being drunk.

In this particular case, it was more than inconvenience for the mother. The child was in pain. Also, many doctors here mentioned that a child with otitis could very well be viewed as an emergency. Saying that the fact that woman brought the child to the doctor instead of ER proves that this was not an emergency is ridiculous – we, as lay people, don’t always know what is or isn’t an emergency. Neither did the doctor until he examined the child. Given that one doesn’t just “go to another doctor” and is automatically seen the same day (we don’t even know what time of the day it was) and given that the wait times in the ER could be very long (and that the woman may not know if she should go to the ER or if her problem can wait till the next day), it is quite possible that a child could’ve suffered real lasting harm.

Don’t make yourself seem so stupid.

Nowhere did I equate the legality of this physician’s act with the standards of an ethical act. Those are separate concepts. Nonetheless, his action probably meets the minimum ethical standards of the AMA. That is not necessarily the higher standard to which many people, including many doctors, would judge sufficient for their personal practice, and I do not believe it is intended to be. Those standards do not require philanthropy, something that many contributors to these comments repeatedly fail to grasp. And they do permit the practitioner to exercise considerable latitude in deciding who he may treat. And just because the doctor is a pediatrician and the prospective patient is a child doesn’t change that position. Yes, it may offend. Yes, many find it a very perverse notion of Christian practice. Yes, the patient and her mother were inconvenienced. All that can be true. But as compelling as these ideas might seem to most people, the doctor was still within his rights to do what he did and in doing so still did not breach the standards of ethics of the AMA. The AMA does not prohibit obnoxious beliefs. And you should not expect them to be the last word on “common decency” and other hard to define notions of considerate, compassionate behavior. Other better agencies are suited to make those standards.

And no one said you have to like any of it.