Do Patients Have a Right to Choose Providers Based on Race?

By mmarcotte51/via Flickr

By Shawn Kennedy, AJN editorial director

We have a wonderful librarian here at AJN who is always on the alert for news about nursing and nurses. Recently she sent me a clipping about a legal case, Chaney v. Plainfield Healthcare Center in Indiana’s Court of Appeals, which has important ramifications for nurses. The court ruled in favor of Brenda Chaney, a certified nursing assistant, and reversed the decision of the lower court that had ruled in favor of the Plainfield Healthcare Center nursing home.

Brenda Chaney brought suit against the nursing home for complying with a resident’s request not to have any black health care workers provide care or enter her room, and leaving her in the care of her automated medical alert system. (She also claimed her firing had been racially motivated. The court agreed that it seemed discriminatory.) The court agreed with Chaney that by acceding to the patient’s wishes, her employer created a hostile workplace and violated her rights. The nursing home claimed it was protecting the patient’s rights and that not doing so “risked violating state and federal laws that grant residents the rights to choose providers, to privacy, and to bodily autonomy.” The court did not agree. The crux of the decision is this:

“In any event, Indiana’s regulations do not require Plainfield to instruct its employees to accede to the racial preferences of its residents. The regulations merely require Plainfield to allow residents access to health-care providers of their choice. 410 IND. ADMIN. CODE 16.2-3.1-3(n)(1). If a racially-biased resident wishes to employ at her own expense a white aide, Indiana law may require Plainfield to allow the resident reasonable access to that aide. But the regulations do not say that a patient’s preference for white aides that Plainfield employs trumps Plainfield’s duty to its employees to abstain from race-based work assignments.”

I can’t believe this has been the only case of such discriminatory patient assignments—and wonder if nurses elsewhere have dealt with similar situations.

Bookmark and Share

(Editor’s note: For a little more context, here’s a San Francisco Chronicle story that gets at the role the patients’ rights movement may have inadvertently played in determining the nursing home’s approach.-JM)

2017-02-15T15:02:40+00:00 October 11th, 2010|Nursing|6 Comments

About the Author:

Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.

6 Comments

  1. Sarah January 16, 2011 at 7:27 pm

    I worked on infant/ toddler med-surg floor once, and the same request was made. It wasn’t my patient, but if it was, I would have told the family that we can honor their request if they’d like, but that it could affect the child’s well-being. For instance, one night shift, all the people who provided direct care to the babies were Caucasian. I would tell the parent that if their child stopped breathing in the middle of the night, would they care about race so much then? I may have gotten in trouble for that, but i don’t care. The man was calling us “white devils”. I don’t discriminate about which patients I’ll take care of, whether they hate white people or not, they’ll still get the same courtesy and care as any other family/ patient. I have a feeling that these racist people would change their mind when the only people available to save their child’s life happened to be “white devils”. I don’t think we would be such devils when we save their child’s life. If the family was willing to take that risk and sign papers, I’d respect it, but I’d also try to declare them incompetent to make that decision based on my role as patient advocate. There’s no way on earth, I could just sit and do nothing while a child dies.

  2. CV October 28, 2010 at 3:43 am

    I think this is an interesting debate. The same question can be posed, exchanging the word “race” for “sex.” Does a patient have the right to select providers based on sex? I think, if one follows the same logic as the higher court’s decision, the right to choose a provider based on any discriminatory basis (race, sex, religion, etc) other than professional performance is inappropriate. Certainly, employers cannot hire/fire based on these issues. However, there are plenty of anecdotes available where providers are chosen based on his/her sex. As a nurse, I never want to put a patient in a position where he/she is uncomfortable with me. However, at some point, the patients’ rights may start impeding my ability to do my job. Then, my rights must be addressed too.

  3. R. Shovan October 16, 2010 at 9:19 am

    Working in a suburb of Detroit we are seeing more muslim pts requesting female only providers.
    The tail starting to wag the dog?

  4. MaleNurse, NE October 11, 2010 at 1:03 pm

    Wow! As a male nurse in the Mat/Child field, I will be watching this case. I guess it will have more appeals filed. I can’t comment on the race issue but as a patient advocate I am sensitive to taking assignments that help the patient feel safe and secure usually based on religious grounds. Of course this is acute care and patients don’t often stay long. I am just not sure how to feel especially if the patient was on public assistance.

  5. jm October 11, 2010 at 12:02 pm

    http://www.facebook.com/AJNfans

    Some folks are leaving comments on this one at AJN’s Facebook page. You can join the discussion there, or take part here (we like that too!), but we hope you’ll weigh in. -JM, blog editor

Comments are moderated before approval, but always welcome.