Handling Discriminatory Patient Requests

Patients often make unrealistic demands to hospitals and their healthcare providers. Hospitals and most healthcare providers attempt to accommodate those patient demands even when the demand has no basis in science or fact. However, conceding to a patient’s racist request can subject a hospital to legal claims as Hurley Medical Center learned.

The Civil Rights Act of 1964 prohibits employers from discriminating against employees with regard to their compensation, terms, conditions or privileges of employment based upon race, color, religion, sex or national origin. The assignment of particular healthcare providers to particular patients based upon race, color, religion, sex or national origin may affect the terms, conditions or privileges of employment even if it does not affect the compensation of those employees. Hospitals and other health facilities that concede to the discriminatory requests of patients may be putting the facility at risk of a discrimination claim by their staff.

Hospitals and healthcare facilities need to have policies and procedures in place to deal with patients’ discriminatory demands. Unfortunately, politely advising the patient that the hospital cannot accommodate the request and directing the patient to another facility is rarely a viable option. Often these inappropriate requests are made during an emergency when the hospital and its staff should be focused on resolving the patient’s healthcare crisis rather than addressing an inappropriate or discriminatory request.

Not all patient requests or patient assignments are prohibited discrimination. Assigning particular staff members to specific patients or specialty units in the hospital may be acceptable based upon a bona fide occupational qualification. For example, assigning female staff members to obstetrical units is allowed as a bona fide occupational qualification based upon patient privacy. Race discrimination, on the other hand, is never a bona fide occupational qualification.

Hospitals and other healthcare facilities need to be prepared to handle discriminatory requests appropriately. Most hospitals and healthcare facilities have risk managers and administrators available to handle these situations. Those same hospitals and healthcare facilities need to ensure that their front line staff working directly with the patients know to refer these types of cases to the risk managers and administrators.


Michael L. Smith, JD, RRT is board certified in health law by The Florida Bar and practices at The Health Law Firm in Altamonte Springs, Fla. This article is for general information only and is not a substitute for formal legal advice.