As a family medicine physician specializing in HIV for over two decades, standing up for my patients' rights and speaking out against discrimination in healthcare have become an unavoidable and integral part of caring for my patients. When the Trump Administration in 2019 launched an initiative to end the HIV epidemic in the United States by 2030 featuring HIV preexposure prophylaxis (PrEP) as a central strategy, I was cautiously hopeful that we could break through some of the discriminatory barriers and start to chip away at the stigma that my patients face in accessing healthcare services.
Over the past year, it has been chilling, to say the least, to watch as state policymakers and the courts take actions that are eroding the basic tenets of our healthcare system and allowing religious beliefs to take precedence over patients' rights to make informed decisions regarding their healthcare and over our right as medical providers to practice medicine without undue government interference. Most recently, the decision by a US District Court judge in northern Texas allowing employers in the district to deny coverage of PrEP on the basis of their personal religious beliefs was another major setback to the medical field. This ruling has very dangerous implications for the future of our nation's health and serves only to widen existing health disparities.
The concerning action in northern Texas followed a flurry of actions by states to restrict or deny access to gender-affirming care to transgender youth, with serious penalties for providers who fail to adhere to the law — including being charged with a felony. These discriminatory and harmful laws are advancing despite widespread consensus among the medical community on the importance of supporting access to gender-affirming care for transgender youth.
States also acted swiftly to restrict or deny access to safe abortions after the Supreme Court overturning of Roe v Wade in deciding Dobbs v Jackson Women's Health. According to the Kaiser Family Foundation, more than half of states now limit safe abortion access — which, in addition to other serious consequences for pregnant people, also has infectious diseases implications.
These laws and policies interfere with our ability to practice good medicine and will disproportionately harm populations who have already been let down by our healthcare system:
According to data recently released by AIDSVu, Black and Hispanic people represent 42% and 27% of new HIV diagnoses but just 14% and 17% of PrEP users, respectively.
Black people have the highest pregnancy-related mortality rate (40.8 per 100,000 births), with American Indian and Alaskan Natives second (29.7 per 100,000 births) compared with White people, who have the lowest rate (12.7 per 100,000), according to KFF.
As healthcare professionals, we must take action and stand up for our patients, for our right to practice medicine and for our sworn duty to save lives. Here's what we can do.
Urge local, state, or national organizations you are involved with to take a stand. The Infectious Diseases Society of America and the HIV Medicine Association, which I chair, recently released a policy statement urging state and federal policymakers to take steps to ensure that patients retain the freedom to elect to receive medically recommended care regardless of their race, ethnicity, sex, gender identity, sexual orientation, or disability.
At the local level, engage with your community and state policymakers to educate them on your work as healthcare professionals and your patients' experiences, highlighting the importance of protecting your patients' rights and your ability to offer them the best available medical care.
Challenge and educate your colleagues to end the stigma, discrimination, and misinformation that persist within our profession to the detriment of patients and our nation's health.
Exercise your right to vote and help elect officials who will stand up for science and protect your patients' rights.
As is becoming clearer with each passing day, we in the medical profession can no longer sit on the sidelines, watching the erosion of patient rights in the name of religious or personal beliefs. Healthcare has become political whether we like it or not. We must reclaim our professional autonomy, preserve the sanctity of the provider-patient relationship, fight for the rights of our patients, and save the heart and soul of our nation.
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Cite this: Standing Up for Our Patients' Rights and Our Right to Care For Them - Medscape - Oct 03, 2022.