AMA House of Delegates

AMA meeting: Anti-discrimination policy expanded to transgendered

The addition will allow the AMA to publicly oppose discrimination against transgender physicians, just as it would oppose inequities based on age, race or gender.

By Kevin B. O’Reilly — Posted July 16, 2007

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Transgender physicians, medical students and patients should not be discriminated against, the AMA's House of Delegates said at its Annual Meeting here last month.

The Association voted to modify 13 of its policies relating to human rights, medical staff and medical education to add gender identity to the list of characteristics such as race, sex and age that should be protected from discrimination.

The house also recommended that the Council on Ethical and Judicial Affairs add similar language to its policies on civil rights and physician-patient relationships.

The AMA Advisory Committee on Gay, Lesbian, Bisexual, and Transgender Issues, established in 2004, identified relevant policies and recommended the changes.

R. Nick Gorton, MD, is an openly transgender physician who said he was lucky to come out in a tolerant environment. He testified, however, about a transgender medical student whose school attempted to force him to leave when he announced his gender identity. It was only after outside intervention that the medical school even agreed to print the student's new legal male name on his diploma.

"Without policy opposing such discrimination, the AMA could not publicly support this student and condemn the school's actions," said Dr. Gorton, speaking as an individual.

AMA Trustee Steven J. Stack, MD, said he hopes that recognizing the challenges transgender physicians and patients face can have a larger impact.

"We want to be a thought leader in being as inclusive as possible," Dr. Stack said. Not including gender-identity language in AMA policy was an oversight, he added, "and we're happy to have it corrected."

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ADDITIONAL INFORMATION

Meeting Notes: Medical ethics

Issue: Medical device industry representatives often advise physicians about company equipment, many times during surgery, but the AMA had no ethical policy governing this activity.
Proposed action: A new ethical opinion calling on physicians to prevent industry representatives from breaching patient confidentiality, to assure that their hospitals have mechanisms to verify reps' credentials, and to tell patients if a representative is present during a procedure and explain that person's role. [Adopted]

Issue: Are physicians still obliged to uphold medical ethics when they are serving in nonclinical roles?
Proposed action: An ethical opinion saying that physicians are still bound by their medical ethical obligations to the extent that their nonclinical roles -- practicing health law or working as a health care journalist, for example -- rely on medical experience, perspective or training. [Adopted]

Issue: What should physicians do to avoid conflicts of interest relating to their ownership stake in a health facility?
Proposed action: Update existing ethical opinion to clarify that physician ownership must not be contingent on a specified volume of referrals and that doctors should disclose their financial interests when advising their patients. [Referred for study]

Issue: Some patients have reported trouble filling prescriptions, especially for the emergency contraceptive pill marketed as Plan B, because pharmacists refused to fill the orders on the grounds of conscience.
Proposed action: That the AMA prepare a report on reported delays and recommend ways to make sure patients' legally valid prescriptions are filled in a timely fashion. [Adopted]

Issue: The implantation of rice-grain-sized radio frequency identification tags in humans as a way to store medical information is likely to expand, but poses safety and ethical concerns.
Proposed action: Inform patients about the uncertainties associated with RFID tags, ensure that any information stored on the devices is secure and support further safety and efficacy research. [Adopted]

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