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Comment by peterwwillis | Hacker News Reader

This is going to be a shitshow soon, so here's a terrible comment to kick things off:

Will surgeons soon be able to refuse to operate on patients because they're gay? After all, it's a service in an open market.

edit: it has been legal and common practice for doctors to refuse service to gay and trans people for at least two years. see thread below

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Except the surgeon has no reason to care about the sexual orientation of their patient. In the baker's defense, the couple's sexuality influences the end result of the cake that will then be put on display. Baking, in that regard, is an art form and it'd be silly to force the man to work on a piece of art that he cannot pour all of his soul into. Be it for lack of experience or religious conviction, forcing people is disgusting.

On the premise that it affects the decisions necessary for him to complete his work, I think it's reasonable for him to decide whether or not he wants to work on it. I see nothing discriminatory here.

Without making a statement either way in regards to the ruling, one of the most critical issues in this case is whether or not writing a message on the cake is expressive.

Which is to say, that freedom of speech (or to not make speech) is at the center of this case. There is quite a bit of debate on whether or not decorating the cake is expressive conduct.

I can't see any way in which a surgeon operating on a patient is expressive, and therefore freedom of speech wouldn't come into it. Which means--even if the baker had won on expressive grounds (he didn't)--that the surgeon would still have no grounds for refusing the operate.

An HHS change added this year allows aims to do just that: https://www.snopes.com/fact-check/hhs-allow-doctors-to-refus...

> Will surgeons soon be able to refuse to operate on patients because they're gay? After all, it's a service in an open market.

No my interpretation of this doesn't allow that, nor should it. What it would allow is for a tattoo artist to refuse to ink a gay (or straight, or really anything else) message on someone's arm. Maybe if it's an elective surgery that could be considered to be purely artistic (rhinoplasty?) then the surgeon could refuse but that'd be fairly narrow.

This seems like an odd statement because the bakers refused service only because the content of what they were creating was not in line with whatever morals they had.

It would be _more_ like a doctor not performing a transgender operation.

They had not even discussed the content of the cake when they were refused service.

Maybe if it's a sex reassignment surgery? The baker just refused to bake a wedding cake specifically.

Do you want or trust a surgeon who hates you to operate on you?

Yes. That's part of what makes that surgeon a professional - that they ignore their bias and do their job. If they cannot provide that standard of conduct they are unfit to be a surgeon.

What's better, a world where we have X surgeons who will do a good job for everyone, or a world where we have those X surgeons plus Y surgeons who refuse to operate on certain people, but do a good job for everyone else? It's not a choice between case 2 and a magical fairy tale case where we get X+Y surgeons who will do a good job for everyone.

separate but equal.

Compared to not being treated at all? I might very well be willing to take my chances.

Also, the market's capacity to support surgeons is limited; not everyone who wants to can be a surgeon. And you get better at what you do with experience/practice and with employment in a place where you learn from other qualified folks. Laws that make life hard for surgeons who hate some of their patients have the effect of opening up positions for potential surgeons who wouldn't hate some of their patients.

There is a question of just how fair this is to the surgeon / whether it violates some fundamental rights (which is what SCOTUS was addressing here), but there is absolutely a benefit to society in legislating hateful surgeons out of their jobs.

> Compared to not being treated at all?

Except that's not the relevant comparison.

Why isn't it? What if there's only one in-network surgeon that performs the surgery with your insurance? Or what if you live in a small- or medium-sized town and can't travel to another city where there might be more people able to perform the surgery? I can think of numerous cases where there might only be one surgeon who can perform it -- so you either take your chances or you go without.

I mean if you have a choice in the matter and all other things are equal, clearly you don't. But it turns out not all surgeries are elective, many are emergent and even for the elective ones, surgical experience is not evenly distributed so making it so that some people have a smaller selection of surgeons to chose from is less likely to lead to good health outcomes for that section of the population.

This happens today with trans people and it's a travesty.

I don't believe you.

Please see the sibling comment for recent news stories and a Snopes link.

I think it would be wise for doctors to do this. Does your family physician administrate chemotherapy drugs? No, he refers you to a specialist. It would be wise for any doctor to do the same when he's unfamiliar with the patients uniqueness.

And when it's ER staff that provide negligent care?

https://en.wikipedia.org/wiki/Tyra_Hunter

In patients presenting with problems related to their reproductive organs I tend to agree. That's not actually what's happening, though.

This isn't about "Doctors refuse to give gender hormone/surgery treatment to trans folks", this is "Doctors refer to do normal doctor things to people who happen to be trans".

I'd encourage you to provide some detail so people don't downvote you. Here's some links that I found from Google:

Judge: Doctors Have “Religious Freedom” to Refuse to Treat Trans Patients, Women Who’ve Had Abortions http://www.slate.com/blogs/outward/2017/01/03/doctors_may_re...

When doctors refuse to see transgender patients, the consequences can be dire https://www.washingtonpost.com/national/health-science/when-...

Will Health and Human Services Allow Doctors Refuse to Treat LGBTQ Patients? (Rating: True) https://www.snopes.com/fact-check/hhs-allow-doctors-to-refus...

Doctors Refuse to Treat Trans Patients More Often Than You Think https://www.vice.com/en_us/article/j5vwgg/doctors-refuse-to-...

Thanks for the context.

Well, some bars can kick off Trump supporters. It's a free market. Don't like the service - go elsewhere.

well, luckily, a Trump supporter is not a protected class

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