COMMENTARY

Doctors Don't Have the Right to Threaten to Kill Patients

Arthur L. Caplan, PhD

Disclosures

March 19, 2019

This transcript has been edited for clarity.

Hi. I'm Arthur Caplan, and I'm at the School of Medicine at NYU, where I direct the Division of Medical Ethics.

Lara Kollab was a medical resident at the Cleveland Clinic. You may have heard about her because, sadly, over a 5- or 6-year span, she posted inflammatory, discriminatory, and bigoted comments that basically said she was not going to treat patients properly who are Jewish.[1] She said she was going to give them incorrect medicines, harm them, and try to kill them.

This doctor, who I think had a Palestinian background, can exercise free speech on the Internet or anywhere else and is free to exercise hateful speech. However, I don't think a person like this should be free to be a physician. This doctor violated what we would expect to be the appropriate character and virtue that goes with the privilege—notice, I said privilege—of having a medical license.

Society gives doctors the ability to prescribe medicines, to examine patients in intimate ways (which would not be allowed unless it was in the context of medicine), and to do a fair amount of self-regulation of the profession itself in terms of getting rid of bad apples.

In this case, she was only a resident, so it is hard to take away her license, perhaps, because her training was not utterly complete; however, she should be out of the residency program. If she has her license, she should lose it for a period of time. [Editor's note: Kollab was fired from her first-year residency program by the Cleveland Clinic following discovery of her social media activity.]

Penalties are appropriate when you act in ways that threaten the well-being of a patient or when you act in ways that are discriminatory and threatening based on race, gender, ethnicity, or religious affiliation. Medicine shouldn't tolerate it. State licensing boards shouldn't tolerate it. Peers shouldn't tolerate it. Residency directors shouldn't tolerate it in their programs. We have to be tough and outspoken, and act quickly and promptly when somebody breaks the trust that they must have with their patients.

It isn't "my views first." It should be patients' interests first. Saying threatening things on social media is not the way for medicine to build trust with patients, nor is it honoring the obligation that one has to put patients' interests first, no matter who they are or what their background may be.

I'm Art Caplan at the Division of Medical Ethics at the NYU School of Medicine. Thanks for watching.

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