Social Conflict Seeps Into Medical Societies

By Tamara Mathias

May 24, 2019

(Reuters Health) - In U.S. medical society boardrooms, far from legislative chambers, social conflict is forcing board members to deal with laws that raise issues of medical ethics.

Take the Association of University Radiologists (AUR), a group of more than a thousand medical school radiology faculty whose stated mission is to "inspire and educate the academic radiology community."

In May 2017, less than a year before the organization's annual national meeting was to be held in Nashville, Tennessee, board members were notified of a new California law that barred reimbursements for state employees' travel to Tennessee because of that state's anti-LGBT laws.

The law had been signed by then-Governor Jerry Brown in an effort to avoid supporting or financing discrimination against lesbian, gay, bisexual and transgender people.

AUR board member Dr. Alexander Norbash, who chairs the department of radiology at the University of California, San Diego, told Reuters Health in a phone interview that faculty in his department were informed of the new law because they are state employees.

Confronted with the fact that some members would be barred from attending the meeting - and faced with the possibility that holding the meeting in a state with discriminatory laws would violate the organization's code of ethics - the AUR board decided to consider moving the conference.

In a case study report in the Journal of the American College of Radiology April 30, Norbash and colleagues document the board's decision-making process that resulted in moving the conference from Tennessee to Florida.

When making its decision, the board sought to minimize the financial impact on the Tennessee hotel that had been booked for the conference. It also deliberately excluded California when assessing replacement venues to ensure that Tennessee's revenue loss did not mean California would gain financially.

"I do believe that these discussions are going to take place more frequently in boards than they have in the past," Norbash said. "I have been on the boards of organizations for a number of years and I have not seen this degree of involved discussion as I'm seeing now . . . Boards are becoming more mindful of their responsibility and board training is becoming more of a real thing."

Norbash said selecting board members who have experience dealing with issues of ethics is important, particularly since such issues are often met with conflicting opinions.

"Although organizations may rarely think about their mission and vision statements once they are created, familiarity with these statements may be highly beneficial when debating the best course for an organization to pursue, particularly when there are competing interests expressed within the group," he and his colleagues write in their report.

Mark Meaney, executive director of the Center for Ethics and Social Responsibility at the Leeds School of Business at the University of Colorado Boulder, reviewed the case study for Reuters Health.

The AUR's process "was rigorous and based on respect for their own code of ethics," Meany said. "They concluded that they could not be complicit in discriminatory law and that they would be complicit if they held their annual conference in Tennessee."

Meaney observed that when organizations take stances on ethical issues, they can sometimes effect political change.

"There are instances where because of the amount of money an association brings to a city, that when that association threatens to pull out because of the discriminatory nature of laws or policies of a city, that city revisited those policies and . . . changed them," he said.

Although the AUR board was able to agree on a course of action, not everyone in the organization supported the decision.

At the relocated annual meeting, the group organized a panel discussion to review the issue.

"It was a lively discussion," Norbash said. "We talked about the value of boycotting and what it actually achieves. Sometimes it's not as much as you anticipate, but at least it initiates a dialogue."


J Am Coll Radiol 2019.