Honoring gender-based patient requests for obstetricians: Ethical imperative or employment discrimination?

Patient requests for a female or male obstetrician are fairly common and ar e routinely respected when a physician of the desired gender (usually femal e) is available. We examine whether compliance with such gender-based reque sts is legal, based on accepted standards for employment discrimination and five reported cases of gender-based employment policies in nursing. (There are no reported cases of such policies with regard to physicians.) Legally , we argue, compliance with such requests is permissible but not obligatory . We then consider whether compliance with such requests is ethical, based on considerations of justice as fairness, distinguishing between individual justice claims and social justice claims. We conclude that hospitals and p hysicians should honor those gender-based patient requests that are based o n the individual patient's history or psyche, but they should not honor tho se that are based on gender generalizations.