Three men living with HIV were wrongly denied breast reduction surgeries by a New York plastic surgery clinic based on their statuses, a judge ruled on Wednesday.
Mark Milano of New York and the US sued Springfield Medical Aesthetic in 2015, claiming that the facility’s policy against operating on anyone with HIV violated their rights under the Americans with Disabilities Act. Two other men joined the suit.
Ultimately, the court’s decision hinged instead on a federal law that requires doctors to assess the safety of a procedure based on a patient’s full medical history, including medications they are on.
US District Judge Analisa Torres ruled that the doctors at Springfield had failed to thoroughly evaluate the medical facts in each man’s case to determine if any of them were on medications that could interfere with their surgery outcomes.
A judge ruled Wednesday that three HIV positive men were wrongly denied plastic surgery
Lawyers for the company did not immediately return a message seeking comment Wednesday.
But in court papers, lawyers for Springfield Medical Aesthetic, which operates the medical offices, said the issue was whether a licensed physician could be held liable for refusing to perform elective cosmetic surgery on HIV-positive patients based on the physician’s judgment the patients’ medications could interfere adversely with medications used in the surgery.
‘This case is not about a physician who holds discriminatory animus toward HIV+ patients,’ the lawyers wrote.
‘Importantly, this case is not about fear of infection by the physician or his staff when treating HIV+ patients.’
The lawyers called it an instance of judicial first impression and noted the government did not cite any US case in which a court had applied the ADA or federal or local law to overrule a physician’s medical decision not to treat an HIV-positive patient.
Laws protecting medical rights for people with HIV
A 1998 Supreme Court case established that a person with HIV but no symptoms is protected by the Americans with Disability Act.
The case came about after a dentist refused to treat a woman with HIV in 1994.
Now, healthcare professionals are not allowed to have policies refusing treatment based just on status.
They must evaluate all the medical facts of each patient’s case, and can only deny treatment if they establish that a procedure could interfere with a patient’s medication or condition and cause them harm.
The judge acknowledged the issue had not been addressed before in the courts but said there was precedent in a Supreme Court case that found a teacher living with tuberculosis was unjustly fired. In that case, the trial judge did not conduct an individualized inquiry into the health risks, if any, posed by the teacher’s disease.
Torres wrote that the medical practice at Advanced Cosmetic Surgery violated federal law in HIV-related cases by failing to investigate whether drugs taken by the three men would threaten health as a result of surgery. The judge also said the company violated New York City Human Rights Law.
‘Defendants’ blanket refusal without individualized inquiry is insufficient to pass muster under the ADA,’ the judge wrote.
Lawyer Ali Frick, representing Milano, said the court’s decision ‘elevated science and facts over fear and prejudice.’
‘Discrimination against people living with HIV remains a pervasive problem,’ the lawyer said. ‘A doctor cannot hide behind his medical degree to discriminate against patients.’
There will be a damages trial, and Milano could be entitled to a financial payment.
Milano said he had lived with HIV for 30 years but felt it ‘like a punch in the gut’ when he was told by the doctor that he never performs procedures on people with HIV.
‘It left me on the verge of tears,’ he said. ‘I had never experienced such blatant HIV discrimination in my life.’
In court papers, lawyers for the government wrote that a doctor did not have ‘unfettered discretion to decide, without any supporting medical evidence, that he can turn away whatever patients he wishes.’