Many Physicians and Medical Facilities Engaging in Political Activism, Registering Patients to Vote

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There used to be no intersection of healthcare and politics but that is not longer the case as medical institutions across the United States are increasingly involved in voter registration efforts.

This trend raises serious ethical questions about the role of physicians and the potential exploitation of vulnerable patients.

At the heart of this movement is Vot-ER, a nonprofit organization founded by Alister Martin, an emergency room physician at Harvard Medical School. Vot-ER provides tools for healthcare workers to register patients to vote, including a badge with a QR code that links to an online registration platform. While Vot-ER claims to be nonpartisan, its staff, funding, and associations suggest a progressive lean.

The scope of these voter registration efforts is broad and sometimes troubling. Doctors have registered patients in various settings, from cancer hospitals to emergency rooms. Even parents of newborns in neonatal intensive care units have been approached.

As Dr. Lisa Patel, a pediatric hospitalist at Stanford University, stated on social media, “I spoke to every family I saw in the newborn nursery about voting because their health and the health of their newborn depended on it.”

This practice has gained support from major medical organizations and even the federal government. The American Academy of Pediatrics, the American Nurses Association, and the Association of American Medical Colleges all encourage clinicians to discuss voting with patients.

The Department of Health and Human Services, following a Biden 2021 executive order, now promotes “voter registration activities” in federally funded health centers.

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Critics argue that these efforts blur the line between medical care and political activism. Sally Satel, a lecturer in psychiatry at Yale Medical School, expressed strong disapproval: “I can’t even begin to tell you how inappropriate this is. It’s such a contamination of a physician’s role.”

The potential for abuse is particularly concerning in psychiatric settings. The Pennsylvania Psychiatric Institute, an 89-bed facility affiliated with Pennsylvania State University, offers voter registration to inpatients regardless of their diagnosis or stability.

Julie Graziane, a geriatric psychiatrist at the institute, argues that voting can “increase life satisfaction, decrease risky behaviors and increase mental wellbeing.” However, this approach raises questions about patient capacity and consent, especially given that some patients are involuntarily committed or suffering from severe mental illnesses.

Jane Rosnethal, a psychiatrist and medical ethicist at New York University’s Tisch Hospital, voiced her concerns: “Oftentimes these patients do not have the capacity to make a decision early on in an acute hospitalization. What are we doing ethically posing this kind of question to people who are so vulnerable?”

The push to involve healthcare in voting matters extends beyond individual institutions. Epic Systems, the primary health records software in the United States, now allows doctors to record a patient’s “voter status” in their medical chart. The American Medical Association has even declared voting a “social determinant of health.”

Proponents of these efforts argue that because voting affects public policy, which in turn affects public health, a patient’s voter registration status falls within a physician’s purview. However, this reasoning fails to address the potential for abuse of the doctor-patient relationship and the erosion of trust in medical professionals.

Kristen Walsh, a pediatrician in New Jersey, points out the risks: “It’s very easy to insert politically coded speech into these interactions. You are effectively signaling to the patient how you want them to vote. And then you’ve really muddled the patient/doctor relationship.”

As the 2024 election approaches, the politicization of healthcare settings is likely to intensify. This trend threatens to undermine the integrity of both the medical profession and the electoral process.

Physicians should remain focused on their primary duty – providing impartial, high-quality medical care – rather than engaging in activities that could compromise their professional ethics and patients’ trust.

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While civic engagement is important, the exam room is not the appropriate place for political activism. The potential for coercion, whether intentional or not, is too great.