AMA to Advocate for End to ‘Don't Ask, Don't Tell’

The AMA wants Congress to repeal the “Don't Ask, Don't Tell” law that has governed disclosure of sexual orientation in the military since 1993.

Further, the house approved a report from the AMA Council on Science and Public Health that calls for the AMA to work to eliminate inequities in access to health care arising from the inability of same-sex couples to obtain health insurance. That report also asks the AMA to support measures providing same-sex households with the same rights and privileges to health care, health insurance, and survivor benefits as afforded opposite-sex households.

In a sign that the phrase “not your father's AMA” is not just a cliché, the AMA House of Delegates—long perceived as being aligned with conservativism and traditionalism—approved with little debate a resolution that would have the medical organization advocate for repeal of the law that prohibits gay people from disclosing their sexual orientation while serving in the military and subjects them to dismissal if they do.

The AMA's motion on “Don't Ask, Don't Tell” (DADT) originated as a resolution seeking to have the U.S. military change the interpretation of DADT to exempt discussion of sexual orientation with a physician from being a basis for dismissal from the military.

“Not only does DADT put our service members in an ethical dilemma of whether to choose their career over necessary health care, it also puts our doctors in the ethical dilemma of deciding whether to do no harm and not ‘out’ a service member or to forge a legal document that places ourselves at risk of losing our license,” said psychiatrist Jennifer Chaffin, M.D., chair of the AMA's Gay, Lesbian, and Bisexual Advisory Committee.

Ken Certa, M.D., a member of the Section Council on Psychiatry, agreed. “Confidentiality is the bedrock of the business we do, probably more so for [psychiatrists] than for most physicians because of the nature of the things we need to discuss with our patients,” he said. “Not to be able to discuss sexuality is inconceivable to me as a psychiatrist.”

The sentiment was widely supported by physicians from a variety of specialties. But Col. Paul Friedrich, M.C., a delegate from the Section Council on Federal and Military Medicine, reminded delegates that DADT is not a policy that can be interpreted, but a federal law passed by Congress in 1993 that military members are required to uphold. “If you pass this resolution [as written], you will be putting our members of the AMA in uniform in the unenviable position of breaking the law or going against AMA policy.”

The resolution was amended instead to advocate for repeal of the law.

With the same lack of fanfare, and with no opposition, the House of Delegates also approved the Council on Science and Public Health's report titled “Health Disparities in Same-Sex Partner Households.”

The report calls on the AMA to recognize that exclusion from civil marriage may contribute to health care disparities affecting same-sex households and work to reduce health care disparities among members of same-sex households including minor children.

Past APA President Carolyn Robinowitz, M.D., in reference committee hearings, reminded delegates that inequities in health care experienced by same-sex households frequently include mental health care.

“The psychological difficulties that are sometimes experienced by gay and lesbian people add to the difficulties in accessing care, so we think it is vital that we eliminate disparities for general medical care as well as specifically for mental health care.”

The report on health disparities in same-sex households and the resolution calling for repeal of DADT are posted at <www.ama-assn.org/ama/pub/meeting/i09-reports-resolutions/business-hod.shtml>.