Supporters of the Military Readiness Enhancement Act, which would repeal the U.S. military's controversial Don't Ask, Don't Tell policy, are still waiting for the bill to pass.
And delegates to the 2010 National Conference of Special Constituencies, or NCSC, backed a resolution here May 1 that calls on the AAFP to issue a public statement supporting the act.
The resolution, which also calls on the Academy to voice its support for the act in letters to House Speaker Nancy Pelosi, D-Calif., and Senate Majority Leader Harry Reid, D-Nev., was referred to the Board of Directors for immediate consideration.
The Don't Ask, Don't Tell policy, which was enacted in 1993, bans openly gay people from serving in the military.
Mark McLoney, M.D., of Berea, Ohio, testified during the April 30 Practice Enhancement Reference Committee that the policy “is an impediment to the ability of servicemen and women to be completely open with their physicians.”
Victoria Smith, M.D., of Kenner, La., said that communication barrier creates a health issue because if a serviceman or woman can't be honest with his or her physician about his or her sexual behavior or orientation, the physician can't provide appropriate treatment.
Ken Howard, M.D., Calhoun, Ga., testified that the policy hinders his ability to care for patients, who know their records can be requested by the military.
The Military Readiness Enhancement Act has been introduced to the U.S. House of Representatives in 2005, 2007 and 2009. The current bill was referred to the House Committee on Armed Services and the Subcommittee on Military Personnel on April 22.
However, Defense Secretary Robert Gates and Chairman of the Joint Chiefs of Staff Adm. Mike Mullen requested in an April 30 letter to Congress that legislators delay voting on a repeal of Don't Ask, Don't Tell until after the Pentagon finishes a review of the effect of a potential repeal.
Despite a January pledge from President Obama to repeal the policy before the end of the year, the White House issued a statement supporting the request from Gates and Mullen.
A delay could postpone a vote on the issue until after the mid-term elections, and action on the policy could be deferred indefinitely if Democrats lose control of the House in November.
The Don't Ask, Don't Tell resolution was one of several advanced by the gay, lesbian, bisexual and transgender, or GLBT, constituency and supported by the NCSC delegates.
Delegates also adopted a substitute resolution that calls on the AAFP to recommend that CMS and insurance companies cover all medically indicated medications and diagnostic testing regardless of gender status.
Testifying before the Reference Committee on Practice Enhancement, Jennifer Madden, M.D., of Amherst, N.H., said that physicians have problems obtaining insurance coverage for transgender patients when the sex identified on the patient’s chart conflicts with the gender that usually receives certain diagnostic tests or medications. For example, she said she can't prescribe estrogen to those listed as male on their insurance forms.
Delegates also adopted a substitute resolution that calls on the AAFP to revise its policy on Ethics and Advance Planning for End-of-Life Care to include support for a patient's right to determine the disposition of his or her remains, allowing him or her to die with dignity and peace of mind.
George Gay, M.D., of Cambridge, Wis., testifying before the Reference Committee on Advocacy, said he has seen the wishes of his friends completely ignored by their families after their deaths, and he worries that the same will happen to him and others.
"No matter what we put in our advance directives or in our plans for our own funerals, in the state of Wisconsin and most states, the deceased person's remains are the custody of the next of kin," he said. "Even though we may have plans, my mother could come in and cart off my body and have me buried in the family plot, where I'd just as soon not be buried."
Another substitute resolution adopted by delegates calls on the AAFP to recommend that parents, guardians, young people and their families avoid sexual orientation change efforts and instead seek support and services that provide accurate information on sexual orientation and sexuality.
Supporters of the resolution pointed out that several other professional health care organizations already have such policies, including the American Academy of Pediatrics and the AMA.
"It appears AAFP is absent from the organizations that have supported this sort of resolution in the past, and we're conspicuously absent," Gay said. "A basic tenet of medicine is ‘First, do no harm,’ and these programs are notoriously harmful and also not successful."
Other measures supported by the delegates called on the AAFP to
- support full civil marriage equality for same-gender families to contribute to health and longevity, improved family stability and to benefit the children of such families; and
- to support the rights of patients to designate visitors at health care facilities, including individuals designated by legally valid advanced directives, to privileges that are no more restrictive than those of immediate family members.