Difficult patients - difficult doctors

Forget about the law for a moment, and suspend your disbelief: Are patients entitled to reject a particular attending physician because of the doctor's color of her skin, her religious beliefs or for no reason at all? This is the subject of a debate currently ongoing on an international listserv of bioethicists. I must say, I have never given much thought to this issue. I mean, it is straightforward that doctors could not reject to attend to patients for any of those reasons - there are as few conscientious objection rationales for particular procedures, but really even they don't make much sense to my mind and should be rejected. The point is that doctors are professionals and need to act as professionals. Non-professional reasons (aka skin-color, party membership and other such matters) don't count as acceptable rationales for refusing to attend to particular patients.

However, what about patients. There's all sorts of people out there, and some are morons. So, what if a patient doesn't want to be seen by a particular doctor for moronic reasons, say the doctor's membership in a particular church, the doctor's skin color and other non-professional matters. Some of my colleagues, certainly colleagues I hold in high esteem, argue that motives that are unacceptable (eg racist motives) should be ignored and the patient request declined. My gut feeling was initially that that probably is the right approach. Why give in to blatantly racist attitudes for instance. Stuff em I thought.

Well, here's the counter argument: some other bioethicists claim (they did not provide evidence, but let's assume their claim is correct) there is evidence that having to deal with attending doctors that patients can't cope with (for whatever reasons) has a negative impact on health outcomes, and those health outcomes should be our primary concern. That argument persuaded me - that is until I discover that there's no evidence to support the empirical claim I have just outlined.

Tricky one though, hu? What do you think?