Chapter 2.A.2: Wrongful Reasons to Reject Patients

Disability Discrimination

In Costin v. Glens Falls Hospital, 103 F.4th 946 (2d Cir. 2024), the court of appeals reversed the dismissal of a disability discrimination claim brought by a patient with a substance use disorder. In its opinion, the court observed that the hospital did not object to characterizing substance use disorder as a disability and sent the case back to the district court to determine whether the hospital discriminated against the patient on account of her substance use disorder. While most of the patient’s claims sounded in medical malpractice (e.g., accelerating her labor and failing to explain treatment alternatives) and could not support a claim of discrimination on the basis of disability, two claims might. In one, the patient alleged that the hospital always filed reports with child protective services for pregnant patients taking medication for opioid use disorder. In the other claim, the patient alleged that the hospital always tested patients on medication treatment for opioid use to see it they were illegally selling their pills. 

Further Reading

On race-based medicine, Michael J. Malinowski, Dealing with the Realities of Race and Ethnicity, 45 Hous. L. Rev. 1415 (2009); D. Wasserman, The Justifiability of Racial Classification and Generalizations in Contemporary Clinical and Research Practice, 9 Law, Probability & Risk 215 (2010); Erik Lillquist & Charles A. Sullivan, The Law and Genetics of Racial Profiling in Medicine, 39 Harv. C.R.-C.L. L. Rev. 393 (2004); Sharona Hoffman, “Racially-Tailored” Medicine Unraveled, 55 Am. U. L. Rev. 395-456 (2005) (“‘race-based’ medicine might violate numerous anti-discrimination provisions contained in federal law, state law, and federal research regulations and guidelines”); Symposium, 34 J.L. Med. & Ethics 483 (2006); Symposium, 36 J.L. Med. & Ethics 443 (2008); and articles by Jonathan Kahn in 4 Yale J. Health Pol’y L. & Ethics 1 (2004) and 92 Iowa L. Rev. 353 (2007).

On the ADA and denials of care, Carl H. Coleman, Conceiving Harm: Disability Discrimination in Assisted Reproductive Technologies, 50 UCLA L. Rev. 17 (2002); Mary A. Crossley, Of Diagnoses and Discrimination: Discriminatory Nontreatment of Infants with HIV Infection, 93 Colum. L. Rev. 1581 (1993); Wendy F. Hensel & Leslie E. Wolf, Playing God: The Legality of Plans Denying Scarce Resources to People with Disabilities in Public Health Emergencies, 63 Fla. L. Rev. 719 (2011); Kimberly M. Mutcherson, Disabling Dreams of Parenthood, 27 Law & Ineq. 311 (2009); David Orentlicher, Destructuring Disability: Rationing of Health Care and Unfair Discrimination Against the Sick, 31 Harv. C.R.-C.L. L. Rev. 49 (1996); Philip G. Peters, Jr., When Physicians Balk at Futile Care, 91 Nw. U. L. Rev. 798 (1997); and Philip G. Peters, Jr., Health Care Rationing and Disability Rights, 70 Ind. L.J. 491 (1995), which is excerpted in Chapter 8.