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Alex McNabb, a white supremacist podcaster who works as an emergency medical technician in southern Virginia, is under investigation by the state’s Department of Health, a spokesperson for the department confirmed to HuffPost.

McNabb, 35, is a frequent co-host of “The Daily Shoah,” a popular neo-Nazi podcast. On the show he regularly tells stories about being an EMT, often referring to patients by racist slurs and comparing black patients to animals.

An anonymous complaint was made on Nov. 26 against McNabb, who works as an EMT in Patrick County, according to Marian Hunter, public relations coordinator for the Virginia Department of Health’s Office of Emergency Medical Services. Because it’s an “open and active investigation,” Hunter did not describe the nature of the complaint.

His continued employment as an EMT, however, raises ethical and legal questions about whether an avowed racist and white nationalist can objectively make life-and-death decisions for patients of color, Jewish patients and other minorities, experts say.

“Anyone who is espousing this type of vitriolic racism on a regular basis — it casts serious doubts on their ability to provide emergency medical treatment for someone who does not fit their criteria for an ethnostate,” Keegan Hankes, senior researcher at the Southern Poverty Law Center, told HuffPost.

McNabb has not been charged with a crime and will not be suspended from his job during the state’s investigation, which could last up to 60 days.

McNabb didn’t respond to a HuffPost request Friday for comment about the investigation.

In a recurring segment on “The Daily Shoah,” McNabb assumes a persona he calls Dr. Narcan. In these segments, he tells his co-hosts stories about being an EMT. He regularly refers to black patients as “dindus,” a deeply racist slur common among the alt-right.

During a Nov. 8, 2016, episode, McNabb compared black patients to animals. “The heat brings out the wild in the dindu,” he said, adding that, “as winter approaches, the animals go into hibernation and the ridiculousness of the [911] calls goes down.”

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In an Oct. 4, 2016, episode, during a Dr. Narcan segment, McNabb referenced an apartment complex that houses people from “all over Africa and West Africa.” He said emergency workers called it “Ebola Alley.” He then called a black woman a “Dinduisha” and compared her to a shaved “Harambe,” referring to the famous gorilla.

“It’s hard to find a dindu vein anyway, because they’re black,” he said during the episode.

He then told another story of an “unruly young African-American male child running around” an emergency room.

“As it turned out, this young African-American male was there to get blood drawn, so guess who volunteered to take his blood?” he told his co-hosts, who laughed in response. “Dr. Narcan enjoyed great, immense satisfaction as he terrorized this youngster with a needle and stabbed him thusly in the arm with a large-gauge IV catheter.”

Vickie Gendraw, pediatric phlebotomy coordinator at Tufts Medical Center, told HuffPost she was “appalled” at McNabb’s story. Medical professionals, she said, should “never, ever” use large-gauge needles on a pediatric patient.

Typically only small-gauge needles are used for children. Large-gauge needles, Gendraw said, “tend to hurt, because the needle is large, and it bruises the pediatric patient.”

In a statement sent to HuffPost over Twitter, McNabb wrote that “Doctor Narcan is a work of fiction.”

On the Nov. 30 episode of “The Daily Shoah,” McNabb said he didn’t treat patients differently based on their ethnicity or religion.

“It’s a professional duty,” he said. “You have a fucking duty, to go out there and give 100 percent on every single call. It doesn’t matter what race or color or what situation it is.”

He added, “I mean, no one’s going to do something to put their job in jeopardy or do something that makes them look like an incompetent asshole.”

McNabb, who attended the deadly white supremacist rally in Charlottesville, Virginia, in 2017, has appeared on over 130 episodes of “The Daily Shoah” (“shoah” is a Hebrew word for “calamity” and is used most commonly to refer to the Holocaust), according to research from Megan Squire, a computer science professor at Elon University who studies the far right. Titles of these episodes include “J.E.W.s Always Lie,” “Are You Ready For Some RaceWar?” and “BLACK ALERT! BLACK ALERT!”

He appears on many episodes alongside prominent neo-Nazi figures, some of whom have openly called for exterminating Jews and blacks. Among these guests were Andrew Anglin, Christopher Cantwell and Richard Spencer.

In an article on the neo-Confederate website Identity Dixie, McNabb wrote that he “would certainly never complain if 911 calls for crackheads and morbidly obese negresses had to be picked up by black EMTs.”

McNabb is an administrator of a Facebook group called The Final Solution to the Optics Problem, which features a Nazi flag as its banner image. The “Final Solution” is a reference to the Nazi plan to exterminate the Jews during World War II. “The Optics Problem” refers to an ongoing debate in alt-right circles on how best to expand their movement.

McNabb also writes many blog posts on The Right Stuff, an alt-right website, in which he expresses vitriol against blacks, Jews, obese people and the queer community.

The website Angry White Men, which monitors white supremacist figures, first reported on McNabb’s position as an EMT earlier this year. McNabb — who, unlike many in the white nationalist community, does not use an alias — made posts on social media showing himself in an EMT uniform.

Last week, McNabb posted to Twitter that he was aware of HuffPost’s investigation into his work as an EMT. He also suggested HuffPost lodged the anonymous complaint with the Virginia Department of Health. HuffPost did not file a complaint.

“Alex McNabb, to my knowledge, is a paid employee with Jeb Stuart Volunteer Rescue,” Steve Allen, Patrick County’s Emergency Services Coordinator, told HuffPost. EMT services in any given county often include a mix of volunteers and paid employees.

HuffPost found no direct evidence that McNabb treats patients differently due to their race, religion or sexual orientation.

Robert Veatch, professor emeritus of medical ethics at Georgetown University, told HuffPost that it’s only ethical to employ McNabb if it can be ensured that he doesn’t act on his political beliefs.

“Even if one holds that the white supremacist has the right to his views, he does not have the right to act on them while in a public role such as an EMT,” he said. Medical professionals on a battlefield, Veatch noted, “are supposed to care for all casualties without regard to personal characteristics, such as loyalty to an enemy.”

Still, Jeb Stuart Volunteer Rescue would likely be within its legal rights to fire him.

J.H. Verkerke, director of the program for employment and labor law studies at the University of Virginia School of Law, said the First Amendment in a situation like this, while protective of a person’s hateful speech, doesn’t necessarily protect that person’s job.

Racist comments about patients, Verkerke said, would give both public and private medical employers a “pretty strong argument that those statements signal problems with care” and “reveal attitudes that are inconsistent with his duty of caring for patients properly.”

An employer, Verkerke said, could also argue that a medical professional’s hateful statements “could be viewed as disruptive to the workplace.”

The captain of the Jeb Stuart Volunteer Rescue, Derek Wagner, did not return repeated requests for comment regarding McNabb’s employment. In a blog post, McNabb claimed that his captain, after a “discussion with the lawyer representing their agency... did not see any reason to take action against me.”

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This article originally appeared on HuffPost.