Don't ask, don't tell

The declarations, two of a host of resolutions adopted Tuesday, came a day after AMA delegates rebuffed an effort by some doctors to persuade the organization to drop last week's qualified support of the U.S. House health care reform bill that passed Saturday.

The call for a repeal of the don't ask, don't tell policy says it violates doctor-patient confidentiality and causes a dilemma for gay and lesbian individuals fearful their military careers will be jeopardized if they disclose their sexual orientation when talking about certain health matters. Military doctors are bound by the law to report personnel's sexual orientation to their superiors.

An AMA committee said testimony from such personnel noted “the chilling effect” of the policy.

President Barack Obama pledged in his campaign to end the policy, instituted by President Bill Clinton, but has not made it a priority in his first year of office. He renewed the pledge in October in a speech before the advocacy group the Human Rights Campaign.

Geoffrey Corn, a South Texas College of Law professor who writes frequently on national security issues, said the AMA resolution seems like “another nail in the coffin for the policy.” He said a middle ground would be for the law to be changed to exempt doctors but added that “it's hard to argue the momentum is not in the direction of revoking the policy altogether, probably sooner rather than later.”

The resolution that gay marriage bans adversely affects homosexuals followed an AMA committee report noting that marriage is a strong predictor of health insurance, particularly among women. Gays' partners typically are excluded from health care benefits, such as insurance and family and medical leave rights, it said.

“Gay and lesbian couples account for 1 percent of U.S. households,” said Dr. Russell Kridel, a Houston facial plastic surgeon and a member of the AMA Council on Science and Public Health, which produced the report. “Do we really want to cause disparities to those populations?”

Kridel said the AMA didn't call for an end to gay marriage bans because that's “a political position,” not a medical issue. He said one way to address the problem without legalizing gay marriage would be through civil unions, recognizing such relationships and extending health care benefits to couples in them.