As a physician assistant (PA) with an appointed position of leadership in the American Academy of Physician Assistants (AAPA), a national PA organization, I was shocked when I read statements by well-known neurosurgeon Dr. Benjamin Carson likening gay, lesbian and bisexual individuals to people who abuse children and animals. On March 26, Carson, appearing on Fox News' Hannity, where he is a regular guest, had the following exchange with the eponymous host:
Sean Hannity: We have the issue of the Supreme Court dealing with two issues involving gay marriage. ... What are your thoughts?
Dr. Benjamin Carson: Well, my thoughts are that marriage is between a man and a woman. It's a well-established, fundamental pillar of society, and no group, be they gays, be they NAMBLA [The North American Man/Boy Love Association], be they people who believe in bestiality, it doesn't matter what they are, they don't get to change the definition. So it's not something that is against gays; it's against anybody who wants to come along and change the fundamental definitions of pillars of society. It has significant ramifications.
It takes a lot to make me angry, and I've tried to understand what it is about Carson's comments that triggered such an unusually strong personal response. What I've come up with is one word: betrayal.
Physician assistants first appeared some four decades ago, birthed by a medical profession and a society desperately in need of clinicians ready and able to provide care for populations traditionally shortchanged by the medical community. Patients and families hit by poverty, violence, racism and bigotry were most commonly left out of the equation, and we PAs were there to fix it. We bridge the gap between rich and poor, insured and uninsured, those with and without documentation of citizenship. We're designed to be bias busters, the providers on the front lines who are able to identify inequalities and deliver the right care, at the right time, to anyone who can find their way to us and ask for help. And when one of our family, a physician long associated with PAs, speaks openly to a national audience likening our gay, lesbian and bisexual patients and colleagues with people who abuse animals and children, it's just tough to fathom.
But what I learned next completely blindsided me: Dr. Carson had been offered a keynote speaking slot at the American Academy of Physician Assistants conference in May and had been selected to receive a Paragon award, one of the AAPA's highest honors.
I have proudly belonged to the AAPA for 13 years, and I have many friends and colleagues on the academy board. Knowing them as I do, I expected quick and decisive action on the matter, anticipating that Dr. Carson would be replaced as keynote speaker and would no longer receive the award. Instead, the board appears to be engaged in old-school handwringing, apparently having caught a bad case of "both-side-ism." The only communication from the board has been in the form of a limp email from the chair asking for patience as the board considers all viewpoints and reaches out to members to see what we think.
Of course, the inevitable "freedom of speech" issue has surfaced as well, with some PAs already publicly asserting that Dr. Carson was simply exercising his right to free speech and claiming that finding another speaker who does not liken gay, lesbian and bisexual people to pedophiles would violate Dr. Carson's rights. Viewpoints? Free speech? Can our academy leaders really believe that there are two sides to this? Make no mistake: This is not a free-speech issue, and calling it such is a red herring. The litmus test is this question: Is there anything that anyone could say that would prompt the AAPA's board of directors to prevent that person from speaking at the annual conference? If the answer is yes, then we can place the free-speech assertion back in its dusty drawer.
The AAPA has absolutely no obligation to Carson. In fact, it has an ethical and medical duty to not give Carson a platform, given his defamatory, untrue and harmful notions about LGBT people.
Dr. Benjamin Carson can think and say whatever he chooses. He can belittle marriage equality and call it unnatural. He can liken our gay, lesbian and bisexual colleagues and patients to pedophiles. Our constitution guarantees Dr. Carson that right. But when he makes such statements, he betrays the very promise that led to the PA profession. We PAs are duty-bound to give the best care imaginable to all our patients, regardless of their race, documentation of citizenship, sexual orientation, gender identity or any other trait that traditionally results in biased care. So when a physician granted a high-profile speaking engagement and a coveted award designation for the national PA conference unveils beliefs that are dramatically inconsistent with the values of the PA profession, it feels like betrayal in the strongest sense imaginable.
Free speech means that anyone can say anything, and that's something to fight for. But accountability is something completely different. And a profession built on the foundation of equality, inclusiveness and community deserves spokespeople who get it. Degrading and humiliating our gay, lesbian and bisexual colleagues and patients is nothing short of betrayal of the principles that brought PAs into existence over four decades ago and compels academy leaders to act, and to act now.
Sign the Change.org petition asking the American Academy of Physician Assistants to cancel Dr. Benjamin Caron's keynote address at the annual AAPA conference in May.