Physicians enjoy the rights and privileges of free speech shared by all Americans. In addition to these ordinary political rights, physicians have a particular and enhanced duty to work for the reform of, and to press for the proper administration of, laws that affect health care issues. When patients turn to them for advice about health care matters, physicians are in a position to offer them well-informed, thoughtful opinions. Thus, it is natural for physicians to express their views to patients or their families, and doing so may also solicit the support of patients or their families for particular positions, parties, or candidates. However, these rights and privileges must be exercised with sensitivity to the context of the patient-physician relationship in general and to the particular encounter.
Political conversations should not exploit the medical authority of the physician. To avoid the over-reliance of patients on physicians' non-medical opinions, the ideal discussion should be an interactive one in which the patient receives information from the physician but feels free to exercise his or her own judgment. Communication about political matters must be undertaken with sensitivity to the threats such communication can pose to the patient-physician relationship, especially when the patient is vulnerable and dependent on the physician's help. Physicians should exercise due care in discussing specific issues or opinions on matters that are directly related to the patient's health condition. Finally, physicians should cease political conversations if it becomes apparent that the patient or family is at all uncomfortable, even if the patient or family member initiated the conversation.