DETROIT (AP) – It's been called one of medicine's "open secrets" – allowing patients to refuse treatment by a doctor or nurse of another race.

In the latest example, a white man with a swastika tattoo insisted a black nurse not be allowed to touch his newborn. Now two black nurses are suing a Michigan hospital, claiming it bowed to his illegal demands.

The cases focus on Hurley Medical Center in Flint. They are among several lawsuits filed in recent years that highlight this seldom-discussed issue, which quietly persists almost 60 years after the start of the civil rights movement.

The American Medical Association's code of ethics bars doctors from refusing to treat people based on race, gender and other criteria, but there are no specific policies for handling race-based requests from patients.

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