DETROIT – 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 that black nurses not be allowed to touch his newborn. Now two black nurses are suing the hospital, claiming it bowed to his illegal demands.

The Michigan cases 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.