Wednesday, May 4, 2016

The Stigmatized Disabled and Medical Discrimination

Among the conditions which the medical profession treats are the various disabilities. The lay public sometimes makes moral judgments or otherwise discriminates against such medical conditions (see a previous article's mention of cerebral palsy), but health care professionals should be above such prejudices.

In reality, disabled people need to realize that disability discrimination in medical care often happens, and that the disabled need to take measures to prevent this from impacting the care they receive.

Mention of the problem is readily found online: A Wikipedia entry notes:
The disabled remain at a disadvantage with respect to health and health care.
An article last September in The New England Journal of Medicine by Georgina Peacock, M.D., M.P.H., Lisa I. Iezzoni, M.D., and Thomas R. Harkin, J.D. observes:
Many factors may contribute to these disparities, including physical barriers to care (e.g., inaccessible medical diagnostic equipment such as examination tables, weight scales, and imaging technologies); noninclusive health or wellness programs designed for people without disabilities; transportation problems, especially in areas with poor public transportation; inaccurate or inadequate knowledge or stigmatizing attitudes of clinicians about disabling conditions; competing priorities in the health care system; prior difficult or unpleasant experiences getting health care; and communication barriers, such as failure to accommodate deaf patients who require sign-language interpreters.  (Emphasis added)
A Disability Rights Washington staff bio includes:
[David Carlson] was ... awarded the TASC Excellence in Advocacy Award from the National Disability Rights Network. This in response to the first of two reports addressing discriminatory practices of medical professionals against people with disability, for which he was the lead author. (Emphasis added)
When the disabled go to the doctor they need to
  • Select their personal physician carefully. Some are equitable and professional. Others may condescend, talk down, assume the patient should be humble and apologetic, expect the patient not to question the doctor's decision, treat the patient as mentally limited or uncooperative, or assume the patient is an ideal candidate for experimental procedures.
  • If necessary, include a friend or family member in contacts with medical staff, so that they understand they are not dealing solely with a person they may consider to be at a disadvantage.
  • Make sure no medical treatment is undertaken without informed consent. (What are the alternatives to the proposed treatment? What outcome can be expected in each case, and what are the tradeoffs?)
  • Be willing to ask for a second opinion.
  • Ask for complete information after a procedure has been completed. (What did the physician encounter when s/he began the procedure? How well did it go? What can the patient expect during the recovery period? What medications or self-care procedures will the patient be responsible for? How long will these be in effect?)
  • Expect to be treated with consideration and respect. Contact the facility's patient relations staff (whatever the facility calls them) if necessary.
  • Contact disability rights resources in your community or state if necessary.
The "stigmatizing attitudes of clinicians about disabling conditions" and the "discriminatory practices of medical professionals against people with disability" have been publicly documented in the above cites, which also note that the disabled often have "prior difficult or unpleasant experiences getting health care." This is the reality of being disabled in our society, and you who are disabled need to be prepared.

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A previous post, What Others are Saying, contains links to Independence Chick's blog and other online resources for dealing with disability discrimination.