Unethical Practices of Medical Providers - Past, Present, and Positive Steps for People with Disabilities

For over a century, people with disabilities have faced discrimination and unethical treatment in healthcare. In 1927, the U.S. Supreme Court's Buck v. Bell decision upheld forced sterilization laws, declaring eugenics programs constitutional. Justice Oliver Wendell Holmes' statement - "Three generations of imbeciles are enough" - legitimized sterilizing thousands of Americans with disabilities or from marginalized communities. Similar atrocities occurred state wide and internationally.

  • ✘ North Carolina (1930s-1970s): Over 7,000 sterilized under eugenics laws.
  • ✘ Canada (1928-1972): Alberta's Sexual Sterilization Act targeted Indigenous and disabled people without consent.
  • ✘ While overt eugenics has been discredited, it's underlying bias persists in modern healthcare.

Systemic Bias in Modern Healthcare

✘ Northwestern University's Feinberg School of Medicine has documented on-going discrimination:

    "I Am Not the Doctor for You" (Health Affairs, 2022), nearly half of surveyed physicians did not strongly welcome disabled patients into their practice. Only 40% felt confident providing equal care, and over 80% believed disabled patients have lower quality of life. Many physicians were unfamiliar with the Americans with Disabilities Act (ADA) or uncertain about required accommodations.

    A 2025 Northwestern study (Journal of General Internal Medicine) found that disability is often ignored or misrepresented in medical school curricula, reinforcing misconceptions and leaving students unprepared to provide equitable care.

    Physicians with disabilities themselves face workplace mistreatment, indicating bias exists both in treatment and in the profession.

Contemporary Examples of Discrimination

  • ✘ Coercive decisions: Women in California prisons (2010-2013) were sterilized without proper consent.
  • ✘ Resource denial: During COVID-19, several U.S. states deprioritized disabled patients for ventilators and ICU beds.
  • ✘ Withholding life-saving care: The UK's 2018 Learning Disability Mortality Review documented DNR orders placed solely due to disability.
  • ✘ Failure to accommodate: Patients still encounter inaccessible facilities, lack of interpreters, and unsuitable equipment.

Positive Steps That Have Improved Doctor-Patient Relations

  • ✅ Medical Education and Training
  • ✅ Integration of disability competency modules, simulations, and case studies improves physician confidence and empathy.
  • ✅ Lived-experience teaching, where disabled individuals instruct students, fosters understanding and respectful care.
  • ✅ Legal and Policy Reforms
  • ✅ ADA enforcement and hospital accessibility audits ensure physical and communication accommodations.
  • ✅ Accreditation standards now require disability competence and accessibility in care delivery
    • .

    Professional Guidelines and Communication Tools

  • ✅ Use of plain language, interpreters, captioning, and adaptive devices enhances patien engagement.
  • Clinical guidelines emphasize accommodations tailored to patient needs.

    • Patient Advocacy and Partnership

  • ✅ Patientadvisory councils and peer support programs include disabled voices in policy-making and clinic design, building trust.
  • ✅ Empowered patients improve collaboration and adherence to treatment.

    • Technology and Accessibility Tools

  • ✅ Telemedicine with accessibility features expands care for mobility, vision, or hearing impairments.
  • ✅ Adaptive exam tables, wheelchair-accessible scales, and other equipment reduce barriers.

    • Cultural Awareness and Bias Reduction

  • ✅ Awareness campaigns highlight disabled individuals' contributions, reducing stigma in healthcare.

    • Evidence-Based Interventions

  • ✅ Collecting and publishing disability-specific healthcare outcomes encourages accountability and systemic improvement.

Ethical Imperative and Call to Action

History demonstrates the consequences of letting prejudice guide medical care. Modern research shows bias persists, but positive steps prove that progress is possible. To build a truly equitable healthcare system:

  • ✅ Mandatory disability competency training for all healthcare providers.
  • ✅ Inclusion of disabled professionals in leadership, ethics boards, and policy committees.
  • ✅ Strict enforcement of accessibility standards and anti-discrimination laws.
  • ✅ Patient-centered partnerships that elevate disabled voices in policy and care design.
  • ✅ Ongoing data collection and research to identify and correct disparities.

True medical ethics demand vigilance: every patient's life, dignity, and autonomy must be respected. When healthcare embraces inclusion, accessibility, and empathy, it can correct historical wrongs and set a standard for equitable treatment for all.

    Prepared by Lou, Author
    New Horizons Un-Limited

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