Do doctors assume the worst about people with disabilities?
January 9th, 2008A thought-provoking piece by Ann-Marie Rosland, MD, in the Journal of the American Medical Association (subscription or $15 purchase required):
Dr. Rosland tells the story of her “aunt Jean,” who was not offered chemotherapy when she was diagnosed with metastatic colon cancer. Instead, the oncologist proposed only that she be kept as comfortable as possible.
Dr. Rosland thinks the oncologist may have made some biased decisions about her aunt’s care based on Jean’s unusual physical appearance. Jean is a very tiny woman who has a rare genetic disorder; she also has a very full life, a job and many friends, none of which was obvious to the doctors.
The episode made Dr. Rosland realize that attitudinal barriers can prevent people with disabilities from getting the health care they need.
“Jean had faced unfounded assumptions about her abilities before, but in the medical setting the assumptions seem more dangerous, both in their subtlety and their potential for harm,” she writes.
Ultimately, Jean reversed the hospital’s conclusions about her and won her chemotherapy by getting out of bed, putting on street clothes, and “walking laps around the nurses’ station, belting a hearty hello each time she passed by.” Jean told her niece that people with disabilities “could have better cancer treatment outcomes [than other people] because of the fighting spirit that has helped them beat the odds all along.”
Anybody else have an experience like this? Please write and tell us!
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January 9th, 2008 at 8:06 pm
Dr. Rosland’s story and analysis of the experience of her aunt, “Jean,” is most perceptive. It describes how and why we MDs — and *all* of us — sometimes think and jump to conclusions, too often to the detriment of others. Her ending is superb, how she herself short-changed dear Jean.