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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Ableism | 3/6 | https://en.wikipedia.org/wiki/Ableism | reference | science, encyclopedia | 2026-05-05T14:56:04.369561+00:00 | kb-cron |
=== Clinical settings === These "disability-specific barriers" to seeking health care also expand into, "physical barriers (e.g., lack of accessible entrances and wayfinding assistance at treatment facilities), transportation barriers (e.g., shortage of accessible, reliable, and affordable transit options), and information barriers (e.g., inaccessible intake paperwork, after-visit summaries, and online patient portals)." Each of these circumstances represent ableism in the healthcare system that prevents people from getting the care they require. In June 2020, near the start of the COVID-19 pandemic, a 46-year-old quadriplegic in Austin, Texas named Michael Hickson was denied treatment for COVID-19, sepsis, and a urinary tract infection and died 6 days after treatment was withheld. His physician was quoted as having said that he had a "preference to treat patients who can walk and talk." The physician also had stated his belief that Hickson's brain injury made him have not much of a quality of life. Several complaints have since been filed with the Texas Office of Civil Rights and many disability advocacy groups have become involved in the case. Several states, including Alabama, Arizona, Kansas, Pennsylvania, Tennessee, Utah, and Washington allow healthcare providers, in times of crisis, to triage based on the perceived quality of life of the patients, which tends to be perceived as lower for those with disabilities. In Alabama, a ventilator-rationing scheme put in place during the pandemic enabled healthcare providers to exclude patients with disabilities from treatment; such patients were those who required assistance with various activities of daily living, had certain mental conditions (varying degrees of intellectual disability or moderate-to-severe dementia) or other preexisting conditions categorized as disabilities. Instances of ableism in healthcare like those described above are especially dangerous because they are often regarded to simply be "common sense". This "common sense" mentally means that, "often results in the application of a utilitarian approach to defining 'extraordinary,' 'heroic' and 'futile' measures that may be employed to preserve or prolong human life." This creates additional issues, as activities or practices that disabled people often engage in can seem like indicators of poor health for medical professionals which can lead to improper treatment or biased treatment.
=== Criminal justice settings === The provision of effective healthcare for people with disabilities in criminal justice institutions is an important issue because the percentage of disabled people in such facilities has been shown to be larger than the percentage in the general population. A lack of prioritization on working to incorporate efficient and quality medical support into prison structures endangers the health and safety of disabled prisoners. Limited access to medical care in prisons consists of long waiting times to meet with physicians and to consistently receive treatment, as well as the absence of harm reduction measures and updated healthcare protocols. Discriminatory medical treatment also takes place through the withholding of proper diets, medications, and assistance (equipment and interpreters), in addition to failures to adequately train prison staff. Insufficient medical accommodations can worsen prisoners' health conditions through greater risks of depression, HIV/AIDS and Hepatitis C transmission, and unsafe drug injections. In Canada, the usage of prisons as psychiatric facilities may involve issues concerning inadequate access to medical support, particularly mental health counseling, and the inability of prisoners to take part in decision-making regarding their medical treatment. The usage of psychologists employed by the correctional services organization and the lack of confidentiality in therapeutic sessions also present barriers for disabled prisoners. That makes it more difficult for prisoners with disabilities to express discontentment about problems in the available healthcare since it may later complicate their release from the prison. In the United States, the population of older adults in the criminal justice system is growing rapidly, but older prisoners' healthcare needs are not being sufficiently met. One specific issue includes a lack of preparation for correctional officers to be able to identify geriatric disability. Regarding that underrecognition of disability, further improvement is needed in training programs to allow officers to learn when and how to provide proper healthcare intervention and treatment for older adult prisoners.
=== Healthcare policy ===
Ableism has long been a serious concern in healthcare policy, and the COVID-19 pandemic has greatly exaggerated and highlighted the prevalence of this serious concern. Studies frequently show what a "headache" patients with disabilities are for the healthcare system. In a 2020 study, 83.6% of healthcare providers preferred patients without disabilities to those with disabilities. This policy is especially concerning since according to the CDC, people with disabilities are at a heightened risk for contracting COVID-19. Additionally, in the second wave of the COVID-19 pandemic in the UK, people with intellectual disabilities were told that they will not be resuscitated if they become ill with COVID-19.
=== Healthcare research === The concept of ableism is often misused in medical research and population health research, which causes issues in understanding the impact of ableism. Such research also typically does not consult with actual disabled individuals enough to understand their experiences outside of a clinical, medical sense. In other words, there is a lack of understanding of "disabled people to be reliable narrators of their experiences in clinical settings." These circumstances can lead to a narrow understanding of disabilities and ableism in medical population health research. Solutions proposed for the pervasive issues on disability and ableism research includes focus on the challenges to "traditional and often unarticulated assumptions" about disability and ableism. Research needs to emphasize on lived experiences of disabled people outside the healthcare system, in order to gain a deeper understanding of those disabilities, but also of the ableism that may be impacting individual experiences.