关于精神疾病和《美国残疾人法案》合规性的医疗执照问题。

Medical Licensure Questions About Mental Illness and Compliance with the Americans With Disabilities Act.

作者信息

Jones James T R, North Carol S, Vogel-Scibilia Suzanne, Myers Michael F, Owen Richard R

机构信息

The coauthors are eternally grateful for their friend and colleague James T. Jones, who passed away on May 3, 2018. Dr. Jones was Professor of Law, Louis D. Brandeis School of Law, University of Louisville, Louisville, Kentucky. Dr. North is Medical Director, The Altshuler Center for Education & Research at Metrocare Services, Dallas, Texas, and The Nancy and Ray L. Hunt Chair in Crisis Psychiatry and Professor of Psychiatry, Director, Division of Trauma & Disaster, The University of Texas Southwestern Medical Center, Dallas, Texas. Dr. Vogel-Scibilia is Assistant Clinical Professor, Chatham University, Pittsburgh, Pennsylvania. Dr. Myers is Professor of Clinical Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Owen is Director, Center for Mental Healthcare & Outcomes Research, Central Arkansas Veterans Healthcare System, Professor of Psychiatry, University of Arkansas for Medical Sciences College of Medicine, and Professor of Epidemiology, University of Arkansas for Medical Sciences College of Public Health, Little Rock, Arkansas.

出版信息

J Am Acad Psychiatry Law. 2018 Dec;46(4):458-471. doi: 10.29158/JAAPL.003789-18.

DOI:10.29158/JAAPL.003789-18

PMID:30593476

Abstract

Substantial numbers of medical students and physicians live with some form of mental illness. Over the years, many medical licensure boards have asked physician medical licensure applicants with Doctor of Medicine (MD) degrees intrusive questions about whether they have any psychiatric history. This has discouraged many who need psychiatric treatment from seeking it because of fear of the questions. Gradually, court decisions and the United States Department of Justice have established that such questions violate the Americans with Disabilities Act (ADA). The 2014 Louisiana Supreme Court Settlement Agreement set definite limits on law licensure mental health questions, followed by a least one licensing body revising its physician licensure questions to be consistent with ADA standards. In this article we examine the current medical licensure questions from each state and the District of Columbia about the mental health of applicants and discuss their validity under ADA standards. Our original investigation of these questions found that the majority still ask questions that are unlikely to meet ADA standards. The judicial and Department of Justice developments, however, may compel them to abandon these questions. If not, legal action will enforce ADA compliance. This change will significantly benefit applicants who need psychiatric treatment.

摘要

大量医学生和医生患有某种形式的精神疾病。多年来，许多医学执照委员会向拥有医学博士（MD）学位的医生执照申请人提出侵扰性问题，询问他们是否有精神病史。这使得许多需要精神治疗的人因害怕这些问题而不敢寻求治疗。逐渐地，法院判决和美国司法部已确定此类问题违反了《美国残疾人法案》（ADA）。2014年路易斯安那州最高法院和解协议对法律执照心理健康问题设定了明确限制，随后至少有一个执照颁发机构修改其医生执照问题以符合ADA标准。在本文中，我们研究了每个州以及哥伦比亚特区目前关于申请人心理健康的医学执照问题，并根据ADA标准讨论其有效性。我们对这些问题的初步调查发现，大多数问题仍不符合ADA标准。然而，司法和司法部的进展可能会迫使他们放弃这些问题。否则，法律行动将强制其遵守ADA规定。这一变化将极大地惠及需要精神治疗的申请人。