Doebrich Adrienne, Quirici Marion, Lunsford Christopher
School of Medicine, University of Virginia, Charlottesville, VA, USA.
Thompson Writing Program, Duke University, Durham, NC, USA.
J Pediatr Rehabil Med. 2020;13(3):393-404. doi: 10.3233/PRM-200763.
The COVID-19 era exposes what was already a crisis in the medical profession: structural racism, ageism, sexism, classism, and ableism resulting in healthcare disparities for Persons with Disabilities (PWD). Early research highlights these disparities, but we do not yet know the full impact of this pandemic on PWD. Over the last 20 years, many medical schools have attempted to develop disability competency trainings, but discrimination and inequities remain, resulting in a pervasive distrust of medicine by the disability community at large. In this commentary, we suggest that disability competency is insufficient because the healthcare disparities experienced by PWD are not simply a matter of individual biases, but structural and systemic factors requiring a culture shift in the healthcare professions. Recognizing that disability is a form of diversity that is experienced alongside other systemic disadvantages like social class, race, age, sex, gender identity, and geographic location, we explore the transformative potential of disability conscious medical education, training, and practice that draws on insights from intersectional disability justice activism. Disability conscious medicine is a novel approach, which improves upon competency programs by utilizing disability studies and the principles of disability justice to guide us in the critique of norms, traditions, and institutions to more fully promote the respect, beneficence, and justice that patients deserve.
结构性种族主义、年龄歧视、性别歧视、阶级歧视和对残障人士的歧视,导致残疾人在医疗保健方面存在差距。早期研究突出了这些差距,但我们尚不清楚这场大流行对残疾人的全面影响。在过去20年里,许多医学院校试图开展残疾能力培训,但歧视和不平等现象依然存在,导致广大残疾人群体对医学普遍不信任。在这篇评论文章中,我们认为残疾能力培训是不够的,因为残疾人所经历的医疗保健差距不仅仅是个人偏见问题,而是结构性和系统性因素,需要医疗行业进行文化转变。认识到残疾是一种与社会阶层、种族、年龄、性别、性别认同和地理位置等其他系统性劣势并存的多样性形式,我们探讨了借鉴交叉性残疾正义行动主义的见解,开展具有残疾意识的医学教育、培训和实践的变革潜力。具有残疾意识的医学是一种新颖的方法,它通过利用残疾研究和残疾正义原则来改进能力培训项目,以指导我们对规范、传统和机构进行批判,从而更充分地促进患者应得的尊重、善行和正义。