Equality for people with disabilities in medicine
BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7420.882 (Published 16 October 2003) Cite this as: BMJ 2003;327:882
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We participated in the excellent multidisciplinary conference which
addressed disability and doctors, to which reference is made in a recent
editorial (1). It is encouraging that disability is at last being
recognised as a major issue.
However, we believe that radical change is needed in the way that
disability is addressed in society in general and by the medical
profession in particular. There are many parallels with racism and sexism.
The editorial made brief mention of this, and the need to engage with the
wider disability movement: we believe that this should be the focus in
addressing disability. Disabled people have used the Social Model of
Disability to identify the fact that much of the disadvantage they
experience is due to physical, social, and attitudinal barriers rather
than their own impairments (2)(3). As such, disability is fundamentally a
civil rights issue.
Increasing the proportion of disabled people who become medical
students means realising that disabled people are more likely to live in
poverty than the general population (4). Therefore the current debate
about student tuition fees is very relevant. It also means removing any
barriers that the education system puts in the way of disabled children
achieving the high standard in public examinations necessary for medical
school entry. These barriers are not just physical, but also attitudinal
and they can consign disabled children to a life of exclusion and
underachievement (5). Medical students are currently campaigning for a
more inclusive medical profession; this is welcomed, but they need to take
these barriers into account.
The medical profession cannot expect to be taken seriously when
talking about equality for disabled people whilst it is actively involved
in antenatal screening programmes in the UK. These programmes were set up
to identify so-called “handicapped” fetuses in order to destroy them, thus
reducing the number of disabled people who are born.
Medicine also develops increasingly sophisticated and expensive ways
of trying to make disabled people conform to society`s perception of
normal. Instead, why not focus on changing society so that diversity is
valued and groups perceived as different (and inferior) are fully included
rather than marginalised?
Doctors, in general, are reluctant to acknowledge that disability is
about oppressing certain members of society. Is this because if they
acknowledged that, they would also have to acknowledge that they number
among the oppressors?
References
1. Mercer S, Dieppe P, Chambers R, MacDonald R. Equality for people
with disabilities in medicine. British Medical Journal 2003; 327: 882-883
2. Carter J, Markham N. Disability discrimination. British Medical
Journal 2001; 323: 178 – 179
3. Oliver, M. The Politics of Disablement. London: Macmillan,1990
4. Barnes, C. Disabled People in Britain and Discrimination: A Case
for Anti Discrimination Legislation. London: Hurst and Co/BCODP, 1991
5. Rae, A. Bolton Data for Inclusion: Survivors from the Special
School System. Bolton: Bolton Institute,1997
Competing interests:
None declared
Competing interests: No competing interests
This editorial draws attention to the need for the NHS to change.
The NHS is in increasing competition with other employers for
suitable employees. The "poor record of the medical profession"(1) may
well make it less attractive to suitable candidates - some of whom will be
disabled. In addition, the ability of the NHS to retain people who become
disabled whilst working for it may well not match the attraction of
organisations outwith it.
There is benefit to be gained from doctors with disabilities engaging
with "other health professionals with disabilities and with the wider
disability movement." There is benefit too in disabled doctors recognising
that their disability is not the only feature that defines them. Other
'groups' (including those defined by race and sex) may well also feel
disadvantaged. And further, they have, at least partially, addressed these
matters. Disabled people may well benefit by considering how these
‘groups’ have addressed their disadvantage.
Doctors and students with disabilities may indeed require support as
their career progresses. Their able-bodied colleagues however, including
those who are well-meaning, may lack both the knowledge and the ability to
offer that support. Disabled doctors and students have a responsibility to
facilitate their learning. Able-bodied people have the duty to learn about
this subject, but disabled people should facilitate it. If there is co-
operation, rather than antagonism, the benefit to all will be greater.
If the current attitude of the NHS to disabled staff continues the
gap between the increasing needs of disabled people and the ability of
staff to treat them will become even wider. The editorial by Mercer et.
al. draws attention to an area that has for too long been neglected.
Mercer S (et. al.) Equality for people with disabilities in
medicine. BMJ. 2003 Oct 18;327(7420):882-3
Competing interests:
Disabled within the meaning of the DDA 1995,
Competing interests: No competing interests
Editor:
The view of the General Medical Council in respect of students with
disabilities going to medical school is crystal clear and very positive.
We believe that students with a wide range of disabilities can – and
we know that they do – successfully complete the medical curriculum. We
would only get concerned in the rare instances where public safety might
be at risk. This is spelled out in Tomorrow’s Doctors (www.gmc-
uk.org/med_ed). Being in a wheel chair, for example, should not of itself
be a bar to studying medicine and I am personally aware of one such
student who recently began their medical studies.
I set this position out in Career Focus in the Journal of 18 October
2003. I was therefore surprised and disappointed by your editorial in the
same issue because it gave the erroneous impression that the GMC gets in
the way of students with disabilities going to medical school – we don’t.
Since the editorial was not cross referenced to my article, despite the
latter being commissioned by one of the authors of the former, quite the
wrong message was conveyed.
Your editorial is also misleading in its references to the Heidi Cox
case by stating that she “won her initial complaint” against a “ruling” by
the GMC that she should not study medicine. This is incorrect. Ms Cox has
never won any complaint against the GMC and her case had no basis in law.
Peter Rubin
Chairman GMC Education Committee
Competing interests:
None declared
Competing interests: No competing interests
This editorial should link to an article in this week's career focus
where Professor Peter Rubin,chairman of the GMC's Medical Education
Committee, sets the record straight about the GMC's policy on admitting
people with disabilities into medical school. We unintentionally missed
out this link so here it is now
http://bmj.bmjjournals.com/cgi/content/full/327/7420/s123
many apologies
Competing interests:
one of the authors of this editorial and editor of career focus
Competing interests: No competing interests
In the fourth paragraph of this editorial it is said:
"Owing to the timing of the case, the incorporation of the Human
Rights Act into the law of member states of the European Union (which took
place in 2001) was not applicable."
I wonder whether the authors are trying to say, since the European
Convention on Human Rights(rather than the Human Rights Act)was formaly
incorporated into the domestic Human Rights Act 1998,only in October
2000(rather than 2001),the GMC's alleged act(which predates October
2000)was not applicable to be considered under the Human Rights Act 1998.
However, it is a fact that in some instances, the application of the
Human Rights Act 1998, can be considered retrospectively.
Perhaps, the authors might care to offer a clarification.
Competing interests:
Disabled within the meaning of the DDA 1995
Competing interests: No competing interests
Medical Editor Spanish
I am a medical editor and translator in Spanish, I worked for the
news agency Reuters during four years, but they closed my position on
December 31, 03, so I am unemployed now.
I am a disabled doctor (polio, right leg) and I want to work close to
people with disabilities in medicina, because I know that it is time for
action and partnership, as your article says.
Please get in touch with me.
Martha Castilleja, MD
Competing interests:
None declared
Competing interests: No competing interests