Disability Law Commons^™

Affirmatively Furthering Health Equity, Mary Crossley

Articles

Pervasive health disparities in the United States undermine both public health and social cohesion. Because of the enormity of the health care sector, government action, standing alone, is limited in its power to remedy health disparities. This Article proposes a novel approach to distributing responsibility for promoting health equity broadly among public and private actors in the health care sector. Specifically, it recommends that the Department of Health and Human Services issue guidance articulating an obligation on the part of all recipients of federal health care funding to act affirmatively to advance health equity. The Fair Housing Act’s requirement that …

Contractual Incapacity And The Americans With Disabilities Act, Sean M. Scott

Faculty Scholarship

The doctrine of contractual incapacity allows people with mental disabilities to avoid their contractual liability. Its underlying premise is that the law has an obligation to protect people with such disabilities both from themselves and from unscrupulous people who would take advantage of them; mental incapacity provides this protection by rendering certain contracts unenforceable. The Disability Rights Movement ("DRM"), however, has challenged such protective legal doctrines, as they rest on outmoded concepts about people with mental disabilities.

This essay argues that the mental incapacity doctrine undermines the goals of the DRM and the legislative goals of the Americans with Disabilities …

Reproducing Dignity: Race, Disability, And Reproductive Controls, Mary Crossley

Articles

Human rights treaties and American constitutional law recognize decisions about reproduction as central to human dignity. Historically and today, Black women and women with disabilities have endured numerous impairments of their freedom to form and maintain families. Other scholars have examined these barriers to motherhood. Unexplored, however, are parallels among the experiences of women in these two groups or the women for whom Blackness and disability are overlapping identities. This Article fills that void. The disturbing legacy of the Eugenics movement is manifest in many settings. Black and disabled women undergo sterilizations at disproportionately high rates. Public benefit programs discourage …

Special Issue "Health Care Law And The Rights Of Individuals With Disabilities", Elizabeth Pendo, Guest Editor

All Faculty Scholarship

People with disabilities are vulnerable. They carry high risk for poor health and health outcomes. As a group, they experience social disadvantages such as poverty, underemployment and unemployment, isolation, and discrimination at a higher rate than the general population. They also face multiple barriers to quality health care and report poorer health status than people without disabilities. This Special Issue will explore the key health disparities and barriers to health care experienced by people with disabilities, and explore the legal, ethical, and social issues they raise. It will investigate the legal requirements of the Americans with Disabilities and other antidiscrimination …

Ending-Life Decisions: Some Disability Perspectives, Mary Crossley

Articles

In the forty years since Quinlan, disability has been present in the conversation within medicine, bioethics, and law about the acceptability of death-hastening medical decisions, but it has at times been viewed as an interloper, an uninvited guest to the party, or perhaps the guest whom the host was obliged to invite, but whose presence was not entirely welcomed. Notwithstanding some short-term reversals and counter-currents, the steady arc of end-of-life law during the past four decades has been towards liberalization of ending-life choices by and for patients who are severely compromised or near the end of their lives. During …

Quality Of Healthcare And The Role Of Relationships: Bridging The Medico-Legal Divide, Sagit Mor, Orna Rabinovich-Einy

Sagit Mor

This article focuses on an often overlooked barrier to efforts to enhance the quality of health care: the relationship crisis that currently exists between physicians and patients. This state of affairs has resulted from the divide between the medical and legal worlds. The medical arena has understandably tended to view the doctor-patient relationship as a purely medical issue, ignoring the law’s impact in generating and sustaining problematic relationship patterns. The legal world has yet to fully recognize this state of affairs, and the law’s role in its evolution and persistence. We offer a relational approach to healthcare law as a …

Health Care Rationing And Disability Rights, Philip G. Peters Jr.

Faculty Publications

This article explores the extent to which federal disability rights law limits the use of effectiveness criteria to allocate health care, either alone or as a part of cost-effectiveness analyses. To be more precise, it considers the circumstances in which disability-based classifications by health plans which would otherwise violate the anti-discrimination laws can be legally and ethically defended by proof that the excluded treatments are less effective than those which are provided. Part I introduces the expanding use of effectiveness analysis in health care, explains its discriminatory potential, and reviews the Oregon experience. Part II outlines the current federal law …

Medical Futility And Disability Discrimination, Mary Crossley

Articles

The concept of medical futility, which originally developed in the medical literature as a basis for allocating between physician and patient decisional authority regarding end-of-life treatment, is increasingly appearing in discussions regarding possible methods of containing medical costs by limiting treatment. This use of medical futility as a rationing mechanism, whether by a state Medicaid program or by a hospital, raises concerns regarding its impact on persons with severe disabilities near the end of life. This article considers how the applicability of the Americans with Disabilities Act to cost-conscious futility policies might be analyzed. After developing arguments that proponents and …

The Principle Of The Least Restrictive Alternative For Mentally-Retarded Persons: The Constitutional Issues, David L. Chambers

Book Chapters

Mentally retarded people are people. When strong reasons exist to treat them differently from other people, they should be provided the necessary services, restraint, or protection through means that intrude as little as possible on their freedom to live the life that others are permitted to live. "Normalization" is the term professionals use to define the goal and the process of helping mentally retarded citizens lead a "normal" life. The attainment of this goal involves undoing the multitude of formal constrictions governments have typically placed on the retarded citizen's freedom: his place of residence, his schooling, his control over his …