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In the COVID-19 pandemic, concerns exist that ventilator triage policies may lead to discrimination against people with disabilities. This study evaluates whether preclinical medical students demonstrate bias towards people with disabilities during an educational ventilator-allocation exercise. Written student responses to a triage simulation activity were analyzed to describe ventilator priority rankings and to identify themes regarding disability. Disability status was not cited as a reason to withhold a ventilator. Key themes observed in ventilator triage decisions included life expectancy, comorbidities, and social worth. Although disability discrimination has historically been perpetuated by health care professionals, it is encouraging that preclinical medical students did not demonstrate explicit bias against people with disabilities in ventilator triage scenarios.
In the COVID-19 pandemic, concerns exist that ventilator triage policies may lead to discrimination against people with disabilities. This study evaluates whether preclinical medical students demonstrate bias towards people with disabilities during an educational ventilator-allocation exercise. Written student responses to a triage simulation activity were analyzed to describe ventilator priority rankings and to identify themes regarding disability. Disability status was not cited as a reason to withhold a ventilator. Key themes observed in ventilator triage decisions included life expectancy, comorbidities, and social worth. Although disability discrimination has historically been perpetuated by health care professionals, it is encouraging that preclinical medical students did not demonstrate explicit bias against people with disabilities in ventilator triage scenarios.
Disability rights and LGBT2SQ+ rights are intertwined. LGBT2SQ+ individuals are more likely to be disabled persons and both communities experience societal stigma surrounding their sexuality. Crip theorists posit that ableism, heterosexism, and cissexism are rooted in the same fear of the untamable nature of the body/mind and its potential divergence from social norms. Building from queer theory, McRruer’s crip theory critically examines the concept of compulsory able-bodiedness as another facet of heteronormativity, where heterosexual, cisgendered, non-disabled bodies/minds are centered as the corporeal norm in society. Universal design encompasses the emergence of a society that considers diverse ways of being at conception, rather than creating environments that orbit around hegemonic norms with inclusion as an afterthought. Utilization of universal design is imperative in knowledge production spaces. Sexuality research conferences may be described as heterotopias, a phrase developed by Foucault to describe spaces in society that reside outside the hegemonic bounds of society, and yet mirror it in ways. Sexuality research conferences offer a space to explore themes around sexuality outside of rigid societal conventions. Yet, hegemonic norms may unconsciously seep into these spaces, resulting in the exclusion of disabled, Deaf, and LGBT2SQ+ individuals. Conferences frequently do not incorporate universal design. Utilizing a critical queer crip theory lens, we explore universal design in knowledge production spaces through a literature review and critical analysis of lived experiences with universal design planning of a sexuality research conference (i.e., CSRF, 2019). Translation of findings are summarized with recommendations of inclusive practices for future conferences.
Keywordsdisability health • medical education • inclusive education • patients of all abilities • ability level • disability • pre-clinical • inclusion • attitudes • medical model of disability • health disparities • patient-centered careTh e experience of evaluating a patient with a neurocognitive disability during an early clinical rotation truly stands out in my mind as one of the least prepared moments of my life. Th e pediatrics team I was rotating with as a part of my inpatient clerkship during my second year of medical school was notifi ed of a patient in the emergency department. Th e patient was a young man with cerebral palsy who did not use verbal language to communicate, and I was tasked with gathering information pertinent to the patient's admission into the hospital. Without much time to think or prepare, the senior resident and I were on our way to see the patient. I had made the trip down the elevator to see patients many times before, clipboard in hand and stethoscope on my neck, but this time, questions swirled in my head about what to do during the encounter. Do I direct my questions toward the patient? Or to a caregiver if they are present? What if he isn't very interactive with me? How do I pivot? How should I go about performing a physical exam on him? What if I off end the patient? I tried to refl ect on prior education I had received on patient encounters and realized that I was simply unprepared. I had no training to fall back on for this situation.Within minutes, I was standing in front of the patient and his mother. Without hesitation and after a very brief introduction, I began taking a history as I had been taught in my hundreds of hours of clinical courses and instruction from my preceptors. Before long, I could feel the tension build as I awkwardly and rapidly bounced between topics and who I was directing my questions toward in that moment. My anxiety continued to rise, my mind blurred, and after just a few minutes, I could not think of anything else to say even though I had hardly gathered any necessary information. Th e patient's mother looked at me with concern. She was rightfully worried that her son was in the hands of a vastly underprepared student. Th e resident, observing my discomfort and struggle, stepped in and fi nished the encounter. I felt embarrassed and ashamed that I was unable to off er more in this moment.
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