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AMA Journal of Ethics

Michael Argenyi
Applicants to medical schools who are deaf and hard of hearing (DHoH) or who have other disabilities face significant barriers to medical school admission. One commonly cited barrier to admission is medical schools' technical standards (TS) for admission, advancement, and graduation. Ethical values of diversity and equity support altering the technical standards to be more inclusive of people with disabilities. Incorporating these values into admissions, advancement, and graduation considerations for DHoH and other students with disabilities can contribute to the physician workforce being more representative of the diverse patients it serves and better able to care for them...
October 1, 2016: AMA Journal of Ethics
Lisa I Iezzoni
Erroneous assumptions among health care professionals about the daily lives, preferences, values, and expectations of persons with disability can contribute to documented health care disparities, faulty communication, and substandard quality of care affecting this heterogeneous population. Efforts to reduce racial and ethnic disparities have focused on expanding diversity in the physician workforce. Would expanding the numbers of physicians with disability benefit patients with disability? Increasing the number of physicians who identify as "disabled" is one strategy for proactively confronting disability-related barriers affecting patients, but such efforts will likely face substantial challenges...
October 1, 2016: AMA Journal of Ethics
Patricia M Davidson, Cynda Hylton Rushton, Jennifer Dotzenrod, Christina A Godack, Deborah Baker, Marie N Nolan
The Americans with Disabilities Act prohibits discrimination on the basis of disability and requires schools to provide reasonable accommodations for persons with disabilities. The profession of nursing is striving for diversity and inclusion, but barriers still exist to realizing accommodations for people with disabilities. Promoting disclosure, a supportive and enabling environment, resilience, and realistic expectations are important considerations if we are to include among our ranks health professionals who can understand, based on similar life experiences of disability, a fuller range of perspectives of the patients we care for...
October 1, 2016: AMA Journal of Ethics
Leslie Francis, Anita Silvers
The meaning of "disability" has shifted with changes in public policy. Half a century ago, Congress was convinced that narrow determinations of disability are easy for physicians to make. But with the advent of universal civil rights protection against disability discrimination in the US, deciding whether particular individuals are disabled became increasingly contentious, until Congress intervened. What should now be addressed in each case is not whether the functionally compromised person is severely disabled enough to exercise a right, but whether mitigating interventions and reasonable accommodations can together achieve equitable access for that person...
October 1, 2016: AMA Journal of Ethics
Krista L Kaups
Consideration of the effects of aging on physicians' practice is crucial to addressing aging clinicians' competence, that is, their ability to practice with reasonable skill and safety. Given physician workforce shortages even in resource abundant countries, the establishment of a compulsory retirement age in the US is impractical and unlikely. Several US hospitals and institutions have sought to address concerns about competence by establishing mandatory age-linked testing and evaluation for physicians. However, these procedures have raised questions regarding age discrimination and test validity...
October 1, 2016: AMA Journal of Ethics
Samuel R Bagenstos
This article will discuss the legal obligations of medical schools to accommodate applicants and students with disabilities. The article begins by describing the problem of denial of medical education to such students, a problem that results from both discrimination in admissions and denial of accommodations to incumbent students with disabilities. The article then discusses the disability rights legislation that prohibits discrimination against-and requires reasonable accommodation of-qualified medical students with disabilities...
October 1, 2016: AMA Journal of Ethics
Joel A DeLisa, Jacob Jay Lindenthal
Although progress has been made in diversifying medical school admissions and faculty, this has not extended to physicians with physical disabilities. To improve our understanding of medical students and physicians with physical and sensory disabilities, the authors propose systematically gathering information on the needs and experiences of four groups: physicians who had disabilities before beginning practice, physicians whose disabilities were incurred during their medical careers, physicians drawn from those two groups, and patients of physicians with disabilities...
October 1, 2016: AMA Journal of Ethics
Michael McKee, Ben Case, Maureen Fausone, Philip Zazove, Alicia Ouellette, Michael D Fetters
Students with sensory and physical disabilities are underrepresented in medical schools despite the availability of assistive technologies and accommodations. Unfortunately, many medical schools have adopted restrictive "organic" technical standards based on deficits rather than on the ability to do the work. Compelling ethical considerations of justice and beneficence should prompt change in this arena. Medical schools should instead embrace "functional" technical standards that permit accommodations for disabilities and update their admissions policies to promote applications from qualified students with disabilities...
October 1, 2016: AMA Journal of Ethics
Peter Angelos
When an esteemed elderly colleague needs assistance completing procedures safely, fellow health professionals have the responsibility to respond in order to mitigate risk to patients. There is a strong ethical basis for bringing the surgeon's declining capacity to his or her attention as well as to the attention of others. Ongoing capacity assessments could be one method for tracking diminished capacities among surgeons so that they can stop practicing surgery before putting patients at risk.
October 1, 2016: AMA Journal of Ethics
Frederick Romberg, Bennett A Shaywitz, Sally E Shaywitz
We examine the dilemmas faced by a medical student with dyslexia who wonders whether he should "out" himself to faculty to receive the accommodations entitled by federal law. We first discuss scientific evidence on dyslexia's prevalence, unexpected nature, and neurobiology. We then examine the experiences of medical students who have revealed their dyslexia to illustrate the point that, far too often, attending physicians who know little about dyslexia can misperceive the motives or behavior of students with dyslexia...
October 1, 2016: AMA Journal of Ethics
Anna T Mayo, Anita Williams Woolley
Teams offer the potential to achieve more than any person could achieve working alone; yet, particularly in teams that span professional boundaries, it is critical to capitalize on the variety of knowledge, skills, and abilities available. This article reviews research from the field of organizational behavior to shed light on what makes for a collectively intelligent team. In doing so, we highlight the importance of moving beyond simply including smart people on a team to thinking about how those people can effectively coordinate and collaborate...
September 1, 2016: AMA Journal of Ethics
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March 2016: AMA Journal of Ethics
Arina Evgenievna Chesnokova
No abstract text is available yet for this article.
March 2016: AMA Journal of Ethics
Kelly A Kyanko, Jun-Chieh James Tsay, Katherine Yun, Brendan Parent
No abstract text is available yet for this article.
March 2016: AMA Journal of Ethics
Joseph S Kass, Rachel V Rose
No abstract text is available yet for this article.
March 2016: AMA Journal of Ethics
Mary Anderlik Majumder, Christi J Guerrini
No abstract text is available yet for this article.
March 2016: AMA Journal of Ethics
Abigail English, Julie Lewis
No abstract text is available yet for this article.
March 2016: AMA Journal of Ethics
Christine Khaikin, Lois Uttley
No abstract text is available yet for this article.
March 2016: AMA Journal of Ethics
Nicolle K Strand
No abstract text is available yet for this article.
March 2016: AMA Journal of Ethics
Thomas J Nasca, Douglas Carlson
As we've stated, GME is the final common pathway toward clinical medical practice in the US. It makes sense, then, that national physician workforce policy aimed at meeting future public health demands should be directed at this phase of medical education. It would also make sense that ACGME, as the single accreditor of all residency programs in the US, should be engaged in physician workforce policymaking on behalf of the public. We identified three issues that must be addressed in order for the ACGME to assume this role: First, there must be a national agreed-upon and long-term plan for the design and implementation of the health care delivery system...
March 2016: AMA Journal of Ethics
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