Baltimore hospital settles allegations of disability discrimination with $180,000 payment | Legal Newsline

BALTIMORE (Legal Newsline) — The U.S. Equal Employment Opportunity Commission (EEOC) announced April 27 that Harbor Hospital Inc., trading as MedStar Hospital, will pay $179,576 after allegations of federal disability discrimination.

Source: Baltimore hospital settles allegations of disability discrimination with $180,000 payment | Legal Newsline

“Health care providers, like all employers, must be mindful of the obligation to provide a reasonable accommodation that allows an employee with a disability to remain employed,” said EEOC Philadelphia district office director Spencer H. Lewis Jr. “It’s not only a good employment practice to retain loyal and productive workers; it’s required by federal law.”

According to EEOC, MedStar Harbor Hospital violated the Americans with Disabilities Act (ADA) when it fired Jerome Alston, a respiratory therapist, because of his disability. Alston had had a kidney transplant and needs to take medications. These medications weaken his immune system. Alston asked for a “work-around” accommodation, so that he would not have to work in isolation rooms with a mechanical ventilation system designed to trap infectious airborne materials. MedStar did not grant him the accommodation and fired him instead, EEOC said.

“An employer must provide a reasonable accommodation to an employee with a disability such as renal failure, whether it is needed because of limitations caused by the disability itself or by the side effects of medication or treatment for the disability,” said EEOC regional attorney Debra M. Lawrence. “We are pleased that MedStar Harbor Hospital took these claims seriously, cooperated in resolving this matter, and agreed to make meaningful policy changes to ensure that its employees and applicants are protected from disability discrimination and receive the accommodations to which they are entitled under the ADA.”

Breaking the Stigma — A Physician’s Perspective on Self-Care and Recovery

Adam B. Hill, M.D.

N Engl J Med 2017; 376:1103-1105

March 23, 2017 DOI: 10.1056/NEJMp1615974

http://www.nejm.org/doi/full/10.1056/NEJMp1615974

My name is Adam. I am a human being, a husband, a father, a pediatric palliative care physician, and an associate residency director. I have a history of depression and suicidal ideation and am a recovering alcoholic. Several years ago, I found myself sitting in a state park 45 minutes from my home, on a beautiful fall night under a canopy of ash trees, with a plan to never come home. For several months, I had been feeling abused, overworked, neglected, and under-appreciated. I felt I had lost my identity. I had slipped into a deep depression and relied on going home at night and having a handful of drinks just to fall asleep. Yet mine is a story of recovery: I am a survivor of an ongoing national epidemic of neglect of physicians’ mental health.

AUDIO INTERVIEW

Interview with Dr. Stuart Slavin on depression and suicide among physicians and trainees and how to address stigma associated with mental illness.

Interview with Dr. Stuart Slavin on depression and suicide among physicians and trainees and how to address stigma associated with mental illness. (6:24)

In the past year, two of my colleagues have died from suicide after struggling with mental health conditions. On my own recovery journey, I have often felt branded, tarnished, and broken in a system that still embroiders a scarlet letter on the chest of anyone with a mental health condition. A system of hoops and barriers detours suffering people away from the help they desperately need — costing some of them their lives.

Last year, I decided I could no longer sit by and watch friends and colleagues suffer in silence. I wanted to let my suffering colleagues know they are not alone. I delivered a grand-rounds lecture to 200 people at my hospital, telling my own story of addiction, depression, and recovery. The audience was quiet, respectful, and compassionate and gave me a standing ovation. Afterward, hundreds of e-mails poured in from people sharing their own stories, struggles, and triumphs. A floodgate of human connection opened up. I had been living in fear, ashamed of my own mental health history. When I embraced my own vulnerability, I found that many others also want to be heard — enough of us to start a cultural revolution.

My years of recovery taught me several important lessons. The first is about self-care and creating a plan to enable us to cope with our rigorous and stressful work. Personally, I use counseling, meditation and mindfulness activities, exercise, deep breathing, support groups, and hot showers. I’ve worked hard to develop self-awareness — to know and acknowledge my own emotions and triggers — and I’ve set my own boundaries in both medicine and my personal life. I rearranged the hierarchy of my needs to reflect the fact that I’m a human being, a husband, a father, and then a physician. I learned that I must take care of myself before I can care for anyone else.

The second lesson is about stereotyping. Alcoholics are stereotyped as deadbeats or bums, but being humbled in your own life changes the way you treat other people. An alcoholic isn’t a bum under a bridge or an abusive spouse: I am the face of alcoholism. I have been in recovery meetings with people of every color, race, and creed, from homeless people to executives. Mental health and substance-abuse conditions have no prejudice, and recovery shouldn’t either. When you live with such a condition, you’re made to feel afraid, ashamed, different, and guilty. Those feelings remove us further from human connection and empathy. I’ve learned to be intolerant of stereotypes, to recognize that every person has a unique story. When we are privileged as professionals to hear another person’s story, we shouldn’t take it for granted.

The third lesson is about stigma. It’s ironic that mental health conditions are so stigmatized in the medical profession, given that physicians long fought to categorize them as medical diagnoses. Why do medical institutions tolerate the fact that more than half their personnel have signs or symptoms of burnout? When mental health conditions come too close to us, we tend to look away — or to look with pity, exclusion, or shame.

We may brand physicians who’ve had mental health conditions, while fostering environments that impede their ability to become and remain well. When, recently, I moved to a new state and disclosed my history of mental health treatment, the licensing board asked me to write a public letter discussing my treatment — an archaic practice of public shaming. Indeed, we are to be ashamed not only of the condition, but of seeking treatment for it, which our culture views as a sign of weakness. This attitude is pervasive and detrimental — it is killing our friends and colleagues. I’ve never heard a colleague say, “Dr. X wasn’t tough enough to fight off her cancer,” yet recently when a medical student died from suicide, I overheard someone say, “We were all worried she wasn’t strong enough to be a doctor.” We are all responsible for this shaming, and it’s up to us to stop it.

The fourth lesson is about vulnerability. Seeing other people’s Facebook-perfect lives, we react by hiding away our truest selves. We forget that setbacks can breed creativity, innovation, discovery, and resilience and that vulnerability opens us up to personal growth. Being honest with myself about my own vulnerability has helped me develop self-compassion and understanding. And revealing my vulnerability to trusted colleagues, friends, and family members has unlocked their compassion, understanding, and human connection.

Many physicians fear that showing vulnerability will lead to professional repercussions, judgment, or reduced opportunities. My experience has been that the benefits of living authentically far outweigh the risks. When I introduced myself in an interview for a promotion by saying, “My name is Adam, I’m a recovering alcoholic with a history of depression, and let me tell you why that makes me an exceptional candidate,” I got the job. My openly discussing recovery also revealed the true identity of others. I quickly discovered the supportive people in my life. I can now seek work opportunities only in environments that support my personal and professional growth.

The fifth lesson is about professionalism and patient safety. We work in a profession in which lives are at risk, and patient safety is critically important. But if we assume that the incidence of mental health conditions, substance abuse, and suicidal ideation among physicians is similar to (or actually higher than) that in the general population, there are, nevertheless, many of us out there working successfully. The professionals who pose a risk to patient safety are those with active, untreated medical conditions who don’t seek help out of fear and shame. Physicians who are successfully engaged in a treatment program are actually the safest, thanks to their own self-care plans and support and accountability programs.

Instead of stigmatizing physicians who have sought treatment, we need to break down the barriers we’ve erected between our colleagues who are standing on the edge of the cliff and treatment and recovery. Empathy, unity, and understanding can help us shift the cultural framework toward acceptance and support. Mentally healthy physicians are safe, productive, effective physicians.

The last lesson is about building a support network. My network has been the bedrock of my recovery. You can start small and gradually add trusted people, from your spouse and family to friends, counselors, support groups, and eventually colleagues. Then when you fall flat on your face, there will be someone to pick you up, dust you off, and say, “Get back out there and try it again.” A support network can also hold you accountable, ensuring that you remain true to your own personal and professional standards.

Without question, my own successful recovery journey has made me a better physician. My newfound perspective, passion, and perseverance have opened up levels of compassion and empathy that were not previously possible. I still wear a scarlet A on my chest, but it doesn’t stand for “alcoholic,” “addict,” or “ashamed” — it stands for Adam. I wear it proudly and unapologetically.

When a colleague dies from suicide, we become angry, we mourn, we search for understanding and try to process the death . . . and then we go on doing things the same way we always have, somehow expecting different results — one definition of insanity. It’s way past time for a change.

Disclosure forms provided by the author are available at NEJM.org.

SOURCE INFORMATION

From the Indiana University School of Medicine and the Riley Hospital for Children, Indianapolis.

Women’s Refugee Commission – Maternal & Newborn Health and Disability

Source: Women’s Refugee Commission – Maternal & Newborn Health

Worldwide, more than 350,000 women die every year from complications related to pregnancy and childbirth—that’s nearly one every minute. For women affected by conflict or disaster, who are displaced from their homes and communities, the risk of maternal death or injury is especially high. In fact, over 60 percent of the world’s maternal deaths occur in 10 countries, nine of which are currently experiencing or emerging from conflict. With the breakdown of traditional social structures during times of war or conflict, women face an increased threat of sexual abuse, exploitation and violence. And sexual violence puts them at high risk of unwanted pregnancies and unsafe abortions, especially since they often lack access to emergency contraception and emergency care for pregnancy and childbirth complications.

Access to quality health services can mean the difference between life and death. In crisis settings, this access is particularly limited, increasing the risk of maternal death, the main causes of which are: hemorrhage, unsafe abortions, high blood pressure or prolonged and obstructed labor without access to cesarean section. The lack of access to health care also raises the risk of newborn death, usually caused by preterm birth, infection or asphyxia (lack of oxygen) during childbirth. However, there are several steps that can be taken to prevent maternal and newborn death. Training attendants to assist mothers during childbirth and making cesarean section readily available can prevent mothers and their infants from dying needlessly.


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An Ordinary, Extraordinary Day

OFCCP Director Blogs About Updated Veteran/People with a Disability Regulations

– See more at: http://outsolve.com/blog/ofccp-director-blogs-about-updated-veteran-people-with-a-disability-regulations#sthash.tvtBwib0.dpuf

Karla wrote for her daughter, a high school student with cerebral palsy who, her mom points out, “will be as qualified as anyone else” when she enters the workforce. Gerald wrote to make sure we didn’t forget the continuing barriers Vietnam veterans like him still face when trying to enter or re-enter the workforce. And Mike wrote just to say thank you – for helping people “to live improved lives by having a job.”

For millions of workers around the nation, March 24 was just another Monday, the first day of another week of work. But at the Office of Federal Contract Compliance Programs, March 24 was a special day: the day our rules expanding employment opportunities for qualified workers with disabilities and protected groups of veterans went into effect.

For my staff; for Karla, Gerald and Mike; for the hundreds of people who wrote to us supporting our proposals during the rulemaking process; and for thousands of people like them, March 24 was a day of new opportunities. In fact, leaders from the National Organization on Disability and the Easter Seals have suggested that March 24, 2014, will join the anniversary of the Americans with Disabilities Act and even Veteran’s Day as another major milestone in our nation’s journey of expanding rights for veterans and people with disabilities.

These two rules are game-changers. But change is a process, not a switch. That’s true for the contractor community, and it’s true for all of us. Thousands of people have already participated in OFCCP webinars on the new rules, and more training will be coming over the next three months.

At OFCCP, we are committed to getting this right. We know it’s important to be flexible, open and inclusive; to be good enforcers as well as good listeners. We also know that diverse workplaces are better workplaces. They are safer and fairer; they are more productive and, yes, more profitable.

Our job is to protect workers, promote diversity and enforce the law. In doing so, we facilitate the success of businesses, workers and the federal agencies that rely on contracted work. That’s good government and good business sense working together for the good of the country we serve.

Patricia A. Shiu is the director of the Office of Federal Contract Compliance Programs.

Disclosure of Disabilities by Medical Students

Source: Disclosure of Disabilities by Medical Students

In Reply Ms Schwartz emphasizes the importance of disclosure as it relates to providing opportunities to medical students with disabilities. Although disclosure is important, if not necessary, for receiving accommodations from an institution, disclosure alone is unlikely to change the broader attitudes and cultural norms that limit access to medical education for students with disabilities. First, the direction of causality is unclear. The fear of disclosure and the culture that precipitates that fear are likely jointly determined: lack of disclosure may contribute to a less-inclusive culture for students with disabilities, but that culture may also breed a fear of disclosure. Second, full disclosure would be difficult to enforce. The decision to disclose may be weighed differently by the applicant, who desires admission, compared with the matriculant, who has already been admitted and desires accommodations. Third, not all disabilities are readily apparent. Although Schwartz emphasizes physical disabilities, research suggests that nonphysical disabilities such as attention-deficit/hyperactivity disorder, learning disabilities, and psychological disabilities are more prevalent among US medical students.1 Those with nonapparent disabilities may face considerable bias that disclosure alone does little to resolve.

Deaf Medical Student Wins ADA Case Against Creighton

Deaf Medical Student Wins ADA Case Against Creighton

On September 4, 2013, Michael Argenyi, a deaf medical student, represented by the National Association of the Deaf (NAD), the law firm of Stein & Vargas and Disability Rights Nebraska, won a jury trial against Creighton University in the United States District Court for the District of Nebraska. Mr. Argenyi had been a student in the medical school at Creighton University beginning in 2009, and had requested that Creighton University provide him with real time captioning for classes and oral interpreters for clinics. Creighton refused to provide him with such services and also refused to allow Mr. Argenyi to bring interpreters even if he paid for the interpreters himself.

With NAD and the other lawyers representing Mr. Argenyi, a lawsuit was filed against Creighton in the United States District Court for the District of Nebraska. The District Court originally dismissed Mr. Argenyi’s case and ruled that Mr. Argenyi had not demonstrated that medical school was beyond his capacity without captioning or interpreting services. Upon appeal, the Eighth Circuit Court of Appeals reversed the District Court’s ruling, and remanded the case back to the District Court, holding that “Section 504 of the Rehabilitation Act and Title III of the ADA each require Creighton to provide reasonable auxiliary aids and services to afford Argenyi ‘meaningful access’ or an equal opportunity to gain the same benefit as his nondisabled peers.”A trial began in Omaha with opening arguments on August 22nd and ended with closing arguments on August 30th, and the jury returned with a verdict that Creighton University violated Mr. Argenyi’s right to communication access under the Rehabilitation Act and the ADA.

The NAD appreciates the strength and courage of Michael Argenyi for standing up to the improper conduct of Creighton University.

“Every university, college and school in the country should take note that deaf and hard of hearing people can achieve any dream including becoming a doctor, and the law clearly requires communication access to make such dreams possible. All schools should heed this case and support these dreams,” said Howard A. Rosenblum, CEO of the National Association for the Deaf.

For more information, contact Marc Charmatz at the National Association of the Deaf via email at nad (dot) info (at) nad (dot) org or telephone at 301-587-1788, or Mary Vargas at Stein & Vargas, LLP by email at Mary (dot) Vargas (at) steinvargas (dot) com or telephone at 240-793-3185.

Deaf Student Denied Interpreter by Medical School

Deaf Student Denied Interpreter by Medical School

Deaf Student, Denied Interpreter by Medical School, Draws Focus of Advocates

By JOHN ELIGON

Speaking with the parents of a sick infant, Michael Argenyi, a medical student, could not understand why the child was hospitalized. During another clinical training session, he missed most of what a patient with a broken jaw was trying to convey about his condition.

His incomprehension, Mr. Argenyi explained, was not because of a deficiency in academic understanding. Rather, he simply could not hear.

Mr. Argenyi, 26, is legally deaf. Despite his repeated requests to use an interpreter during clinical training, administrators at the Creighton University School of Medicine in Omaha, Neb., have refused to allow it. They have contended that Mr. Argenyi, who is able to speak, communicated well enough without one and that patients could be more hesitant to share information when someone else was present. They added that doctors needed to focus on the patient (not a third party) to rely on visual clues to make a proper diagnosis.

Mr. Argenyi took a leave of absence at the end of his second year, in 2011, after suing Creighton for the right to finish his medical training with an interpreter. The case, scheduled to go to trial on Tuesday in Federal District Court in Omaha, is attracting the attention of the federal government and advocates who are concerned that it could deal a setback to continuing efforts to achieve equality for people with disabilities.

“I couldn’t understand so much of the communication in the clinic,” Mr. Argenyi wrote in an e-mail. “It was humiliating to present only half of a history because I had missed so much of what was communicated. I was embarrassed every time I would miss medicine names that I knew from classes but couldn’t understand when the patient or a colleague spoke them.”

Despite making tremendous strides over the past four decades with the passage of the Rehabilitation Act and the Americans with Disabilities Act, those with disabilities remain underrepresented in higher education and in the work force. In the medical field, people who are deaf or hard of hearing remain less likely to hold high-skilled positions than those without impairments.

Universities tend to provide requested accommodations after admitting a student who they know has a disability, proponents for the deaf say. And most arrangements for the deaf are settled long before any issues reach a courtroom, said Curtis Decker, the executive director of the National Disability Rights Network, a federally financed association of legal services programs.

But, he said of Mr. Argenyi’s lawsuit, “It’s a very important case because, I think, if it’s successful it will send a very powerful message to the university community that the law does cover them and the law is clear about the accommodations that they need to provide.”

Creighton officials maintain that they have provided Mr. Argenyi with the necessary tools for him to succeed in medical school.

“Michael Argenyi is a very bright, capable young man who Creighton believes will make a good doctor,” said Scott Parrish Moore, the lead counsel for Creighton.

After being accepted to Creighton four years ago, Mr. Argenyi asked the university to provide a real-time captioning system for lectures and a cued speech interpreter. (Mr. Argenyi, who does not know sign language, can read lips. An interpreter helps by mouthing words while using hand signals to clarify sounds.) These were the same accommodations that Mr. Argenyi, who had a diagnosis of profound deafness when he was 8 months old, received for much of his schooling, from grade school through undergraduate studies at Seattle University.

Creighton provided Mr. Argenyi with just one of the aides that his audiologist had recommended — an FM system, which amplifies the sounds he hears in cochlear implants. The university also provided note takers for lectures, priority seating and audio podcasts. Soon after classes began, Mr. Argenyi told school officials that the accommodations were inadequate and that he was missing information. He sued in federal court in Omaha in September 2009, arguing that the university was legally required to pay for and provide necessary aides.

Mr. Argenyi said he hired his own interpreter and transcription service, which cost him more than $100,000 during his two years in medical school. The breaking point, he said, came during his clinical work in his second year when Creighton refused to allow him to use an interpreter, even if he paid for it himself. The university did allow Mr. Argenyi to use interpreters during a couple of clinics while the Justice Department was trying to broker a settlement, but stopped when a deal could not be reached. Mr. Argenyi is pursuing degrees in public health and social work at Boston University, which is providing his requested transcription services, while the lawsuit is pending.

Study Finds Medical Procedures Violating the Civil Rights of People with Disabilities: Stunting Growth, Removing Body Parts with No Judicial Review

Study Finds Medical Procedures Violating the Civil Rights of People with Disabilities: Stunting Growth, Removing Body Parts with No Judicial Review

Washington, DC – In a first of its kind study, the National Disability Rights Network (NDRN) determined that performing certain medical procedures or withholding life sustaining treatment in non-terminal situations without judicial review violates the civil rights of people with disabilities.

The initial catalyst for the report is the so-called Ashley Treatment which received worldwide attention 5 years ago.  Ashley was a six-year-old child with developmental and physical disabilities whose growth was stopped through estrogen treatments and whose uterus and breast buds were removed. The intent of this treatment was to keep her permanently small and child-like.  NDRN believes this practice is spreading worldwide.

“The thought of doctors and guardians, together, deciding to remove the body parts and stunt the growth of a child based on assumptions about their awareness and quality of life is shocking and disgusting,” said NDRN’s executive director, Curt Decker.

Further investigations by the nation’s federally mandated Protection and Advocacy agencies, which NDRN represents in Washington, DC, have uncovered other cases in which medical treatment and even basic food and water are being denied to individuals with disabilities during minor illnesses with the intent of letting the illness progress until death.

“In one case, the parents of a 13-year-old boy with a developmental disability refused to allow him access to antibiotics so that the cold he had would progress to pneumonia. They got their wish and the boy died,” said Decker.

“Every person is born with civil and human rights and an inherent dignity,” continued Decker. “The reality that this is happening in the United States is anathema to the core values that we as Americans say we hold. That it is happening to those unable to use their own voice is even worse. This report is meant to start the conversation about how society can and should make medical decisions that uphold the constitutional rights of all people with disabilities.”

The report, “Devaluing People with Disabilities: Medical Procedures that Violate Civil Rights,” puts individuals with disabilities at the center of discourse.  It reviews the facts of Ashley X, as a case study and presents a continuum of similar experiences and treatment of individuals with disabilities within a context of medical decision making that devalues them as people and discriminates against them based on their disability.

The report explores the conflict of interest that medical decision making may present between a parent and their child.  It describes the vital role that the legal and judicial systems have in ensuring that the civil and human rights of individuals with disabilities are protected regardless of their severity and in contrast to opinions regularly expressed in the medical and ethics community.

Finally, the report presents a series of recommendations for how the legal and medical systems at a local, state and national level, including protection and advocacy agencies, ethics committees, institutional review boards, and the courts can perform critical “watch-dog” functions to ensure that the human and civil rights of persons with disabilities are protected.

Read the full report.

Download the executive summary and recommendations.

View the report webpage here http://www.ndrn.org/en/media/publications/483-devaluing-people-with-disabilities.html.

Additional References

Burkholder, Amy. “Disable girl’s parents defend growth-stunting decision.” CNN. com 13 March, 2008. http://www.cnn.com/2008/HEALTH/conditions/03/12/ pillow.angel/index.html.

Caplan, Arthur, Ph.D. “Commentary: Is ‘Peter Pan’ treatment right?” MSNBC. com 05 January, 2007. http://www.msnbc.com/id/16472931/.

Dahlstrom, Linda. “Doctor at crux of stunting debate kills self.” MSNBC.com 11 October, 2007. http://www.msnbc.com/id/21225569/.

Diekema, Doug, The Case of Ashley X, NWABR Ethics in Science Online Course, 2007.

Gibbs, Nancy. “Pillow Angel Ethics.” Time 07 January, 2007. http://www.time. com/time/nation/article/0,8599,1574851,00.html.

Gibbs, Nancy. “Pillow Angel Ethics, Part 2.” Time 09 January, 2007. http://www.time.com/time/nation/article/0,8599,1574851,00.html.

McDonald, Anne. “The other story from a ‘Pillow Angel’.” Seattle Post- Intelligencer 17 June, 2007. http://www.seattlepi.nwsource.com/ opinions/319702_noangel17.html.