August 13, 2019
Ahead of a crucial hearing into the petition challenging the Medical
Council of India’s discriminatory guidelines barring people with certain
disabilities from studying medicine comes a major show of support from
leading doctors’ and doctors’ groups from around the world. Read on to find
out.
A major show of support for doctors with disabilities in India who are
legally fighting to get the Medical Council of India (MCI)
to withdraw guidelines that bar students with certain disabilities from
studying medicine. Many doctors and organisations that are working to make
medicine inclusive across the United States, United Kingdom and Australia
have written letters questioning the 80% cut off various disabilities.
Urging the MCI to assess students’ capacities in relation to the career
choices they are considering, Adam Stein of the
Association of Academic Physiatrists has said in the letter
to disability rights advocate Dr Satendra Singh:
One of the fundamental concepts in disability studies is that there is no
one-to-one correspondence between a medical diagnosis and a disability. The
extent of disability an individual caused by a particular condition depends
not only on the severity of that condition, but on the individual’s
residual strengths and the supports available in the physical and social
environment. Therefore, we would encourage you to avoid eligibility
criteria that relate simply to medical diagnosis and rely, instead, on
assessments of the student’s capacities when given reasonable
accommodations. –Adam Stein, President, Association of Academic
Physiatrists
In February this year, Dr Singh, who heads the Doctors with
Disabilities in India challenged the government’s decision in court.
He has submitted these letters of support in court to bolster his petition.
His case will come up for hearing next tomorrow, 14 August.
The MCI guidelines have been set aside by many High Courts as well as the
Supreme Court of India in different petitions yet the
blanket ban persists and is in violation of the Rights of Persons
with Disabilities Act 2016, which the Ministry of Social
Justice and Empowerment (MSJE) is expected to administer.
One of the main arguments put forth by the government in upholding these
guidelines is the need to keep patient safety paramount, but as
Lisa Meeks from the Medical School University of
Michigan points out, “no case to date has identified patient safety
violations involving a physician with a disability. Many concerns regarding
safety are unfounded and often times physicians with disabilities overlay
additional checks and balances systems to avoid any safety issues”.
She also refers to federal regulations in the US which guide evaluation of
patient safety, which require the school or programme to make an
“individualised assessment based on reasonable judgment to ascertain the
nature, duration, and severity of the risk; the probability that the
potential injury will actually occur; and whether reasonable modifications of
policies, practices, or procedures or the provision of auxiliary aids or
services will mitigate the risk. In the absence of this individualized
assessment, any concerns regarding patient safety are grounded in assumption,
fear, bias and stigma”.
The reasoning behind the 80% cut off has also been questioned by the doctors.
Dr Kelly Lockwood of the Disabled Doctors
Network, UK. Calling the MCI guidelines “shocking”, Dr Lockwood says
providing definitive evidence that a person’s mobility is 80% impaired as
opposed to 78% would be very difficult. She further adds, “Here in the UK..
in order to state a threshold of 80% impairment as a cut off for being
allowed to undertake medical education, we would have to provide high quality
robust evidence”.
Among the experts who has supported Dr Singh’s petition is Dr Dinesh
Palipana from Australia. He is the first quadriplegic medical intern
in Queensland. In her letter, Dr Meeks has cited real life instances of
doctors with disabilities who are successful in their respective fields of
medicine to question the logic of 80% disability as the cut off.
