Disability Nondiscrimination in Medical Treatment Decisions

Abstract: This panel explores implementation strategies for the “Medical Treatment” provisions of the 2024 Health and Human Services Final Rule on disability nondiscrimination. The Final Rule, which updates and clarifies Section 504 of the Rehabilitation Act of 1973 and related disability rights law, prohibits recipients of federal funds “from denying or limiting medical treatment based on the provider’s belief that…life with a disability is not worth living.” Over 26% of Americans have a disability and are at risk for experiencing health disparities, in part because of clinician and institutional biases.
In this interactive session, the panel presents the collaborative effort of approximately 30 bioethicists from twenty-four institutions supported by an academic bioethics center, to translate this rule into actionable strategies in their respective organizations. Panelists describe interpretation and implementation challenges, given commonly ableist views when balancing patient autonomy, clinical judgment, and medical decision-making.
This session addresses concerns about potential conflicts in situations of medical uncertainty, and the need for objective language to align appropriate care with patient values. Presenters with diverse clinical and organizational roles discuss their process of developing recommendations for staff education, policy language, and procedural ethics support to embed nondiscrimination principles within an overarching equity framework.
Participants will gain tools for performing a gap analysis and mitigation approach at their institution, focusing on disability bias in ethics policy and practice, and developing explicit guidance for nondiscriminatory language. The discussion will highlight the critical role for clinical ethicists in education and mediating complex cases to ensure equitable care.

Keywords: Disability, Discrimination, Medical Treatment