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Rethinking systemic ableism: A response to Zagouras, Ellick, and Aulisio.

Erin E Andrews^1,2, Kara B Ayers^3,4, Joseph A Stramondo⁵

¹VA Texas Valley Coastal Bend Health Care System, Harlingen, TX, USA.

Clinical Ethics

|June 7, 2023

Summary

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This article critiques a case study of a pregnant woman with a disability. It argues that healthcare providers and family exhibited ableism and coercion, questioning her autonomy and decision-making capacity.

Area of Science:

Bioethics
Disability Studies
Reproductive Health

Background:

A case study examined a pregnant woman with a physical disability facing pressure to terminate her pregnancy.
Her healthcare team and parents questioned her decision-making capacity, citing her disability and sheltered upbringing.

Purpose of the Study:

To critique the original case study's analysis of a pregnant disabled woman's autonomy.
To highlight instances of systemic ableism and coercive practices in reproductive healthcare.

Main Methods:

Critical analysis of a published case study.
Application of feminist and disability ethics frameworks.

Main Results:

The original case analysis failed to address systemic ableism and discriminatory attitudes.

Keywords:

autonomy competency disability ethics pregnancy

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The healthcare team's actions demonstrated infantilization and misinterpretation of relational autonomy.

Family coercion and healthcare provider collusion were evident in the case.

Conclusions:

The case exemplifies discriminatory and culturally incompetent reproductive healthcare for disabled women.
Questioning a disabled woman's autonomy requires careful consideration of societal ableism and coercion.
Ethical reproductive healthcare must uphold the decision-making capacity and autonomy of all individuals, irrespective of disability.