Disability Bias in Patient Prioritization: How Patients' Mobility Impairments Influences Prioritization to Mechanical...

Area of Science:

• Medical Ethics
• Health Disparities
• Disability Studies

Background:

• Concerns exist regarding the de-prioritization of disabled patients during medical resource scarcity, particularly noted during the COVID-19 pandemic.
• Empirical evidence on physician prioritization of patients with disabilities remains limited.

Purpose of the Study:

• To investigate how physicians and medical students prioritize hypothetical patients with mobility impairments.
• To assess the correlation between physicians' attitudes toward disabled individuals and their prioritization decisions.

Main Methods:

• A questionnaire study involving physicians and medical students using patient vignettes.
• Vignettes described hypothetical patients needing mechanical ventilation, varying in disability status (paralysis), parenthood, and employment.
• Attitudes toward people with disabilities and prioritization choices were analyzed for associations with de-prioritization.

Main Results:

• Over 60% of participants made de-prioritization decisions, with a significant portion excluding all disabled patients.
• Negative attitudes towards disabled individuals were a predictor of de-prioritization.
• Mediation analysis indicated that negative attitudes influenced the consideration of non-clinical factors (social/familial roles), leading to discrimination.

Conclusions:

• Physicians may de-prioritize patients with lower limb paralysis based on non-clinical factors, indicating potential bias.
• Negative attitudes contribute to discriminatory practices in emergency medical resource allocation.
• Enhanced physician education on bias and robust ethical guidelines are crucial for equitable healthcare access for disabled patients.