Author Affiliations: Georgetown University Law Center, Washington, DC (Mr Gostin and Ms Feldblum). Mr Webber is in private practice in Philadelphia, Pa.
Health Law and Ethics Section Editors: Lawrence O. Gostin,
JD, the Georgetown/Johns Hopkins University Program in Law and Public
Health, Washington, DC, and Baltimore, Md; Helene M. Cole, MD,
Contributing Editor, JAMA.
The Americans With Disabilities Act (ADA) was widely hailed
at the time of its enactment in 1990 as providing broad protection
against disability discrimination, including discrimination against
individuals infected with the human immunodeficiency virus (HIV). In
the years since its enactment, however, courts frequently interpreted
the ADA as providing far less protection than was initially
anticipated. The Supreme Court's first case involving HIV and the
acquired immunodeficiency syndrome, Bragdon v Abbott,
addressed this trend by ruling that a woman with asymptomatic HIV
infection is protected from discrimination in accessing dental
services. In doing so, the Court endorsed an interpretation of the ADA
that is broadly protective for individuals with disabilities. The Court
also ruled that health care professionals may legally refuse to treat a
patient because of concern that the patient poses a direct threat to
safety only if there is an objective, scientific basis for concluding
that the threat to safety is significant. In addition to the ADA, state
laws frequently prohibit disability discrimination and apply to some
employers and others not regulated by federal law. A state-by-state
survey of those laws demonstrates that, consistent with Bragdon v
Abbott, individuals with asymptomatic HIV have widespread
protection on the state level.
Gostin LO, Feldblum C, Webber DW. Disability Discrimination in America: HIV/AIDS and Other Health Conditions. JAMA. 1999;281(8):745–752. doi:10.1001/jama.281.8.745
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