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Disability Rights in an Ableist Health Care Environment

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Disability Rights in an Ableist Health Care Environment University of Windsor Scholarship at UWindsor Electronic Theses and Dissertations Theses, Dissertations, and Major Papers 7-30-2019 Disability Rights in an Ableist Health Care Environment: How do Women with Disabilities Understand and Address Systemic Barriers to Preventative Community Health Services? Cynthia Brown University of Windsor Follow this and additional works at: https://scholar.uwindsor.ca/etd Recommended Citation Brown, Cynthia, "Disability Rights in an Ableist Health Care Environment: How do Women with Disabilities Understand and Address Systemic Barriers to Preventative Community Health Services?" (2019). Electronic Theses and Dissertations. 7778. https://scholar.uwindsor.ca/etd/7778 This online database contains the full-text of PhD dissertations and Masters’ theses of University of Windsor students from 1954 forward. These documents are made available for personal study and research purposes only, in accordance with the Canadian Copyright Act and the Creative Commons license—CC BY-NC-ND (Attribution, Non-Commercial, No Derivative Works). Under this license, works must always be attributed to the copyright holder (original author), cannot be used for any commercial purposes, and may not be altered. Any other use would require the permission of the copyright holder. Students may inquire about withdrawing their dissertation and/or thesis from this database. For additional inquiries, please contact the repository administrator via email ([email protected]) or by telephone at 519-253-3000ext. 3208. Disability Rights in an Ableist Health Care Environment: How do Women with Disabilities Understand and Address Systemic Barriers to Preventative Community Health Services? By Cynthia Brown A Thesis Submitted to the Faculty of Graduate Studies through the Faculty of Law in Partial Fulfillment of the Requirements for the Degree of Master of Laws at the University of Windsor Windsor, Ontario, Canada 2019 © 2019 Cynthia Brown Disability Rights in an Ableist Health Care Environment: How do Women with Disabilities Understand and Address Systemic Barriers to Preventative Community Health Services? by Cynthia Brown APPROVED BY: ______________________________________________ N. Liem Hôtel-Dieu Grace Hospital ______________________________________________ T. Sheldon Faculty of Law ______________________________________________ L. Jacobs, Advisor Faculty of Law 30 July 2019 DECLARATION OF ORIGINALITY I hereby certify that I am the sole author of this thesis and that no part of this thesis has been published or submitted for publication. I certify that, to the best of my knowledge, my thesis does not infringe upon anyone’s copyright nor violate any proprietary rights and that any ideas, techniques, quotations, or any other material from the work of other people included in my thesis, published or otherwise, are fully acknowledged in accordance with the standard referencing practices. Furthermore, to the extent that I have included copyrighted material that surpasses the bounds of fair dealing within the meaning of the Canada Copyright Act, I certify that I have obtained a written permission from the copyright owner(s) to include such material(s) in my thesis and have included copies of such copyright clearances to my appendix. I declare that this is a true copy of my thesis, including any final revisions, as approved by my thesis committee and the Graduate Studies office, and that this thesis has not been submitted for a higher degree to any other University or Institution. iii ABSTRACT This thesis explores how women with disabilities understand and address their rights to preventative health care within a context of systemic barriers. As the investigator of an empirical study consisting of interviews of five women with disabilities (WWDs) who participated in a barrier-free cancer screening clinic day, I began by exploring the context within which WWDs must operate as they strive to obtain preventative health services to which they are entitled. To this end, a literature review revealed numerous barriers to health care services for WWDs across jurisdictions. In addition, human rights and accessibility legislation, primarily within the Canadian jurisdiction was explored, along with key cases related to health care access for persons with disabilities (PWDs) and WWDs. The interview data was analyzed according to grounded theory methodology, using a feminist theoretical framework and a critique of the literature related to ableism, identity development and rights consciousness. The data, supported by the literature, confirms the existence of multiple barriers to health care for WWDs, and the existence of health care ableism. Most significantly, the data suggests that health care access for WWDs centers around their relationship with their rights to access versus their relationship with the access barriers. I propose a model of rights consciousness, composed of three stages of identity: Imposed Identity, Formative Identity and Integrated Identity. Based on this model, the stages of identity development influence WWDs’ recognition of exclusion and rights infringement related to health care, as well as their decision and degree of support required to act upon it. iv DEDICATION This thesis is dedicated to all the people with disabilities that I have come to know throughout my career as an occupational therapist (OT). My experiences with every one of them over the past thirty-five years has shaped me both personally and professionally. v ACKNOWLEDGEMENTS I wish to thank my advisor, Professor Laverne Jacobs. Your quiet patience and support throughout this challenging project were invaluable to me, and I am most grateful. Thank you for helping me to find my passion! I would also like to thank Professor Tess Sheldon, my internal department reader, and Dr. Nathania Liem, my external department reader. Both of you have been very supportive of my research project. I would also like to express my appreciation to everyone at Windsor Law, including faculty, staff and fellow LLM students. I appreciate the unique knowledge that I gained from each of my course instructors, Professor Laverne Jacobs, Professor William Conklin, Professor Vasanthi Venkatesh and Professor Anneke Smit. Each of you instilled your own wisdom and style. Thank you to Kristie Sabga for your kind support. I would be remiss if I did not mention the team with whom I collaborated in order to conduct my empirical research: Dr. Nathania Liem and her medical students Abbey Nicoletti and Kawmadi Abeytunge, Marla Jackson, Dr. Jennifer Voth and Rachel Gough, of the Department of Research and Evaluation Services at Hôtel-Dieu Grace Hospital, Gayle Iannicello and Ben Parent of the Erie St. Clair Regional Cancer Program, and Dr. Milrod. I could not have found a more supportive group with whom to negotiate access to study subjects! I wish to thank my family and friends who encouraged me every step of the way. Thank you to my son Dan and daughter Erin and my special friends Carol and Marcie for encouraging me to take the next right step. A special thank you to Professor G.E. Lasker, who gave me the initial inspiration to pursue higher studies, and who has offered unfailing support throughout. vi I wish to extend my deepest appreciation to those women with disabilities who came forward and agreed to an interview as part of this research project. I greatly value your time and effort, and I trust that your thoughts and ideas are accurately reflected in this work. Finally, I offer the most special thank you to my mom, Jean, aged 96, whose experience with rehabilitation following a stroke in 1975 inspired me to pursue a career in Occupational Therapy, which ultimately led me to this Master of Laws Degree. vii TABLE OF CONTENTS DECLARATION OF ORIGINALITY ........................................................................... iii ABSTRACT ................................................................................................................... iv DEDICATION ................................................................................................................ v ACKNOWLEDGMENTS .............................................................................................. vi LIST OF TABLES ...................................................................................................... xiii LIST OF FIGURES ...................................................................................................... xiv LIST OF APPENDICES ................................................................................................ xv LIST OF ABBREVIATIONS ....................................................................................... xvi CHAPTER 1 INTRODUCTION...................................................................................... 1 1.1 Statement of the Problem................................................................................ 1 1.2 Outline ........................................................................................................... 2 CHAPTER 2 BARRIERS TO HEALTH CARE .............................................................. 3 2.1 Background .................................................................................................... 3 2.2 Literature Review ........................................................................................... 3 2.2.1 Quantitative Studies .............................................................................. 3 2.2.2 Quantitative Comparison Studies .........................................................
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