ABSTRACT
The United States Constitution's Fourteenth Amendment codifies the protection that no State shall "deny any person within its jurisdiction the equal protection of the laws." In 1990, Congress enacted the Americans with Disabilities Act (ADA), public law 101-336, which extends equal protection to individuals whose physical or mental impairments substantially limit one or more life functions. Congress cited a history of isolation and discrimination to explain the need for this law:
Historically, society has tended to isolate and segregate individuals with disabilities, and despite some improvements, such forms of discrimination . . . continue to be a serious problem . . . Individuals with disabilities are a discrete and insular minority who have been faced with restrictions and limitation, subjected to a history of purposeful unequal treatment, and relegated to a position of political powerlessness in our society based on characteristics that are beyond the control of such individuals and resulting from stereotypic assumptions not truly indicative of the individual ability of such individuals to participate in, and contribute to society. (ADA, 1990)
While the ADA contains no explicit references to health care delivery, its requirements reach to the core of medical thought because through it Congress legislates a reconceptualization of the meaning of "disability." The ADA codifies into law the understanding that a disabling condition is a state of society itself, not a physical or mental state of a minority of society's members, and that it is the way society is organized, rather than personal deficits, which disadvantages this minority.
