Stigma of Disability in America

  • an identifying mark of shame, discredit or disease
  • a condition or characterisitc that engenders pejorative beliefs by society, individuals or even an effected individual.
  • a physical or mental impairment that substantially limits one or more major life activities.

America's relationship with our disabled is changing for the better. The enactment of the Americans with Disabilities Act (ADA) in 1990 prohibits discrimination on the basis of disability in employment, State and local government, public accommodations, commercial facilities, transportation, and telecommunications.

To be protected by the ADA, one must have a disability or have a relationship or association with an individual with a disability. An individual with a disability is defined by the ADA as a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such impairment, or a person who is perceived by others as having such impairment.

The passage of the ADA is a milestone on a long road toward remodeling American's perception and interaction with our disabled citizens. It is one step toward extinguishing the stigma associated with being different in mind or body. We are all aware, to some degree, of the indignities and prejudice visited upon our disabled citizens but we may not be aware of the atrocities. Within many of our lifetimes and certainly within those of our grand parents, institutionalization and coercive/forced sterilzation of the disabled, chronically ill and socially disadvantaged was the law in many American states.

It began in 1907, decades before the atrocities of Nazi Germany; Indiana became the first state in the modern world to enact a law that allowed the involuntary sterilization of "confirmed criminals, idiots, imbeciles and rapist". "In addition, Indiana established a state-funded Committee on Mental Defectives that carried out eugenic family studies in over twenty counties and was home to an active "better babies" movement that encouraged scientific motherhood and infant hygiene as routes to human improvement."

The stigma of disability and the popular support for eugenics was summarized in the 1927 U.S. Supreme Court decision (Buck v. Bell), Chief Justice Oliver Wendell Holmes writing the court opinion, stated "The judgment finds the facts that have been recited, and that Carrie Buck is the probable potential parent of socially inadequate offspring, likewise afflicted, that she may be sexually sterilized without detriment to her general health, and that her welfare and that of society will be promoted by her sterilization"..... "We have seen more than once that the public welfare may call upon the best citizens for their lives. It would be strange if it could not call upon those who already sap the strength of the State for these lesser sacrifices, often not felt to be such by those concerned, in order to prevent our being swamped with incompetence. It is better for all the world if, instead of waiting to execute degenerate offspring for crime or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind."

While Indiana was the first state to enact a eugenical law, North Carolina has the indignity of being the last in the U.S. to repeal its eugenics law in 1987. From 1933 until 1977, North Carolina "endorsed sterilization of people who had epilepsy, sickness, “feeblemindedness” and other disabilities. Eugenics was a popular movement, especially prior to the World War II, and other states had similar programs. However, North Carolina was the only state that allowed social workers to petition for the sterilization of members of the public. These local social workers would petition the board to sterilize a person, and the board would make the final decision. Over 70% of North Carolina’s sterilization victims were sterilized after 1945 in contrast to other states that conducted the majority of their sterilizations prior to World War II and 1945."

Many historic events contributed to America's eventual repeal of eugenics and grudging tolerance of disability. Some of these events include: consistent Catholic opposition, Nazi atrocities, the civil rights movement and the efforts Eunice Kennedy Shriver, founder of the Special Olympics and life long champion of the mentally ill.

As nurses, we must acknowledge the central role of health professionals in the American eugenics movement. We inherit the duty to be vigilant for disability discrimination and bias that frustrate full potential, regardless of origin. Affected individuals and their families are entitled to pursue health and happiness without contrived or presumed impediments.

“all human beings are created equal in the sense that each has the capacity and a hunger for moral excellence, for courage, for friendship and for love. Whatever the speed of our feet or the power of our arms, each of us is capable of these highest virtues. Intelligence does not limit love, nor does wealth produce friendship."

Eunice Kennedy Shriver