Nurse anesthetists and the Americans With Disabilities Act.

A recent case reminded me that it has been almost 15 years since Congress passed the Americans with Disabilities Act at the urging of President George Herbert Walker Bush. While everyone supported the goals of the Act, some lawyers were unclear about the changes that the Act would bring and the effect they might have. In anesthesia, what disabilities would be protected by the Act and what kinds of accommodation would hospitals and employers have to make for anesthetists with disabilities? I recently looked through the reported legal cases involving nurse anesthetists to find those that dealt with the Americans with Disabilities Act. The Americans with Disabilities Act prohibits private employers, state and local governments, employment agencies, and labor unions from discriminating against a “qualified individual with a disability.” A “disability” is defined as: (a) a physical or mental impairment that substantially limits one or more major life activities; (b) a record of such an impairment; or (c) being regarded as having such an impairment. A “qualified individual with a disability,” the person protected by the Act, is defined as an individual with a disability who, with or without “reasonable accommodation,” can perform the essential functions of the employment position that such individual holds or desires. The Act was not entirely clear about what it meant by a “reasonable accommodation,” but the Act gave 2 examples. The first was making existing facilities used by employees readily accessible and the second was job restructuring. Examples of changes to existing facilities might include installing wheelchair ramps or elevators. Examples of job restructuring might be having 2 part-time employees cover what used to be 1 full-time position or providing breaks or rest periods. In what ways might the Act affect anesthesia?