Special Issue Editorial: An Invitation to Reorient and Re-imagine

“Change never happens at the pace we think it should. It happens over years of people joining together, strategizing, sharing, and pulling all the levers they possibly can. Gradually, excruciatingly slowly, things start to happen, and then suddenly, seemingly out of the blue, something will tip.” –– Judith Heumann¹

Now more than ever, the illusory societal lines differentiating spaces for the sociopolitical, philosophical, ethical, professional, educational, and humanistic are dissolving. This change is affording us opportunities for reimagining cultural identity and value systems within society.

The permeability between and among these spheres of thought and influence can also introduce threats to those same cherished values and identities. In these times, it is the simultaneous recognition of opportunities for growth as well as the need to protect our core values of benevolence, equity, inclusion, and justice that will serve us best—as fellow humans, community members, and global citizens.

Nuanced Critical Thinking

Healthcare practitioners and educators have a particularly consequential fiduciary responsibility to the public to serve, commit to excellence, and advance our skills and knowledge. As the profession evolves to keep pace with dynamic societal landscapes, practitioners would do well to engage in more nuanced critical thinking.

It is time to adopt a philosophical approach to healthcare in addition to the critical reasoning already emphasized in health professions. This type of critical reflection, explained by physical therapist and bioethicist Barbara Gibson, encourages individuals to “commit to questioning the taken-for-granted.”²

This approach is particularly relevant to this special issue of the Journal of Humanities in Rehabilitation, which centers the voices and lived experiences of student, educator, and clinician advocates for Disability inclusion within Physical Therapy.

Hard Truths Revealed

At first glance, this may seem like a non-essential or possibly redundant topic to highlight within a caring profession. Don’t rehabilitation professionals demonstrate inherent inclusion of people with disabilities given the nature of their work? Healthcare practitioners, often altruistic by nature, would unlikely be complicit in perpetuating inequity and lack of access for the disabled community. Correct?

Through the powerful experience of speaking at and attending the American Council of Academic Physical Therapy (ACAPT) Inclusive Horizons Summit, it became clear to me that these oft taken-for-granted notions do not reflect the current realities faced by patients with disabilities—as well as practitioners, educators, and healthcare students living with a disability. The summit revealed hard truths—and suggested paths forward for rehabilitation professionals to better promote disability inclusion and equitable access.

Leaders Forging Change

Choosing a path forward requires moral courage. Thankfully, we have many voices within the Disability community—as highlighted in the compelling student narratives and the Disability resource section within this issue—to guide us. There are scholars such as Dr. Gibson—and Dr. Lisa Meeks, and Dr. Amanda Sharp, showcased herein—who continue to lead in these spaces, and invite others to join them in this important work.

Because of the perseverance and diligent work of advocates, positive change is happening. Despite unanticipated turns and disorienting switchbacks along the journey, (which has been the case throughout history) the path toward access, inclusion, and justice continues in a benevolent direction. The foundational elements of critical inquiry will serve as guideposts for practitioners endeavoring to become anti-ableist in their practice and individual lives.

A Three-Step Plan

Actualizing Dr. Gibson’s framework in the context of Disability inclusion may involve three key steps:

1. Questioning the taken-for-granted. Approaching with curiosity the notion that being in a healthcare field inherently leads to Disability inclusivity and justice.
2. Attending to power dynamics. Recognizing the power inequities often present in practitioner-patient and/or non-disabled-disabled relational dynamics, and actively seeking strategies to empower and collaborate vs. instruct and dictate.
3. Critiquing the dominance of positivism. Challenging the notion that all scientific realities and lived experiences (including those of Disabled individuals) can or ought to be measured in objective and neutral ways, decontextualized from time and place, and detached from the realm of emotions, subjectivity, and sociopolitical influence. Upending this narrow notion invites one into a space of humble reflection and encourages a broader way of viewing the world.

There are many entry points to this path toward greater Disability inclusion within healthcare professions. We hope that this special issue of JHR invites our readers into such contemplative spaces—encouraging a sense of curiosity, of vulnerability with oneself and others—and inspires the moral courage needed to continue the vital and necessary work of caring for each other.