UPDATES & ANALYSIS

Chiropractic School Must Provide Blind Student a “Sighted Assistant” to Interpret X-Rays

by Ryan Leemkuil | June 27, 2014

By Ryan Leemkuil

Aaron Cannon has been blind since birth.  He enrolled at Palmer College of Chiropractic in 2004, despite warnings from a school representative that Cannon’s blindness would make it difficult, if not impossible, for him to meet the Palmer’s technical standards, which require “sufficient use of vision . . . necessary to perform chiropractic and general physical examination” and review radiographs.  After completing the undergraduate program, Cannon met with the school’s disability steering committee, which again warned him that it was doubtful he could satisfy the technical standards requiring radiology and diagnostic coursework.  But, Cannon suggested, perhaps a “sighted assistant” could be enlisted to relay visual information so Cannon could “analyze it and learn to make diagnoses accordingly.” In the committee’s judgment, however, this arrangement would “place too much responsibility on the assistant” and could run afoul of the standards set by the school’s accreditation body.  Cannon ultimately withdrew from the school after growing frustrated with Palmer’s response to his proposed accommodations.

Today, the Iowa Supreme Court agreed with Cannon that Palmer failed to provide reasonable accommodations for his blindness.  In doing so, the Court rejected Palmer’s arguments that the proposed accommodations would require a “fundamental alteration” of the school’s academic programs, and that the Court should defer to Palmer’s judgment on that point. Deference, the Court explained, is “inadequate in the disability discrimination context,” because courts “must go significantly further in their inquiries to insure inappropriate generalizations do not deny meaningful access to the benefits provided by educational institutions.”  So, the Court went “significantly further” and concluded that Cannon’s proposals wouldn’t require a fundamental alteration of Palmer’s program—plenty of chiropractors work without X-rays, and some just consult with radiology specialists as needed. And even some medical schools have admitted and accommodated blind students in recent years. In light of these facts, the Court held Palmer failed to show any fundamental alteration of its curriculum.

Justice Waterman, joined by Justice Mansfield, issued a sharply-worded dissent, describing the Court’s holding as a “ludicrous” and “unprecedented” intrusion into academic judgment.  That intrusion, Justice Waterman wrote, “elevates political correctness over common sense,” and allows a blind student to interpret X-rays based on what an “untrained reader” tells him—a scenario which could lead to misinterpreted X-rays and “lifelong paralysis.”  Instead of striking a “balance,” as the majority claimed it was, the Court’s opinion ran “roughshod over Palmer’s legitimate interests and the integrity of Palmer’s chiropractic program.”

The decision shows that the Iowa Supreme Court will not be quick to defer to a college’s judgment about the “fundamental” components of its curriculum.  In reviewing that judgment, the Court relied in part on cases from the employment context addressing “fundamental” or “essential” job functions, but it remains to be seen how the Court will apply the Palmer College decision outside of the academic arena.

*Ryan Leemkuil is legal counsel at Fareway  Stores and before that was an attorney at Nyemaster Goode.