The American with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act have made little progress towards preventing disability-based discrimination within the organ transplant evaluation process. Intellectual and developmental disabilities (I/DD) pose a unique problem for transplant teams and transplant physicians because I/DDs can simultaneously be a legitimate contraindication for transplantation and a mechanism for invidious discrimination against intellectually disabled persons. A culprit for ongoing disability-based discrimination is a transplant center’s authority to develop its own eligibility criteria. While medical criteria for eligibility are generally well-settled, psychosocial criteria — an amorphous constellation of risk factors for post-transplant success — can serve as a facially neutral disguise for social worth determinations of individuals with I/DDs. Consequently, individuals with I/DDs are unjustifiably denied eligibility for organ transplantation and transplant-related services.This Article begins by identifying the pitfalls of current federal antidiscrimination legislation. It then discusses the foreseen benefits and drawbacks of House Resolution (H.R.) 8981, a recently proposed federal bill, that expressly prohibits disability-based discrimination within the organ transplant evaluation process. The Article ends by offering potential solutions for professional organizations and transplant centers that aim to provide for equitable access to organ transplantation and transplant-related services for intellectually disabled individuals.

中文翻译：

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重新调整移植资格标准：确保智障人士公平获得器官移植

《美国残疾人法案》(ADA) 和《康复法案》第 504 条在防止器官移植评估过程中基于残疾的歧视方面进展甚微。智力和发育障碍 (I/DD) 给移植团队和移植医生带来了一个独特的问题，因为 I/DD 可以同时成为移植的合法禁忌症和对智力障碍者进行恶意歧视的机制。持续存在的基于残疾的歧视的罪魁祸首是移植中心制定自己的资格标准的权力。虽然资格的医疗标准通常已经确定，社会心理标准——移植后成功风险因素的无定形组合——可以作为 I/DD 个体社会价值确定的面部中性伪装。因此，患有 I/DD 的人被无理拒绝了器官移植和移植相关服务的资格。本文首先确定了当前联邦反歧视立法的缺陷。然后讨论了众议院决议 (HR) 8981 的预期好处和缺点，这是一项最近提出的联邦法案，明确禁止在器官移植评估过程中基于残疾的歧视。