This essay will give an explanation and analysis of the nature and extent of discrimination in the UK, introducing the nine characteristics and focusing on disability discrimination. The report will also analyze the importance of current legislation that ensure equal opportunity, specifically the Equality Act (2010), and explain the importance of codes of conduct and practice, such as the BPS Code of Ethics and Conduct (2018) and the BPS Practice guidelines (2017) on ethical professional care.
Discrimination is defined as the unjustified distinctions and treatment of a certain group of people, or an individual, based on aspects of a person's identity and lifestyle such as the reasons presented within the Equality Act 2010, known as protected characteristics, which include race, sex, pregnancy and maternity, marriage and civil partnership, religion or belief, disability, gender reassignment, sexual orientation and age (see appendix one). Examples of discriminatory practices are physical and verbal assault, excluding individuals, avoiding individuals, negative non-verbal communication, making assumptions, and devaluing people (Moonie,2000). Acts of discrimination may be overt, which is often done intentionally with malicious intent and is also known as direct discrimination, such as treating someone less favorably because of their disability. Or covert, also known as indirect discrimination, such as an employer not employing an individual due to their views on a disabled individual's capabilities. Possible outcomes of discrimination can range from low self-esteem, depression linked to stress and helplessness, estrangement from society, and expecting to be rejected or excluded (etc.). In situations in which individuals experience severe persistent discrimination, one may end up withdrawing from attempting to control their own lives, for instance, one may withdraw from communicating their issues with healthcare professionals as past experiences have shown their queries were not acknowledged or they were not respected. This is somewhat explained in Bandura's theory of self-efficacy, in which prolonged exposure to general or institutionalized discrimination is assumed to cause low self-efficacy in education and employability skills (Moonie, 2000).
When considering disability discrimination in particular, the Equality and Human Rights Commission lists six types of disability discrimination: direct discrimination, indirect discrimination, failure to make reasonable adjustments, discrimination arising from disability, harassment, and victimization. However, discrimination can also derive from stereotypes, a way of grouping individuals together and attributing the same qualities and characteristics to each of them, and prejudices, an attitude that is based on pre-judgments made about others and is usually based on ignorance and stereotyped views. Views of disabled individuals stem from values and beliefs entrenched within society that encourage societal attitudes, which are beliefs influenced by governments, historical backgrounds, and other prevailing conditions. Negative societal attitudes based around disabilities from these sources have continued throughout history, and though not as direct, they have ingrained certain stereotypes and prejudices into modern-day society which is often shown through indirect discrimination. However, the Equality Act (2010), which replaced previous laws such as the Disability Discrimination Act (1995), was set out with specific intentions to protect individuals within the said nine characteristics, from discrimination by employers, education providers, public bodies, and local authorities, and health and care providers (citizens advice, 2021).
Nevertheless, multiple accounts of discrimination within modern-day society despite this legislation are still prominent. For example, Scope (2021) claim that disabled individuals are twice as likely to be unemployed, which is arguably due to common stereotypes and prejudices associated with disabled individuals, such as being limited in what they can achieve and incapable of fully participating in day-to-day life. Life costs £583 a month more, on average, if one is disabled. Moreover, an additional report carried out by Scope (see appendix 2) claimed over four in ten individuals (42%) who are part of families that rely on disability benefits are in poverty, which suggests economic and opportunity inequalities, and subtle but detrimental forms of indirect discrimination. Furthermore, during the current pandemic, online streaming services have helped improve many individuals' moods, helping them to feel included in wider culture and conversation. However, Scope (2020) found that 66% of disabled users felt either frustrated, let down, excluded, or upset by inaccessible TV programs and films, and a further 20% of disabled individuals stated they had canceled a subscription or stopped using a video streaming service because of accessibility issues, this is a specific type of disability discrimination known as ableism, in which able-bodied individuals are viewed as normal and superior to those with a disability, which isolates those affected and in this case caused the individuals to feel 'forgotten' and 'excluded'. As mentioned previously, though disability discrimination is usually indirect within modern-day society, it is commonly reported that individuals with visible disabilities, such as dwarfism, face discrimination in everyday life. Usually in forms of harassment, otherwise known as behavior which causes an individual group to feel intimidated or humiliated, or that they may find offensive, in support of this a report about the lives of people with dwarfism in the UK found that 63% of people with dwarfism felt unsafe when out in public (Shakespeare, 2008).
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Disability discrimination is also evident within care, a report by the Care Quality Commission (2014) claims that individuals with dementia, who are protected under the Equality Act 2010, have poorer outcomes in acute hospitals when compared to those without dementia, and state that individuals with this diagnosis are likely to experience poor care at one point along their care pathway. In addition, the same report expresses concern in relation to GPs often not being involved in the care of children with complex health needs (Care Quality Commission, 2015). Furthermore, outcomes and access to preventative services are often poorer for individuals with learning disabilities than for the general public when using primary health services, and although many of the services from GPs for individuals with learning disabilities have improved since 2010, issues of delays in diagnosis and treatment, lack of communication and information, and poor-quality health checks were still prominent, according to the report. Discrimination is clear in other specific disabilities too, for example, the Care Quality Commission stated that inappropriate 'Do Not Attempt Cardiopulmonary Resuscitation' (DNACPR) notices caused potentially avoidable deaths during the second wave of the pandemic. Though usually made for individuals too frail to benefit from CPR, Mencap claim that several of them were issued plainly because the individuals had learning disabilities (Mencap, 2020). Moreover, the final report of the Confidential Inquiry into premature deaths of people with learning disabilities (2013) found that 84% of individuals with learning disabilities that were dying prematurely had sought medical attention in a timely manner. However, 41% encountered problems with investigations and 33% died with undiagnosed significant illness, showing serious cases of indirect discrimination due to failure to make reasonable adjustments, and what could be assumed to be victimization in regard to the problems with investigations (University of Bristol, 2021). Victimization is a type of discrimination in which one is treated badly or is subjected to a detriment because they complained about discrimination (Citizens Advice, 2021).
Although these statistics are not recent, they occurred after the Equality Act (2010) and so diminish the legislation. A more recent and notable occurrence of indirect discrimination, specifically failures in making reasonable adjustments which is a requirement under the Equality Act (2010), is the avoidable death of Oliver McGowan in 2018 (see Appendix three and four). This incited further skepticism regarding the reliability of the current legislation and sparked the government to commission the Learning Disability Mortality Review (LeDeR) Programme, which reviewed a common theme in deaths and called for better training and awareness of learning disabilities and was the introduction of mandatory training in learning disabilities and autism for all health and social care staff.
Cases such as Oliver Mcgowan, and others such as Richard Handley and that of a young individual within the more recent Healthcare Safety Investigation Branch Bulletin (2019) show discrimination does not have to be intentional to be unlawful (Equality and Human Rights Commission, 2019). Competence is an ethical duty, and so healthcare workers not being subjected to training for specific areas of care, such as autism, by not providing equal standards of service or specific care needs, and in turn risking harm to that specific group of individuals is a form of discriminatory practice. Health care providers, such as Psychologists, have the Equality Act 2010, other legislations, and principles such as the FREDA principles (fairness, respect, equality, dignity, and autonomy) embedded into their codes of conduct, such as the BPS codes of ethics and conduct (2018) and their practice guidelines, such as the BPS Practice Guidelines (2017), to protect both health care workers and service users from neglect and harm. In order to provide equal and ethical care, a psychologist must provide services in line with these legal and professional frameworks. When facing issues of discrimination an understanding of key ethical values (Autonomy, Justice, beneficence, and non-maleficence), professional practice standards, and forms of advocacy such as whistleblowing is essential in order to promote equality, diversity, inclusion, and to protect human rights, and in turn helps to empower individuals. In addition, person-centered care is vital when considering ways in which a psychologist can decrease potential discriminatory practice. Each individual has unique care requirements specific to their personal needs, views, beliefs, and preferences, and the collaborative approach promotes active participation within care which not only helps create a professional relationship and levels of trust but allows a psychologist to use the knowledge gained to respect the individual's choices and autonomy, coinciding with the BPS codes of ethics and conduct (2018) and the four ethical principles framework presented by Beauchamp and Childress (2001), which encourages ethical practice. In addition, personal attributes such as values and beliefs, play an important role in ethical practice, in that it is also important for a psychologist to maintain a level of professional tolerance when encountering opposing views, beliefs, and values to not only project a high standard of professionalism, according to the BPS Practice Guidelines (2017), but to maintain respect, as required by the BPS Code of Ethics and Conduct (2018) and the service users basic human rights. To further avoid discriminatory practice in relation to potential failure to make reasonable adjustments for service users, a psychologist should refer to the duty of Continuing Professional Development (CPD) which is a fundamental part of adapting to change. CPD is required in order to maintain and enhance professionalism and competence and allows a psychologist to make reasonable adjustments by improving their knowledge in areas they feel they need to.
In conclusion, by using the BPS codes of ethics and conduct (2018) and the BPS practice guidelines (2017), ethical principles, and policies simultaneously, a psychologist will decrease the potential of discriminatory practice by having knowledge of appropriate ways to treat individuals and their responsibilities regarding factors like competence, tolerance and other high standards of professional practice. However, though one can take preventative measures when witnessing any form of discrimination within modern-day society, it is important to acknowledge that true change develops from advocacy, which has influenced awareness, changes in legislation, behavior, and the levels of support in place for vulnerable individuals, and so to further improve services and societal attitudes, forms of advocacy, such as whistleblowing, are also essential.
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