Implementing the Americans With Disabilities Act: Rights and Responsibilities of All Americans.

Gostin LO, Beyer HA, eds. Baltimore, MD 21285-0624, Paul H Brookes Publishing Co Inc, 1993, hardback, 331, pp, $49.

This book consists of 18 chapters and three "front matter" commentaries. It is composed principally of essays authored by health care attorneys and legal educators, ethicists, and disability advocates. There are 22 contributors to the book, including one of the two editors, Lawrence Gostin, who authored 2 chapters. Rather than attempting to provide a technical treatise on the Americans With Disabilities Act (ADA), the authors examine a variety of special topics related to the ADA, and expound on the history and current status of, and future direction for, disability rights in the United States and around the world.

The prologue, written by Irving Zola, the Mortimer Gryzmish Professor of Human Relations at Brandeis University, Waltham, Mass, stresses the demographics and scope of disability. The introduction, written by Justin Dart, Jr, chair of the President's Committee on Employment of People With Disabilities, focuses on the dynamics of empowerment. I King Jordan, President of Gallaudet University, Washington, DC, wrote the foreword, which extols the ADA as the means to ensure equal access to life's opportunities for all.

Part 1 addresses the history of, and legal framework for, establishing rights for persons with a disability. Chapter 1 highlights the history of federal disability legislation, from the Architectural Barriers Act and the Rehabilitation Act, to the Fair Housing Amendments Act and the Individuals With Disabilities Education Act. The chapter's author also delineates the two principal aspects of discrimination against people with disabilities: barriers and prejudice. Chapters 2 and 3 trace the legislative history of the ADA, offering insight into the political considerations inherent in its successful passage. Chapter 4 covers the ADA's antidiscrimination requirements in general, including who is protected, what affirmative obligations apply to employers and businesses, and how enforcement is effected.

Part 2 addresses in detail the four titles of the ADA. Chapter 5 addresses title 1, Employment, which the author labels as "the single most important title of the ADA." included in this superlative chapter are definitions of, and commentary on, the operable ADA terms including "disability ... .. essential functions," "reasonable accommodation," "direct threat," and "undue hardship." It also covers prohibited and permissible pre-employment inquiries, defenses available to employers, and exclusions to coverage under title 1 and the ADA in general.

Chapters 6 and 7 cover vocational rehabilitation programs and the role of organized labor in protecting the rights of workers with disabilities, respectively. Chapter 8 delineates the responsibilities of state and local governments under title 2 in administering public services. This chapter gives several interesting case examples, including suggested answers, involving hospitals, a university library, and a school system. Of special interest to physical therapists is an excellent detailed analysis of architectural and communication access requirements under title 2. Chapter 9 outlines states' statutory obligations regarding public transportation, and includes an interesting presentation of specific requirements for making public conveyances accessible to clients who use wheelchairs. Chapter 10 addresses the legal obligations of business people managing "public accommodations" under title 3, including physical therapists who maintain professional offices. Chapter 11 spells out how titles 2 and 3 supplement existing housing discrimination statutory law to protect people with disabilities, and chapter 12 addresses title 4, Telecommunications, presenting a highly technical description of its provisions and implications.

Part 3 is titled "Innovative and Controversial Issues," which is an accurate title for its chapters' contents. Chapters 13 and 14, written by Gostin, cover important areas with relevance to physical therapists, such as the impact of the ADA on health care delivery systems, and genetic discrimination in employment and insurance coverage, respectively. These chapters are extremely well-written, and include extensive reference lists for further study. Chapters 15 and 16 address the impact of the ADA on people with mental disabilities. Chapter 17 relates the ADA to existing international laws addressing the rights of people with disabilities and offers an interesting discussion of the ADA and developmental disabilities.

Chapter 18 presents a personal perspective on disability policy from the viewpoint of a person with a disability who is at once an advocate, activist, and inspiration for all people who believe in the reality of equality, whether they be disabled or not. Judith Heumann's essay challenging the ADA as mere "patchwork" legislation is well-reasoned and impassioned, and serves as a fitting epilogue to the book. Her chapter is followed by an appendix, containing the text of the ADA, including modifications of the Act made applicable by the enactment of the Civil Rights Act of 1991.

I would highly recommend this book to physical therapist clinicians, students, and educators. Its stirring essays on disability policy and the implications of the ADA for people with disabilities, and for those of us without disabilities, makes it must reading for those who dedicate their professional lives to serving and empowering disabled people.