A reflection on autonomy, medical harm, and what happens when medicine forgets its own oath.
By Tammi Bradley
Estimated reading time: 6–7 minutes
I am a person with a very complex disability. I use a power wheelchair. My life has never been easy, but it is full, deliberate, hard-won, and deeply loved. I have survived things that once felt unsurvivable. I have built meaning in places where others assumed there would be none.
I am still here because I choose to be. That choice should have been respected.
At a routine medical appointment, I asked for something that should have been straightforward. I asked to complete a POLST so that my wishes would be honored if I could no longer speak for myself. A POLST is a legally recognized medical order. Its purpose is not philosophical debate. Its purpose is clarity. It exists so that when seconds matter, medical professionals follow the expressed wishes of the person in front of them.
I said clearly that I want all life-sustaining measures taken.
I want treatment. I want intervention. I want the chance to recover. That should have been the end of the conversation.
Instead, it became the beginning of something deeply disturbing.
Rather than being heard, I was questioned. Repeatedly. My doctor asked if I was sure. Then she asked again. Then she began describing, in graphic detail, what life-sustaining treatment would feel like. Shock to the body. Broken ribs during CPR. Pain. Trauma. Damage.
This was not neutral information. This was pressure.
It felt less like informed consent and more like persuasion. As if the goal was not to document my wishes, but to make those wishes so uncomfortable, so frightening, so burdensome that I might withdraw them.
That is not care. That is harm.
Medicine prides itself on ethics. On compassion. On a commitment to “do no harm.” Yet in that room, harm was inflicted deliberately through words, tone, and implication. My choice to live was treated as suspect. As though survival, in a body like mine, required justification.
The harm was not physical. The harm was moral.
As the conversation continued, I felt myself shrinking. I was no longer simply a patient stating my wishes. I was being evaluated. Measured. Quietly weighed against someone else’s discomfort.
And then there was my son.
My son was there to support me during the appointment. He had to sit and listen while a medical professional questioned whether his parent’s life was worth fully fighting for. He heard me advocate, out loud, for my right to live. For my right to treatment. For my right to recovery.
After the appointment, the incident stayed with me. I carried it longer than I expected to. It lingered because of what it revealed, not just about medicine, but about what my son was exposed to in that room.
When I began writing about the experience, I shared an early draft of this piece with him. I wanted to know how it landed. I wanted to understand what he remembered.
He read it. And then he told me something I wasn’t prepared for.
The incident hadn’t made much of an impression on him at all. It hadn’t stirred anger or confusion. He hadn’t replayed it. In fact, he had largely forgotten about it.
Not because it was insignificant, but because it was familiar.
That realization landed harder than anything that happened in the exam room. The fact that this moment, one that shook me so deeply, registered as forgettable to him told me everything I needed to know.
He has seen this before.
He has watched me be questioned, diminished, and quietly challenged by systems that are supposed to care for me. Over time, those moments have blended together. They have become background noise. Something to move past. Something not worth holding onto.
That is the harm no one talks about.
No child should ever become used to watching their parent defend their right to live. No child should learn that this kind of treatment is ordinary, expected, or unremarkable. No child should absorb the lesson that this is simply how the world responds to certain bodies.
That normalization is its own kind of harm. A quiet one. But no less devastating.
A POLST Is Not a Debate
A POLST is not a discussion prompt. It is not an invitation to test someone’s will to live. It is not an opportunity for clinicians to insert personal discomfort under the guise of realism.
It is a medical order.
I did not ask my doctor what she would choose for herself. I did not ask for her beliefs, fears, or moral framework. I asked for my legally protected right to have my wishes documented and honored.
When a person with a disability says they want all measures taken, that answer should not be interrogated until it softens. It should not be framed as naïve or extreme. It should not be treated as a problem to solve.
It is an answer.
Pressuring someone to reconsider survival based on assumptions about their quality of life is not advocacy. It is coercion disguised as concern.
When Medicine Violates Its Own Oath
The medical field often speaks proudly of progress. Of ethics committees. Of patient-centered care. Yet moments like this reveal a deeper failure.
When a clinician treats a person’s desire to live as negotiable, trust collapses. Safety disappears. The exam room becomes hostile terrain.
That is harm.
And it is a harm disproportionately carried by people whose bodies already make others uneasy.
I am competent. I am informed. I know exactly what I am asking for. But even if I were not, my life would still be worthy of care.
Disability does not erase autonomy. Needing support does not diminish value. A complex body does not grant medicine permission to lower its commitment to survival.
Medicine does not get to decide whose life is worth the effort.
Why I Am Speaking
I am telling this story because silence protects the wrong people. I am telling it for every person with a disability who has left a medical appointment feeling smaller than when they arrived. For every family member who has witnessed these moments and not known how to stop them.
I am telling it because “do no harm” must mean more than avoiding physical injury. It must mean respecting autonomy. It must mean refusing to weaponize fear. It must mean recognizing when bias and discomfort are masquerading as clinical judgment.
I will continue to choose life.
I will continue to say yes to care. Yes to intervention. Yes to recovery.
And I will continue to speak when the medical field forgets that its role is not to decide whether someone’s life is worth saving.
I choose life.
Learn more about Tammi at https://abilitytogether.org/about/board-of-directors/tammi-bradley/
