Disability Friendship as Prophetic Witness for Medical Trainees
Hannah King, Duke Divinity School
The process of medical training comes with a formation into the assumptions of Western biomedicine. This paper will offer the possibility of simultaneous counter-formation via friendship with persons with disabilities. I will explore this formation through my experience going through medical school while also being embedded in a community of adults with and without disabilities. I will discuss the prophetic witness of people with disabilities to speak into and challenge the assumptions of biomedicine, specifically in the context of practicing a Christian theology of friendship. This paper will cover how reciprocal, Christian friendship with persons with disabilities can help a medical trainee move from valuing independence to interdependence, and how this leads to re-envisioning the goals for quality of life that health care providers have for their patients.
The literature on medical students and disabilities largely focuses on two main topics: how to prepare medical students to provide better care to future patients with disabilities and how to improve the experience of medical students with disabilities (Bowen et al. 2025; Neilson 2020). While both are important topics, this paper will not focus on what medicine can bring to the disability community. Instead, this paper foregrounds the prophetic witness of persons with disabilities for the field of medicine. Nurse and practical theologian John Swinton describes this approach saying, “It is not that we need to ‘learn from the disabled.’ The challenge is how we all can learn from one another in ways that take the inherent diversity of the Body of Jesus seriously” (Swinton 2020).
In Western biomedicine, patient independence is a clearly stated goal. For instance, the Cerebral Performance Category Scale, used to inform neuroprognostication, scores patients on their likelihood of performing activities of daily living independently after a critical illness (Kromm et al. 2024). In both pre-clinical and clinical education, this assumption also undergirds many discussions of continuing or withdrawing care. During my clinical rotations, I frequently heard residents and attendings analyzing the odds of patients’ future independence. However, while I was being taught this medical framework, I also spent time with Carly (pseudonym to protect privacy) every Monday night. Carly cannot complete any activities of daily life independently, and yet, she overflows with wisdom and has a life rich with friendships. Even as I was taught that palliative decision making should include a prognostication of the odds of a patient’s future independence, Carly taught me to question whether that independence was the goal we should strive for. My friendship with Carly provided me with counter-formation.
This paper will explore the way that friendship across ability can provide this alternative formation for medical trainees, and how this is distinct from various curricular initiatives to increase disability competence in health professions training. In particular, I will explore Christian theologian and bioethicist Gilbert Meilander’s definition of friendship as both preferential and reciprocal (Meilaender 1981). Utilizing this Christian theology of friendship, a reciprocal relationship that is grounded in an appreciation of the diversity of the Body of Christ, underscores how learning via friendship differs from lecture or class-based learning. It is learning without set power dynamics, at least in the ideal setting. I will use my own experience to argue that being in reciprocal friendships with persons with disabilities has the power to change medical trainees’ values. Ultimately, the prophetic witness of persons with disabilities offers the medical system an alternative understanding of what makes a meaningful life.
Works Cited:
Bowen, Liz, Kerry Devlin, Laura Guidry-Grimes, et al. 2025. “Dismantling Ableism in Undergraduate Medical Education: Promising Practices in Disability-Conscious Training.” Teaching and Learning in Medicine 0 (0): 1–16. https://doi.org/10.1080/10401334.2025.2464672.
Kromm, Julie, Andrea Davenport, and M. Elizabeth Wilcox. 2024. “Neuroprognostication After Cardiac Arrest.” CHEST Critical Care 2 (3). https://doi.org/10.1016/j.chstcc.2024.100074.
Meilaender, Gilbert. 1981. Friendship: A Study in Theological Ethics. University of Notre Dame Press. https://doi.org/10.2307/j.ctv19m62qz.
Neilson, Shane. 2020. “Ableism in the Medical Profession.” CMAJ : Canadian Medical Association Journal 192 (15): E411–12. https://doi.org/10.1503/cmaj.191597.
Swinton, John. 2020. “Disability, Vocation, and Prophetic Witness.” Theology Today 77 (2): 186–97. https://doi.org/10.1177/0040573620920667.
The literature on medical students and disabilities largely focuses on two main topics: how to prepare medical students to provide better care to future patients with disabilities and how to improve the experience of medical students with disabilities (Bowen et al. 2025; Neilson 2020). While both are important topics, this paper will not focus on what medicine can bring to the disability community. Instead, this paper foregrounds the prophetic witness of persons with disabilities for the field of medicine. Nurse and practical theologian John Swinton describes this approach saying, “It is not that we need to ‘learn from the disabled.’ The challenge is how we all can learn from one another in ways that take the inherent diversity of the Body of Jesus seriously” (Swinton 2020).
In Western biomedicine, patient independence is a clearly stated goal. For instance, the Cerebral Performance Category Scale, used to inform neuroprognostication, scores patients on their likelihood of performing activities of daily living independently after a critical illness (Kromm et al. 2024). In both pre-clinical and clinical education, this assumption also undergirds many discussions of continuing or withdrawing care. During my clinical rotations, I frequently heard residents and attendings analyzing the odds of patients’ future independence. However, while I was being taught this medical framework, I also spent time with Carly (pseudonym to protect privacy) every Monday night. Carly cannot complete any activities of daily life independently, and yet, she overflows with wisdom and has a life rich with friendships. Even as I was taught that palliative decision making should include a prognostication of the odds of a patient’s future independence, Carly taught me to question whether that independence was the goal we should strive for. My friendship with Carly provided me with counter-formation.
This paper will explore the way that friendship across ability can provide this alternative formation for medical trainees, and how this is distinct from various curricular initiatives to increase disability competence in health professions training. In particular, I will explore Christian theologian and bioethicist Gilbert Meilander’s definition of friendship as both preferential and reciprocal (Meilaender 1981). Utilizing this Christian theology of friendship, a reciprocal relationship that is grounded in an appreciation of the diversity of the Body of Christ, underscores how learning via friendship differs from lecture or class-based learning. It is learning without set power dynamics, at least in the ideal setting. I will use my own experience to argue that being in reciprocal friendships with persons with disabilities has the power to change medical trainees’ values. Ultimately, the prophetic witness of persons with disabilities offers the medical system an alternative understanding of what makes a meaningful life.
Works Cited:
Bowen, Liz, Kerry Devlin, Laura Guidry-Grimes, et al. 2025. “Dismantling Ableism in Undergraduate Medical Education: Promising Practices in Disability-Conscious Training.” Teaching and Learning in Medicine 0 (0): 1–16. https://doi.org/10.1080/10401334.2025.2464672.
Kromm, Julie, Andrea Davenport, and M. Elizabeth Wilcox. 2024. “Neuroprognostication After Cardiac Arrest.” CHEST Critical Care 2 (3). https://doi.org/10.1016/j.chstcc.2024.100074.
Meilaender, Gilbert. 1981. Friendship: A Study in Theological Ethics. University of Notre Dame Press. https://doi.org/10.2307/j.ctv19m62qz.
Neilson, Shane. 2020. “Ableism in the Medical Profession.” CMAJ : Canadian Medical Association Journal 192 (15): E411–12. https://doi.org/10.1503/cmaj.191597.
Swinton, John. 2020. “Disability, Vocation, and Prophetic Witness.” Theology Today 77 (2): 186–97. https://doi.org/10.1177/0040573620920667.