When Accommodations Conflict

Accommodations can be difficult. Not only for an individual with a disability to identify what accommodation would be relevant or helpful for them, not only convincing whoever to implement the desired accommodation, and not only ensuring that the accommodation continues over time and doesn’t lead to resentment or punishment for the person with a disability. Here is an additional wrinkle – sometimes desired or needed accommodations conflict. What one PWD needs to accommodate her disability could not only not help another PWD, but might actually exacerbate their disability.

Let’s take an example: smoking. For some PWDs, especially those with mental illness, smoking can help ameliorate their symptoms, calm their anxiety, even help some with restoring neurochemical imbalances. The rates of smoking among people with mental illness tend to be much higher than the general population, in which about 20% of people smoke. Here is a chart of smoking rates among PWDs with mental illness:

MENTAL ILLNESS: PERCENTAGE WHO ARE SMOKERS
Bipolar Disorder 70%
Major Depression 60%
Schizophrenia 90%
Panic Disorder 56%
Post Traumatic Stress Disorder 60%

There are lots of theories why people with mental illness smoke. At a recent meditation seminar, the instructor was modeling deep breathing techniques for relaxation and stress reduction. He pointed out that the deep breaths, with an exhale longer than the inhale, breathing from the abdomen, exactly mimicked the breathing of a smoker while inhaling from a cigarette and exhaling smoke. I know people who took up smoking intentionally and specifically in order to help regulate breathing during panic attacks – they report that the 5-7 minutes of regulated breathing during one cigarette is enough to get them through a panic or anxiety attack.

Nicotine, the active ingredient in cigarettes, also acts as a stimulant on the brain. Some report enhanced attention, focus, and concentration, which can be helpful for people with attention or focus problems caused either by their disorders or the medications that treat them. As one study reports: “Certain thinking patterns are affected in schizophrenia including sustained attention, focused attention, working memory, short-term memory, recognition memory and even processes that are preattentive (eg reflexes). Some studies have suggested that there may be improvements in these areas after treatment with nicotine.” Those authors theorize, as have many others, that “it may be that patients “self medicate” to remediate the chemical imbalance in the brain (dopamine hypofunction in the pre-frontal cortex) which may help with certain difficulties with thinking tasks involving this PFC area and might explain why there is smoking persistence in schizophrenia.”

On the flip side, of course, there are many PWD for whom being around smokers or smoke will exacerbate their disabilities and a necessary accommodation is an atmosphere free from smoke. People with asthma and other respiratory problems or people with allergies and chemical sensitivities could be seriously harmed by being around smoke or people who are smoking, and could require an accommodation to be free from smoke exposure.

This sets up the possibility that there could be two PWDs – let’s say one with schizophrenia and one with severe smoke allergies – who require accommodations that are directly conflicting with each other. These situations are much trickier for me than when a PWD is requesting an accommodation that an employer, business, government, or other entity is saying is too difficult or expensive to implement. In those situations, I believe the accommodation rights of the PWD should trump that concern in the vast majority of cases. But handling issues of conflicting accommodations can be much more complicated, because the rule of “you must accommodate PWDs” doesn’t give us any guidance on how to proceed.

This is just one example of desired or needed accommodations that can directly conflict, but there are many others. How do you think these situations should be handled? Have you run into conflicts like this in your own life?

Note: discussions of conflicting accommodations – including the example discussed above – can become very charged and very personal, as readers and commenters may have personal preferences or needs on which accommodation to implement. Please be respectful of the needs of other PWDs in this comment thread. Specifically, comments that imply or state that smokers are inherently evil or people who don’t smoke are inherently intolerant (or similarly bright line rules) will be deleted.

38 thoughts on “When Accommodations Conflict

  1. For me, inhaling secondhand smoke is something that will make me very, very sick and has probably given me the ashtma and severe allergies that have a very large impact on my life even now. If I go to a smoky bar, I will get bronchitis, full stop, every time. It took me a few trips out to realize this, but now I am in a smoke-free state so I don’t think about it as much.

    It’s hard for me to see past my own health to realize that some people smoke to self medicate, even though I know that to be true. I think allowing it outdoors in open areas (within reason) is a fair compromise, although I can’t see this as working for all other situations in which accomodations might clash.

  2. I ran into this in a class I was teaching a few years ago. One of the students was deaf in one ear, so he had to sit at the side of the room that would put the hearing ear towards me. He also needed me to face him while I was talking. Ordinarily, this wouldn’t have been an issue for me, but the classroom we were in had very weird proportions, so that facing him would mean turning my back on at least a few other students. Also, I was going through a flare-up at the time which meant that I had very little use of my left arm, and the only way to face him and point at the board (which was necessary a lot, since this was a math class and I needed to point to the different expressions I was talking about) was to point with my left hand. I tried pointing with my right hand, but that ended up either twisting my back painfully or bringing my arm in front of my face, which just defeated the entire purpose. I finally ended up with a weird sort of dance, like “And then you take” step step turn point “this” unpoint turn step step “side of the equation and subtract 3x, so then you get” step turn write “this” turn step step expression as your final answer.” It sometimes left me exhausted, and I know that I wouldn’t have been able to do it if that student had been in my class this year, since my ankle has been acting up so much lately that all that stepping and turning would have left me crying in pain. I still have no idea what a better solution would have been.

  3. @Ruchama – i would argue that the educational institution should have moved you to a room that would accommodate both the student’s need for you to face him and your own needs. (although i’m sure that would have been, um, difficult to persuade them to do.) but definitely a great example of how your needs and the student’s needs directly conflicted.

  4. I’ve directly experienced this intersection before. When I was on a psych ward for a few days (incidentally, this was when I was diagnosed with bipolar disorder), the only way one could get “outside privileges” was to go along with the smoking patients on cigarette breaks. I’m very, very allergic to cigarette smoke, but I’m also very claustrophobic and the locked ward was minuscule and had very few windows, so I had no choice but to go outside and try to find a spot as far downwind as possible while still being in the allowable range. Even understanding how understaffed the ward was, I still think that the idea that you had to smoke or want to stand with people who were smoking to be allowed to go outside for ten minutes at a time a few times a day was pretty unfair.

  5. I didn’t start smoking as a coping mechanism but I’ve certainly used it as such. Right now I don’t smoke; my wife told me back when we were flirting she wouldn’t kiss me if I kept smoking so I stopped. But if we split up or she died I’d probably start right back up again. Even now when I’m stressed one of the first things I think is “dang I need a cigarette.” I find that just smoking imaginary cigarettes — going through the motions of putting it to my lips and pulling in the smoke and letting it out again tapping the ash off the tip — works pretty well.

    I still want a real one though. (I have written in loving detail about the real cigarette I want.)

    On the other hand? Second-hand smoke makes me sick. Headachy nauseated dizzy coughing sick. First-hand smoke is likely to be worse. It’s probably very good for me to be not smoking.

    So yeah. I actually do support smoking bans in public spaces and regulations that push smokers away from the entrances to buildings so non-smokers don’t have to walk through a cloud of smoke to get to wherever they’re going.

    I do feel like there should be some kind of accommodation made for smokers too; designated spaces that have rain shelters and nice seating and are accessible to people using mobility aids. Away from entrances. Something more than “If you must do that go some place horrid.” Smokers are still human. We’ve (I’m still a smoker — I think — just on sabbatical) been dehumanised rather a lot.

    There are of course inconsiderate smokers who don’t care that their smoke harms others. Who don’t dispose of the butt ends of their cigarettes properly — throwing them from car windows dropping them on pavements and suchlike — which isn’t just littering; it’s dangerous. Fires start this way. There’s much room for improvement on the part of smokers in being responsible members of society: it starts with being aware of the others who breathe the air you add smoke to and with picking up after yourself.

    (But then when I was an active smoker I didn’t smoke in my home or in my car; I didn’t like living with the smell any more than I had to. Even when I lived alone. So I am perhaps not representative of smokers as a population. Going outside to smoke wasn’t a transition I had to make — smoking indoors in bars when it was legal in places I lived felt odd. It seemed to be a necessary defence against the second-hand smoke there; if I wasn’t smoking myself when I was in a smoky place I felt ill. I don’t understand why it worked but it did.)
    .-= kaninchenzero┬┤s last blog ..For trouble Who has to Grade Papers =-.

  6. In Britain in many towns and cities, pedestrian crossings are marked with ‘knobbly’ paving slabs, which I believe are designed to help visually impaired people identify the crossing points. Unfortunately I find them really painful to stand on. They force my feet out of level and twist my ankles, which has a knock-on effect all the way up my legs.

    I don’t know how this should be resolved – I’ve always just put up with it because I know it’s an accommodation for other disabled people.

  7. @dogged I have a similar problem, thought it’s part balance and part sensory. There’s a crossing near me where there is a strip of them and then a strip of regular footpath, so whilst (reasonably) you have to walk over them, you don’t have to stand on them (or be in everyone’s way). I’m sure it was accidental, but it works great.

    In general, I can do most everyday physical things, if with a bit more effort than most people, but it takes me time to learn how. This means that change often poses problem to me. It’s not quite the same as the accommodation being the issue, but the introduction of things like low floored buses (which I was falling on for a while) was hard to deal with.

  8. The biggest accommodation conflicts in my life are over temperature.

    I am overheated 99% of the time. 100% of the summer (which can start as early as March and not end until Halloween).

    I understand keeping the house at 50 F is prohibitively expensive, I get that. But must my sister turn off the fan if I leave the room to go to the bathroom? She is cold a lot, wears jackets and jeans in Memphis summers.

    But one thing I’ve been thinking about – what if a place did provide a seat for me or anyone who needed it? Would it take up space for someone using a scooter or wheelchair?

  9. @Kaitlyn – i’m talking specifically about when two PWDs have accommodation needs that conflict – i understand your temperature example to be a situation where your accommodation need conflicts with your sister’s general preference, not her need for accommodation as a PWD. that said, i can definitely see how PWDs might have temperature accommodation needs that directly conflict!

  10. I just thought of one that’s been bugging me for a while.

    For people with disabilities who are able to drive, and have driving as their preferred method of getting places, huge parking lots are welcoming. Particularly if they’ve got lots of disability parking spaces as well, so it’s really easy to get from one’s car to the storefront.

    For me, someone who’s deathly afraid of driving precisely because of my disability (seriously, try driving somewhere if you can’t consistently judge where other things on the road are), huge parking lots are a hassle, if not just plain dangerous. Having to walk through a quarter mile of pavement from street level to get to the storefront is bad enough. Having to dodge cars going every which way while doing so because there are no markings for safe pedestrian crossing, even worse. And I’m able to walk; I’d be in even more danger if I were getting there from the bus stop in a wheelchair or scooter!

  11. Sorry, Abby Jean, I guess I don’t understand – wouldn’t one person who is always over-heated and one person who is always under-heated both have a disability as regards temperature?

  12. I know what you meant Abby Jean. That was just the first thing in my head – it’s a cliche, but what if both of the parties need it boiling/freezing for health reasons. Never thought of it, except as an excuse to throw blankets at my sister. (Though I knew one girl who said that if it was too cold she got nauseous, just like I get nauseous if it’s too hot. But that was at school, where heating/cooling is all up to you – jackets/fans.)

    Codeman – I’m not the only one freaked out by parking lots! Okay, I’m just freaked out by cars when I’m walking outside of residential areas. Logically, they don’t want to hit me, I know that. But must they go so fast? double digits speeds are just too much!

    Another smoking angle – what if you need a smoke (and thanks for this post, I’ll try to be more charitable to the smokers in my life*) but because of fatigue or anything, you can’t walk far enough away from the food/entryway/person hacking up their lungs from pneumonia? Because so many businesses and such move smoking sections very far away from everything… and that has to be hard.

    Though I still think you shouldn’t smoke within 5 feet of a door on campus (the rules say 25, ha!) because I love walking through it, it’s so much fun!

    *K0, as a non-smoker, you’re awesome. My mom makes her relatives smoke at the end of the driveway when they’re visiting, and when dad lived here, he always smoked outside. My aunt and uncle both smoked, but they both went outside to do it (3 kids inside, one under 5). That has changed, but I like the measures they took. On campus, most of the smokers around here are not considerate… well the only ones you notice are the ones smoking next to the door that you have to breathe in.

    And a friend who smoked tried to help by spritzing herself with febreeze/perfume before coming back in (she still smell liked smoke, but gotta appreciate the gesture)… she’s wouldn’t be helping anyone with severe allergies, would she?

    Those with bad allergies – what’s worse – the smoke or the cover-up?

  13. @abby jean

    Regarding the temperature situation, this is actually an issue I have now with myself, my husband, and boyfriend. I have severe temperature sensitivity because of my fibromyalgia, and I need the house kept at a low temperature. 70F is at the bare range of my tolerance. My husband has arthritis, and my boyfriend has an injured knee which is temperature sensitive, and both of them need the temperature kept above 70F or it causes them pain.

    We get around it, but it’s a LOT of juggling, and it was a much bigger deal when we were living in a one bedroom apartment with no zoning. Since we all have our own rooms/offices in our current housing, we can keep the temperature lower in the common areas and hotter where they need them. (Mine tends to “win out” because I have trouble breathing if the temperature gets too high, and I’ll likely end up vomiting. They’d rather take the extra pain of the common rooms being cooler than they can really handle.)

    It sucks. ­čÖü

  14. Cigarette smoke – especially stale – is a migraine trigger for me, but so are alcohol-based perfumes. Smoke plus cover-up is definitely worse for me than just smoke. Also, the people who *don’t* cover up seem to those who smell less in general, though I don’t know if that’s because they smoke less in the first place (and thus feel less need to cover it) or because they wash their clothing more instead. Things have got drastically better for me since indoor smoking in public places was banned in Australia, and I suspect that physical separation of smoking areas is a possible accommodation that suits both partieis in this case, though I wonder about smokers who also have difficulty moving.

    Thanks for the information on why smoking might be a helpful thing for some kinds of mental illness, though – it’s definitely a privilege check for me, even though I have a mental illness myself!

  15. Oh, and to combine transportation and smoking… it’s always really annoying when someone decides to start smoking while I’m waiting at a covered bus stop. Triggers my allergies every time. But the worst thing is, I can’t exactly suggest other places they can go, since they’re waiting on the bus too… -_-;;

  16. Oh, and Kaitlyn, I totally understand what you mean. I know drivers don’t want to hit me, but most of them are far too into their phone conversations or otherwise distracted to actually notice someone trying to cross… It’s particularly bad when I need to cross the street and a driver who’s turning right doesn’t notice that I have the right of way!

    I actually got hit by a car in a parking lot once. I thought they were slowing down for me, but no, they were just fluctuating in speed because the driver was carrying on a conversation and not really paying attention. -_-;;

  17. As for smoking, thinking about it, this is actually an issue I had with an ex of mine, too. He uses nicotine to help with his anxiety and for the stimulant benefits against his chronic fatigue. However, even before I became as sick as I am now, cigarette smoke was a migraine trigger.

    Part of our room & board agreement with the friends we were renting a room from was that they’d pay for his cigarettes; that wasn’t bad when you consider that they knew where to buy organic tobacco for cheap. The organic tobacco didn’t bother me, oddly, unless he smoked enough that the air in the room was thick (and then I had trouble breathing). There were a couple times, though, where our friends didn’t get around to ordering the organic stuff on time, and so they gave us cash to buy cigarettes at the store. My ex bought a brand he really loved.

    Oh. My. Gods. I’m surprised, thinking back, that I didn’t end up in the ER for a migraine shot. I was sick for two or three days over one cigarette. He felt horrible about it, and we never bought that brand from that point forward, but ugh.

    I broke up with that ex, but the sicker I’ve gotten, even if I hadn’t then, the relationship would have ended because as time went on… there are just too many issues that we are both absolute opposites on as PWDs.

  18. @ Kaitlyn:

    For me, the combination of secondhand smoke and perfume is the worst, but if I had to pick one, I would say smoking because of the direct health risks to me. Smokers who throw perfume on generally don’t cover anything up, they just have the smell longer and then have that weird combination smell from the perfume layering on top of it, which also makes the perfume stink to me.

    Inhaling smoke in moderate amounts means that I will get bronchitis. I don’t want to develop emphysema or lung cancer later in life, which I am at increased risk for as it stands. My perfume allergies suck and can give me migraines and nausea, but AFAIK, there aren’t as many long-term risks to stank perfume exposure, KWI\M?

    I’m trying to carefully toe the line as not to violate the policy for comments wrt this post, but secondhand smoke isn’t just an allergen/irritant like fragrances can be.

  19. i agree that cigarette smoke is different than the allergen/irritant that fragrance can be in that it has known detrimental health effects for everyone, not just those with sensitivity/allergy. and i definitely agree that issue should be part of the conversation, because i would suggest that the negative health effects on those PWDs who do use smoking to self-medicate (to obtain documented biochemical results) or as coping mechanisms are, well, non-negligible. and a complicating issue is that, while cigarettes are extremely addictive in general, it is even more difficult for people with mental illness to quit. we should certainly discuss ways that PWDs who choose to smoke despite the risks or who are unable to have the resources and support to successfully quit can do so without affecting others.

  20. I’m trying to come up with some other examples. Something that I know is an issue in some of the uni accommodations I’ve been in is flashing red lights in addition to the fire alarm to make deaf people aware of it – which end up possibly triggering seizures for people with epilepsy.

    Or, this has never happened to me before but I wonder sometimes – I have noise sensitivities that make a noisy environment painful and loud noises very painful, all of which gets exacerbated if I’m stressed. And I wonder whether some HoH people would need the volume turned up enough that their place-where-they-can-listen-comfortably would be my place-where-I-find-noise-painful. (That said, from what I’ve heard of speaking with HoH people we’d at least agree on background noises.)

    Or, an example that occurred to me recently about blogging – I have a lot of difficulty trying to briefly summarise myself. My comments and posts online tend to be extremely tl;dr because I feel I have to fully explain the background for everything I mention and can’t tell which information is “irrelevant” by neurotypical standards. So accommodating me online means allowing me to write up my tl;dr meandering monster posts of doom. However, there are people who don’t have the spoons or the necessary cognitive abilities, at least at the moment, to read really long involved posts and comments and need some sort of short summary. In that case, my accommodation needs and theirs are in pretty direct conflict.

  21. I know a lot of people need light or white backgrounds with black text, while I would rather have dark backgrounds with light-to-medium non-white text.
    Online I often have to wait until the right time so I can make it through reading whatever blog, forum or site that I want to read, since white or very light backgrounds with black text are very common.

    Smoke from cigarettes or cigars etc induces something like a hayfever attack in me, but I haven’t had to be inside a house or car where people smoke for very long, so often what bothers me more are artificial scents, most often air fresheners that people like to use in their homes/toilets. Those give me bad hayfever attacks. Perfume can do it too, but only if the person who is wearing it has put on too much and I have to be around them for more than a minute or so. I know various people with mental health diagnoses who smoke, but they always go outside to do it, so it’s never been a problem so far.
    All of the people I know who smoke don’t smoke indoors, even in their own home or their cars.

  22. I have problems with knobbly paving slabs too, because of my OCD. I have to take a multiple of four steps on any surface I’m walking on, and the knobbly bits are often too short to do that properly, so I have to either walk around them, take a big step over them, or do a weird little dance, all of which are noticable to other pedestrians.

    I recognize, however, that I face a minor annoyance while the lack of said knobbly slabs would be dangerous for people with sight impairments.

  23. This is a fairly difficult one for me; I spent all of my childhood and teenage years as a virulent anti-smoker, but after a stint in a psychiatric unit I started because I felt it was a more socially acceptable form of self-harm. In that sense it’s worked, to the point that my DOCTOR has actually advised me not to quit at this point in time because of how detrimental it would be to my mental health; I tried, and it resulted in an overdose. But I still think smoking indoors is a really bad thing to do. I don’t unless I’m in an environment where everyone else was smoking so it seems ridiculous to further stress my knees climbing down flights of stairs, and sometimes that’s enough to make me not smoke because it turns out I don’t mentally register cigarettes I haven’t smoked outside.

    I thoroughly understand why even people who don’t have allergies are against people smoking near them; the smell second-hand makes me sick so the point that I actually have a special coat I wear when I go through my smoking ritual (sit in the yard, breathe deeply, try and pace myself and think calmly) at home. I’m lucky my boyfriend, who also has mental issues but has managed to quit smoking, is comfortable enough with his ex-smoker status to not relapse – I couldn’t deal with the guilt. I’m definitely going to quit in the future (I want to have children and I don’t want to put them through selfish harm) but it’s not the right time at the moment.

  24. This one came up in my attendance at WisCon last year. At the time, one of my standby treatments for migraine was daubing peppermint extract on my hairline and under my nose. This is, of course, a trigger for many allergy sufferers and for some other migraine sufferers. I asked the committee what the right thing to do was.

    They suggested warning the people near me in conference rooms that I was using scents to treat illness, so that they could move away if they needed to in order to protect their own healths. (WisCon is really really clued about disability in general IMHO.)

  25. Note for Norah: You need the zap colors bookmarklet. Drag it up to the bookmarks bar of your browser and click it whenever a site is unreadable. It makes many, many sites accessible to this migraine sufferer.

    https://www.squarefree.com/bookmarklets/zap.html

    By default, zap colors zaps the colors to black on white. However, if you look at the code (right-click the bookmark and choose either Edit or Properties and substitute your favorite background for “white” and your favorite font for “black”, you should be good. It leaves links in the traditional colors of dark and light purple; to change that, you’ll have to change the hex codes (they start #00 and #55).

    I’m pretty sure that “zap colors” resets the colors to the default colors in your browser

  26. Jonquil: the bookmarklet sounds nice, but I can’t get it to work. I think I figured out how to put it in my bookmarks, but I can’t do anything with it, including in ‘properties’ and it also doesn’t seem to do anything on its own.

  27. For me, what I think about a lot is service dogs and people with disabling dog allergies or fears.

    Someone actaully came over to the service dog board I am on and told us we were all selfish for using service dogs and this isn’t the first time that has happened. The stories I hear from other members are amazing.

    I do my best to bath my dog much more often than most pet dogs are bathed and I do brush him a lot, but even though he’s a low shedding breed, I still worry. I don’t want to hurt anyone, so I’ve been looking at allergen reducing sprays.

    However, when talking with abled people, a lot of them seem to think that the person with a service dog should leave if someone says they have allergies or is afraid, instead of accommodating both people.

    I also find my self in the tricky area of wondering if people are lying when they say they’re allergic and they just don’t like dogs in public. I don’t want to police other people, but when my dog is lying quietly at my feet and you start yelling at me as I get up to leave, makes me wonder and I don’t like doing that.

  28. I’ve known some people who are a bit afraid of dogs, and some who are incredibly terrified of them. In both cases, the dogs go out (or in, if we’re out) so my guest can be calm, though the first group … well, “Wickett can sit on my lap, but Dixie is too scary!” has been said before. (Wickett weighs less than 10 lbs and Dixie is over 50 lbs)

    I think if it’s someone a little bit scared of dogs, but can handle being around on them as long as they don’t come near or jump, I would think they’d be okay with a service dog because they’re usually much better behaved then the average canine.

    Would it be good training for a service dog to be around people who are scared or uncomfortable (but not TOO scared), to train them to deal with someone with a phobia, someone who may feel hostility towards the dog? More training in ignoring (other) human’s moods, so they can do their job, I guess.

  29. @codeman38
    I’m with you on the smoking at bus stops. Where I live (medium sized city), the people who don’t wish to be around smoking end up outside in the rain and snow while the smokers take over the covered area. So now I can either get really sick from the smoke because of asthma,or breathing-problem-two-the-doctors-can’t-diagnose that makes me turn blue and sends me back to the ER. OR I can go out into the crappy weather and have my arthritis or Raynaud’s act up and maybe not be able to get to my destination. And if the weather is nice, well then I’m surrounded and I can’t move far enough away and still be able to get on my bus. Oh, and I can drive for various autism-related reasons.

    Another example of conflicting accommodations:
    Those talking crosswalk things tend to trigger my sensory issues and make me feel really dizzy, disoriented, and cause pain so that I don’t really walk in a straight line and I’m pretty terrified that one of these days a car will hit me.

  30. Kaitlyn, being calm around people who aren’t is indeed a bit part of training, but I always feel bad about making people feel bad, you know? I also don’t want to pretend that a disabling fear of dogs doesn’t exist, becuase I’m sure it does. I do my best to stay away if I’m in a store, but some places, like yarn shops, aren’t big enough to do that.

  31. Yeah, conflicting disabilities is a hard one. My partner and I have some needs that dovetail and some that conflict. (We have different disabilities.) After almost six years, we’ve *mostly* worked it out! ­čśë

    As a service-dog partner with *severe* multiple chemical sensitivity (and dog allergies — I partner w/hypoallergenic dogs), I’ve run into the issue of conflicting disability needs a lot.

    One thing that I think should be at the forefront of a discussion of conflicting needs is, “Who can’t get in the door?” In the case of MCS, it is often that we cannot leave our homes (or enter our homes and live in cars or tents). Most “normal” allergies, you can take an antihistamine; with MCS, there’s no real treatment, and you’re often talking long-term debilitation, organ damage, sometimes death. (Of course, “normal” allergies can result in death from anaphylaxis, too; so, severity/type of condition/disability is extremely relevant.)

    The crux of it, when I’ve discussed it with friends is, when dealing with ABs, the PWD’s accommodation need comes first. When it’s “dueling disabilities,” it’s who NEEDS the accommodation? Can one survive/enter/cope without the accommodation, but just have less independence/comfort/safety? What is the severity or long-term impact or the number of people affected by the accommodation?

    I could go on and on with personal experiences on both sides of this, but I’ll respect the “gentle reminder” at the end of the post!

  32. I’m one of those people who is afraid of dogs, especially if they bark or jump up. I’ve always been unsteady on my feet, and a big enough dog jumping up on me will knock me over. (Otherwise, I actually like dogs, and they seem to like me.) I’ve trained myself to the point where, if the owner is holding the dog back and the dog doesn’t bark, I can approach and let it sniff me until the initial excitement calms down (mine and the dog’s). I generally have very few problems with service dogs because they’re so well behaved, even when they’re off duty.

  33. There’s also conflicting access needs within one person. That can always get interesting. My body can get into a state where it needs to be both quite cold and quite warm at once. My legs will feel like ice cubes (even in 95F heat with blankets) while my back and half my face will be bright red and burning to the touch (even with air conditioner blasting and/or ice applied). There’s literally no temperature that works for that and the result is agony.
    .-= Amanda┬┤s last blog ..Prism lenses =-.

  34. I’m glad we’re actually discussing this issue; it’s one that many folks involved with providing for and requesting accommodation don’t like to face up to. We want the world to be shiny happy fun times, and sometimes conflicts do occur.

    Here’s another one: fluorescent lighting. It’s a trigger for many folks with sensory issues, migraines, or seizures. On the other hand, people with low vision and people using interpreters need good lighting to see what’s going on. More and more public spaces, at least in the U.S., have switched from incandescent light bulbs to fluorescent because they’re much cheaper to operate. I have interpreter friends who bring portable incandescent spotlights to make them visible for their clients.

  35. I’m one of those people who are allergic to dogs (and cigarette smoke, and a host of other things), and feel fortunate that my dog allergy is mild enough that I can tolerate a service animal for a few hours with nothing worse than sniffles.

    Thetroubleis, I know I’ve had times– not with dogs but with other allergens– where I’ve been slowly getting miserable and not able to figure out why, and lo! there’s the thing bothering my allergies, over there in the corner where I didn’t notice. So that may be why people get weird only when you leave? (Which is no excuse for the nasty way people have behaved toward you and your dog.)

  36. Norah, *darn*. I’m sorry. If I were physically present, I could help you debug, but I’m stumped.

  37. For better or for worse, the case law in the US regarding service dogs says that the need for a service dog trumps allergies and fears.

    I’m not sure how I feel about that. On the one hand, just walking without my dog is hazardous for me, as I fall easily without him and injure even more easily (with a far, FAR higher risk of managing to kill myself from a perfectly normal fall than average). On the other hand, I know that my allergies (which trigger my asthma) has come very close to killing me several times, and I’ve had enough experience of borderline-phobia and panic attacks to know how wretched those can be.

    When you’re talking about a business, the business has to accomodate the service dog first and the fear or allergy second, according to caselaw. I’ve seen some really brilliant ways of managing this – one company, they had the service dog users set their phones to unavailable whenever they left their desks, which showed up on everyone else’s phones so that the employee who was phobic of dogs could just stay at zir desk during those times to avoid them. In terms of a service dog team patronizing a business whose employee is phobic or allergic to the dog, the business has a responsibility to make an arrangement so that the service dog team recieves service.

    I think part of the reason it’s set up this way is because a person with a service dog can’t just park their dog outside and leave it to wait. I mean, the cost to bring my dog to the point where he was ready to be partnered with me was over $22,000. There are, unfortunately, people in this world who believe that we are doing a great evil in ‘making’ service dogs work for us, and some of them are willing to steal or ‘release’ service dogs. Friend of a friend actually had someone start pulling her dog’s harness off and unclipping her from a leash when she was in a bathroom stall with the dog right outside of the stall – she could see her dog’s feet from where she was! Not to mention, when a dog has spent all of its life either being trained to work with and protect you or working with and protecting you, it tends to cause quite a bit of anxiety when they are separated from you.
    I’d honestly never known that smoking could be used in a theraputic manner as has been described here. I’m going to try to work my thinking about smoking/smokers into a more tolerant frame of mind. I don’t have the option of becoming physically more tolerant of smoking – it is very dangerous to me, which has been part of what has created my extremely intolerant mindset. (That, the smell, and some associations I have with a pair of extremely nasty, abusive family members)

    As far as smoking vs nonsmoking accomodations, what about nicotine inhalers? An ex’s mom used them when I was around, because of the violence of my allergy to cigarette smoke and nicotine. It was a more-or-less cigarette shaped thing that she ‘smoked’ about like a cigarette, that gave off a dose of nicotine as it was used. That would give both the chemical and behavioral aid that it sounds like this piece describes while being a huge amount safer for the people around them. I never even got the low end of my reaction to nicotine when I was standing right next to her using it. I know it is probably more expensive to use one of those than to smoke, but it would allow someone to ‘smoke’ in circumstances that could otherwise be endangering other people.

    @Trina – maybe one of those could be useful for you after you give birth? I know it would still present problems during gestation, because you’d still have nicotine in your bloodstream. But after, well, it’d still let you have your ritual. Of course, if you had to not be smoking for 9 months at that point, I don’t know how much that would matter to you.

    I think the important thing is to think first of ways that you can accomodate both people if possible. Sometimes things that at first blush seem to counter each other badly can be worked out. After that, well, I suppose you start thinking about taking turns or whether one person can manage without their accomodation (including if there’s somewhere to put things like canes and scooters and service dogs!)

    ~Kali
    http://www.brilliantmindbrokenbody.wordpress.com

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