# 43


III-4.2600 

                                             October 28, 1992






Mr. Steven J. Cole
Vice President and General Counsel
Council of Better Business Bureaus, Inc.
4200 Wilson Boulevard
Arlington, Virginia  22203-1804

Dear Steve:

     This letter is in response to your inquiry regarding whether
physicians must assist patients with disabilities in dressing and
undressing.

     The ADA authorizes the Department of Justice to provide
technical assistance to individuals and entities having rights or
obligations under the Act.  This letter provides informal
guidance to assist you in understanding the ADA's requirements. 
However, it does not constitute a legal interpretation or legal
advice and it is not binding on the Department of Justice.

     The ADA requires public accommodations to make "reasonable
modifications in policies, practices, or procedures when the
modifications are necessary to afford goods [and] services . . .
to individuals with disabilities, unless the public accommodation
can demonstrate that making the modifications would fundamentally
alter the nature of the goods [or] services . . . ." 28 C.F.R. 
36.302(a).  In most cases, we believe that providing assistance
in dressing and undressing would not fundamentally alter the
nature of the service provided by a physician.

     You are quite correct to point out that the regulations
generally do not require a public accommodation to provide its
customers or clients with services of a personal nature,
including dressing.  28 C.F.R. 36.306.  We do not think,
however, that this limitation to the general rule applies to
assistance in dressing and undressing provided by physicians. 
The personal services limitation is a narrow one and must be
interpreted in light of the nature of the services provided and
the assistance required.  Because the nature of medical services
is inescapably very personal, it is not unreasonable to require
physicians to provide assistance with dressing or undressing,
even though other public accommodations may not be required to 
provide such assistance.  Moreover, because undressing is
commonly crucial to the provision of medical services, applying
the personal services limitation to assistance in dressing and
undressing would inappropriately deny medical care to large
numbers of individuals with disabilities.

     I regret the long delay in answering your request and hope
that the delay has not created a hardship for you.  I really do
appreciate the fine work that the Council of Better Business
Bureaus' Foundation has done in helping implement the ADA.  I
especially value Barbara Bode's efforts on the technical
assistance grant and out on the hustings.  She has been an
invaluable resource and has helped open communications between
business and the disability rights community.

     Thanks again for your inquiry, and let me know if we can be
of any further help to you.


                            Sincerely,



                         John L. Wodatch
                              Chief
                      Public Access Section

cc:  James McIlhenny
     Barbara Bode