This article reports on new guidelines from Massachusetts health officials for potential rationing of ventilators in the event COVID-19 case surge overwhelms available supply.

According to the article, the guidance uses an 8-point scoring system based on a patient’s likelihood of surviving to discharge and likelihood of long-term survival. The system also that gives preference to medical personnel, women further along in pregnancy, and younger patients (when scores are otherwise equal).

The guidelines are based on those developed at the University of Pittsburgh and adopted by Pennsylvania. The guidelines are advisory and not mandatory, and some hospital systems have developed their own policies, some of which are consistent with the Massachusetts and Pennsylvania guidelines and others which differ on certain points, such as priority for health care personnel or consideration of long-term survival.

Some state rationing plans, including Pennsylvania’s, have been subject to civil rights complaints from advocates for persons with disabilities, who argue the plans illegally disadvantage persons with pre-existing disabilities based on biased assessments and generalizations about life expectancy or quality of life of persons with disabilities.