This blog from the Petrie-Flom Center’s Bill of Health argues that many state guidelines for the rationing of scarce resources during a public health emergency disadvantage and devalue the lives of persons with disabilities.
Most scarce resource allocation guidelines prioritize saving the most lives to maximize the utility of available resources, but the author argues that consideration of comorbidities and anticipated future resource needs in this model often inappropriately relies on a medical model of disability that disadvantages persons with disabilities and reflects a version of eugenics and “survival of the fittest.” The author contextualizes this argument within the history of devaluation and denial of resources to persons with disabilities in recent history, including pervasive discrimination in the health care system. The author discusses recent disability discrimination complaints filed against some states based on their resource allocation guidelines and notes the need to incorporate insights from existing guidelines set out by disability advocacy organizations and others, as well as the need to increase inclusion of physicians and bioethicists who claim disability status and can offer valuable perspectives.
he author specifically challenges a provision of New York’s guidelines, which the author argues allows for the confiscation and reallocation of personal ventilators. Notably, others have raised similar questions or objections on this point, but one of the authors of the New York guidelines has explicitly disagreed with this interpretation, arguing that the intended policy was that ventilator-dependent chronic care patients who came to an acute care facility would be triaged in the same manner as other patients with respect to allocation of more powerful hospital ventilators, not that such patients would have their own ventilators seized and reallocated (as discussed in another post).