This article discusses how multiple disability advocacy groups have filed civil rights complaints challenging Washington’s and Alabama’s plans for resource allocation during a public health crisis, arguing that the states’ plans discriminate against persons with disabilities.

The groups argue that the plans discriminate against persons with intellectual and cognitive disabilities in violation of the Americans with Disabilities Act and other federal laws. The challenged Alabama plan (last updated in 2010) includes “severe mental retardation, advanced dementia or severe traumatic brain injury” among ventilator support considerations, and the Washington guidance (issued in 2020) recommends considering transfer to outpatient or palliative care for patients with “loss of reserves in energy, physical ability, cognition and general health.” There is broad ethical consensus that resource allocation under crisis standards of care should work to maximize population benefit, generally by maximizing survival for the most possible patients. As such, only clinically relevant factors are appropriate for triage consideration.

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