Previously-stated DNR status would seem irrelevant to ventilator allocation, and yet some existing and proposed guidelines for triage during a public health emergency list DNR status in the list of criteria for excluding patients from getting ventilators or other life-saving health care. This approach is in direct opposition to the generally agreed-upon goal of maximizing the number of survivors, and could result in confusion and public mistrust of the health care system.
BIOETHICS FORUM ESSAY
It’s been painful to watch health leaders twist themselves into moral knots denying that recently created ventilator rationing guidance will differentially affect Blacks, Latinx, and other people of color. On television, in newspapers, and on listservs, when the predicted disproportionate impacts of these policies are raised, some bioethicists-often white, stonewall. Or repeat a policy’s assertions that race, ethnicity, disability, etc. are irrelevant to care decisions. Or default to the intent of the policymakers.
I helped develop guidelines for the ethical allocation of scarce resources during a public health emergency, such as a pandemic..I hope my contributions have an impact. I especially hope to see my work used since it emphasizes the perspectives of minority and underserved communities, who tend to have less voice in health policy. But now I find myself dreading the use of my work.
In the rush to find a Covid-19 vaccine and one or more drugs to treat the deadly disease, concerns are being raised that ethical standards for conducting human clinical trials and the evidentiary standards for determining whether interventions are safe and effective, might be loosened.
Canada has a fraction of the number of cases of Covid-19 as the U.S. Canadians feel vulnerable. But Canadians and Americans need to find ways to build and maintain trust within and across our borders.
Do the elderly have special obligations during a pandemic, that is, something more than the duty we all have for hand washing, social distancing, and so on? I believe the answer is, yes, and foremost among these is an obligation for parsimonious use of newly scarce and expensive health care resources.
This week, the Department of Health and Human Services Office of Civil Rights resolved one of many civil rights complaints alleging discrimination on the basis of disability–the first instance of federal intervention to enforce civil rights laws in rationing protocols since the beginning of the Covid-19 crisis. But more work is needed to protect patients with disabilities in the allocation of scarce medical resources.
As a 71-year-old bioethicist, I consider rationing mechanical ventilation based on age to be one morally relevant criterion during the Covid-19 pandemic.
The views of the New York State Task Force on Life and the Law on ventilator-dependent chronic care patients evolved over the years. Here’s how, and why.
There is a lack of clarity about the New York State Task Force guidelines on ventilator allocation. I believe disability rights concerns regarding the recommendations on chronic ventilator users are well-founded. This lack of clarity may cost lives.
As hospitals and public health authorities devise triage protocols to allocate scarce critical-care resources during the Covid-19 pandemic, people with disabilities are expressing alarm that these protocols devalue them and exacerbate long-entrenched ableism in health care. Lawsuits alleging disability discrimination in have been filed in Washington and Alabama. The U.S. Office for Civil Rights is investigating disability discrimination complaints in triage protocols. The challenge is to develop protocols that will minimize discrimination in the health care system.