Letter: Medical resources not shared equally
To the Editor:
The coronavirus pandemic offered another in a long line of opportunities for society to treat those of us it considers "disabled" as lesser people.
We have a long history of being marginalized and institutionalized, with others making decisions for us based on how society views us from a distance. And those views have not been kind. For example, the libertarian hero Ayn Rand strongly objected to tax dollars being spent on the "handicapped and sub-normal."
So when the pandemic raised the specter of a shortage of ventilators and ICU beds, we immediately wondered how doctors would prioritize who lived and who died. Would we end up at the end of the line once again? Would the disabled even have any say in the matter?
Last month the Economic Policy Institute analyzed ventilator rationing policies and guidelines from 30 states. All but five took into account factors that disfavored those with disabilities: "patients' expected lifespan; need for resources, such as home oxygen; or specific diagnoses, such as dementia. Some even permitted hospitals to take ventilators away from patients who use them as breathing aids in everyday life and give them to other patients."
Citizens with disabilities have filed complaints with the federal government over these policies and some changes have been made. Alabama, for example, removed a policy stating that those with "severe mental retardation" or dementia would be "poor candidates" for receiving a ventilator. Here in Vermont the UVM health network and the Vermont Department of Health have reworked some of their policies as the result of advocates' efforts. The new policies prioritize access to life saving measures based on medical criteria indicating the likelihood of survival, rather than the subjective value of a life. Health care workers are directed to provide care "without regard to factors such as race, gender, ethnicity, socioeconomic status, disability or region that are not medically relevant." While the state's policy could be improved by removing any chance of alternative interpretations, removing implicit biases is a step forward.
As Vermont rides the coronavirus curve downward, I take some comfort from the fact that we are ahead of the curve when it comes to the ethical allocation of scarce resources during this pandemic. But I still worry that people like the lieutenant governor of Texas, who said older Americans should sacrifice their lives for the economy, think the same about people with disabilities.
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