The Ruderman Family Foundation, a leading disability rights organization, published a new white paper which offers recommendations to help health policymakers make decisions to ensure the lives of people with disabilities are not secondary amid the collective public health goal to save the most lives during the COVID-19 pandemic.
“Fair Resource Allocation During the COVID-19 Pandemic” calls for the implementation of triage guidelines in a way that is as objective as possible. The white paper recommends appointing a critical care physician as a triage officer, as well as a nurse with critical care experience and a hospital administrator, who would document the process and serve as a bridge to the organization’s management team. This team is charged with making decisions about who will be prioritized to receive critical care based on clinical data for each patient, aiming to use resources in a way that maximizes patient survival.
“It is vital during the surge that will hit our hospitals at different times during the coronavirus pandemic, that we don’t as a matter of policy discount the lives of people with disabilities and other compromised populations,” said Jay Ruderman, President of the Ruderman Family Foundation. “A life is a life and while medical personnel may need to make very difficult decisions during triage situations, our society should not put a higher value on able-bodied patients over others. By doing so we will devalue ourselves as a society based on equal rights for all, but by caring for all regardless of preconceived notions of the value of the lives of people with compromised situations we will elevate ourselves as a society.”
Authored by Dr. Dominic Sisti, Director of the Scattergood Program for the Applied Ethics of Behavioral Health Care at the University of Pennsylvania; Dr. Joseph Stramondo, Assistant Professor of Philosophy at San Diego State University; and Dr. Hanna Shaul Bar Nissim, of the Ruderman Family Foundation and Visiting Scholar at Brandeis University — the white paper comes at a time when a number of states have come under scrutiny for their triage guidelines regarding people with disabilities and how they would be deemed secondary for life-saving treatment.
The study also analyzes the landscape surrounding people with disabilities and disaster medicine; attending to patients with disabilities who have medical conditions other than COVID-19; and visitation in hospitals and residential facilities.
As part of the triage team, the white paper recommends including a representative from a disability advocacy organization, increasing public trust in the decisions that are made. “Avoiding mistrust must be a central concern of triage efforts so that patients are not hesitant to seek treatment. To that end, transparency in exactly what the triage criteria are is also essential. Finally, it may even be worth building in (and publicly acknowledging) some kind of appeal and oversight process that reviews triage decisions to make sure that the teams are accurately implementing whatever protocol is being deployed,” the white paper states.
The Ruderman Family Foundation’s response to the bioethical issues surrounding COVID-19 has been informed by the organization’s existing partnership with Boston-based Massachusetts General Hospital (MGH). Earlier this month, the Foundation announced a $100,000 grant for mental health services to medical professionals at MGH. Since 2013, the Foundation has worked to build capacity across the hospital to effectively address the healthcare needs of individuals with autism and other neurodevelopmental disorders across their lifespan.
The full white paper can be accessed here: https://rudermanfoundation.org/white_papers/fair-resource-allocation-during-the-covid-19-pandemic/