Stop Disability Discrimination in Triage Plans
Dear [Decision Maker],
As a supporter of the International Myeloma Foundation, I urge you to review and revise our state ventilator guidelines and/or triage plans to ensure they comply with federal civil rights law and affirm that the lives of people with disabilities are equally worthy and valuable as those of people without disabilities. On March 28, 2020, the U.S. Department of Health and Human Services issued a Bulletin entitled "Civil Rights, HIPAA, and the Coronavirus Disease 2019 (COVID-19)," stating "HHS is committed to leaving no one behind during an emergency, and this guidance is designed to help health care providers meet that goal...Persons with disabilities...should not be put at the end of the line for health services during emergencies. Our civil rights laws protect the equal dignity of every human life from ruthless utilitarianism."
The Bulletin offers broad guidance on the obligations of states and health care providers to comply with federal disability rights laws in developing treatment rationing plans and administering care in the event of a shortage of medical equipment, hospital beds, or health care personnel. All cancers, including myeloma, are considered a form of disability under federal law.It is imperative that doctors or triage teams perform a thorough individualized review of each patient and not assume that any specific diagnosis is determinative of prognosis or near-term survival without an analysis of current and best available objective medical evidence and the individual's ability to respond to treatment. Every patient must be treated as an individual, not a diagnosis. This means that the mere fact that a patient may have a diagnosis of cancer cannot be a basis, even in part, for denying care or making that person a lower priority to receive treatment. The fact that an individual with a disability requires support to perform certain activities of daily living is not relevant to a medical analysis of whether that individual can respond to treatment for COVID-19. Treatment allocation decisions may not be made based on the stereotype that a person's disability will require the use of greater treatment resources, either in the short or long term. Assumptions should not be made about who is immunosuppressed, including individuals with cancer, without an individualized review of each patient.
Federal disability rights laws--including the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, and Section 1557 of the Affordable Care Act--broadly protect people with disabilities against discrimination in receiving medical treatment. These laws apply to hospitals experiencing a medical equipment, bed, or staffing shortage during the COVID-19 pandemic as well as state policies.During this time of uncertainty, cancer patients should be assured that they will receive fair treatment for this deadly pandemic in their state. We ask you to stand with those patients.
Sincerely,[Your Name] [Your Address] [City, State ZIP][Your Email]