State Covid triage policies prompt fear of discrimination

State policies for rationing health care during the coronavirus pandemic could allow doctors to cut off treatment for some of the sickest patients in hot zones and revive the specter of so-called death panels, say disabled rights groups who are rallying the Trump administration to intervene.

The effort has recently gained urgency due to guidelines in Texas and Arizona that let doctors base treatment decisions on factors like a patient’s quality of life if they survive, or the odds they’ll live at least five years. The advocacy groups since March have filed an unprecedented 11 complaints with the Department of Health and Human Services’ Office of Civil Rights, which has mediated four cases and could add more as Covid-19 continues to spread across most of the country…

But the issue gained new resonance in June, when an Austin, Texas, hospital halted treatment of a quadriplegic patient who contracted Covid-19 and moved him to hospice care, where he died. ADAPT of Texas filed a complaint to HHS in late July seeking an investigation into the decision-making about the patient, Michael Hickson, which ran counter to his wife’s wishes.

HHS’ most sweepingaction so farcentered on Tennessee’s crisis standards of care. The state in late June agreed to update triage plans and clarify that providers only consider a patient’s chance of survival, not quality of life or issues strictly related to their disability…

The Arizona triage policy is shaping up to be the next big fight, because of the way it could allow doctors to reject critically ill patients and prioritize people based on their “opportunity to experience life stages.” It also allows health workers to pull ventilators or beds from patients who develop conditions while hospitalized that change their prognosis.

Arizona’s chapter of The Arc appealed to to the HHS civil rights office late last month. The state insists its guidelines won’t “categorically” deny care to anyone “based on stereotypes, assumptions about any person’s quality of life, or judgement about a person’s ‘worth’ based on the presence or absence of disabilities.”

But against this backdrop, Arizona’s hospitals also asked officials to waive the state’s discrimination laws so they can’t be sued if they have to start rationing care.

“Giving physicians and triage committees these kinds of predisposed discriminatory factors to ‘break ties’ is going to bleed over into all kinds of situations that are not necessarily in the writing,” said Matt Valliére, executive directorof the Patients’ Rights Action Fund. “They would be immune from any poor decision-making that’s even more discriminatory than what is in this [guidance], because that’s what happens in crisis scenarios.”

Read more at Politico.com…


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