Harden: Ontario’s COVID triage protocol should respect disability rights
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A little over a year ago, more than 200 community organizations urged the Ford government to remove disability discrimination from triage guidelines. The answer so far: silence.
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The Children’s Hospital in Eastern Ontario is accepting adult ICU patients due to the increasing severity of the COVID-19 crisis. Photo by Errol McGihon /.Errol McGihon
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These are dangerous times in Ontario. A record 4,812 new COVID-19 cases were registered on April 16, 2021.
More than 750 patients are currently being treated in the intensive care units in Ontario. For the first time in its 47-year history, the Children’s Hospital in Eastern Ontario is accepting adult COVID-19 patients in need of intensive care.
There is a real possibility that hospitals will have to ration or “triage” intensive care by the end of the month due to the increasing number of COVID cases. Triage refers to how hospitals decide who receives life-saving care when intensive care units are overwhelmed with COVID patients and run out of beds.
Along with those in charge of disability and human rights, I am deeply concerned that the Doug Ford government’s current clinical triage protocol includes disability discrimination and was not developed with proper consultation.
What’s wrong with the triage protocol that was distributed to hospitals on January 13, 2021? First, it includes a “Clinical Vulnerability Scale”, which means that a patient over 65 with a progressive disease (Alzheimer’s disease, muscular dystrophy, etc.) is assessed on how they can perform 11 different activities of daily living without assistance. This is blatant discrimination against people with disabilities, millions of whom require different levels of support to lead their full lives.
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Second, it contains criteria by which the patient’s likelihood of death one year after admission to hospital is assessed. Even ICU doctors have admitted that such assessments are “estimates” rather than an exact science. This leaves the door open to subjective judgments about a person’s quality of life that might discriminate against people with disabilities as opposed to a short-term assessment of mortality.
Nobody is suggesting that Ontario should not have a triage protocol when ICUs are full. We say that the protocol must respect human rights and the rule of law. It must also be discussed openly and transparently, but this government has taken the opposite approach.
Members of the government’s own bioethics table have criticized the secrecy with which the government has handled its approach to clinical triage. You state that the process “needs to be informed, transparent, inclusive, appropriate and revised in the light of new information or legitimate concerns or claims,” and believe that Ontario has not met these requirements.
News media have also reported that the Ford government is considering suspending portions of the Health Care Consent Act (HCCA), which requires doctors to obtain consent from a patient or their substitute decider before withdrawing critical care.
It is unacceptable for the government to make life and death decisions through a secret memo. If they are considering suspending the HCCA they must publish the details and have an appropriate debate in lawmakers.
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Just over a year ago, more than 200 community organizations wrote to the Ford government urging it to remove disability discrimination from the provincial triage protocol. The government has been aware of these concerns for over a year and has had ample time to consult with leaders of people with disabilities and human rights as they develop their clinical triage protocol.
How did the Ford government react? With complete silence. It has ignored direct appeals from disability groups, the Ontario Human Rights Commission, and the opposition for expressing concerns about the January 13th triage protocol “Emergency Standard of Care”.
What message does this send to the 2.6 million people with disabilities living in Ontario? People with disabilities are more likely to contract COVID-19 and are seriously affected by the virus. This government must assure them that in the terrible event that triage becomes necessary, they will not face any discrimination.
It’s time to end critical care secrecy. It’s time for the Ford government to remove disability discrimination from their clinical triage protocol.
Joel Harden is the NDP MPP for the Ottawa Center and Opposition Critic, Accessibility and People with Disabilities.
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