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No body is expendable: Medical rationing and disability justice during the COVID-19 pandemic
Erin E Andrews1, Kara B Ayers2, Kathleen S Brown3
1VA Texas Valley Coastal Bend Health Care System.
Insights
The COVID-19 pandemic highlights how ableism can impact healthcare access for people with disabilities during medical rationing. Psychologists must advocate for disability justice and equitable pandemic preparedness policies.
Area of Science:
- Public Health
- Disability Studies
- Medical Ethics
Background:
- The COVID-19 pandemic poses unique health risks to individuals with disabilities.
- Medical equipment shortages necessitate triage and rationing decisions.
- Ableism can influence access to care and treatment prioritization.
Purpose of the Study:
- To explore medical rationing and triage approaches during pandemics.
- To examine the psychological underpinnings of ableism in healthcare.
- To advocate for disability justice in health policy and pandemic preparedness.
Main Methods:
- Literature review on medical rationing, triage, and ableism.
- Discussion of psychological factors, social determinants of health, and quality of life perceptions.
- Analysis of disability community advocacy and activism.
Main Results:
- Attitudes toward disability significantly impact rationing decisions and healthcare access.
- Psychology offers insights into prejudice and discriminatory behaviors in societal contexts.
- Existing triage guidelines may disproportionately affect vulnerable populations.
Conclusions:
- Psychologists should champion social justice in pandemic preparedness.
- Promoting disability justice in healthcare settings is crucial.
- Policy changes are needed to ensure equitable allocation of resources and reduce the necessity for rationing.
Abstract:
The health threat posed by the novel coronavirus that caused the COVID-19 pandemic has particular implications for people with disabilities, including vulnerability to exposure and complications, and concerns about the role of ableism in access to treatment and medical rationing decisions. Shortages of necessary medical equipment to treat COVID-19 have prompted triage guidelines outlining the ways in which lifesaving equipment, such as mechanical ventilators and intensive care unit beds, may need to be rationed among affected individuals. In this article, we explore the realities of medical rationing, and various approaches to triage and prioritization. We discuss the psychology of ableism, perceptions about quality of life, social determinants of health, and how attitudes toward disability can affect rationing decisions and access to care. In addition to the grassroots advocacy and activism undertaken by the disability community, psychology is rich in its contributions to the role of attitudes, prejudice, and discriminatory behavior on the social fabric of society. We call on psychologists to advocate for social justice in pandemic preparedness, promote disability justice in health care settings, call for transparency and accountability in rationing approaches, and support policy changes for macro- and microallocation strategies to proactively reduce the need for rationing. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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