Public health emergencies and disabilities

A new paper, from Wendy Hensel and Leslie Wolf of the Georgia State University College of Law, examines the range of ethical conflicts that arise when health officials have to utilize scarce resources to protect populations in public health emergencies, and the inevitable conflicts regarding care for people with disabilities.

Following Hurricane Katrina, the federal government required all states to detail steps to protect people with disabilities in emergency situations. However, the plans implemented by the states varied in their details, setting up situations where people with disabilities are discriminated against even though their disability has no relation to their likely immediate treatment outcome.

“This Article concludes that the protocols promulgated to date display a troubling disregard of both the limits imposed by civil rights laws and the ethical significance of promoting the health of the community at the expense of people with disabilities,” the paper states.

The paper’s authors object to categorical exclusions of people with certain types of disabilities, arguing that individualized determinations are required under the Americans with Disabilities Act.

They also outline concerns regarding duration timelines for medical care, which can be used to exclude small changes that would qualify as “reasonable modifications” under the ADA; quality of life considerations, which are often based on misguided opinions of medical professionals; and medical effectiveness considerations, which if too narrowly applied can lead to decisions based on subjective opinions regarding quality of life outcomes.

“It would be difficult to conclude that protocol criteria based on generalizations, stereotypes, or myths about people with disabilities are legally necessary to the effective administration of resources,” the paper states.