Rights groups file complaint about ‘medical rationing’
Two Arizonans and several advocacy groups have filed a federal complaint that argues the state’s crisis standards, allowed because of COVID-19, discriminate against older Arizonans, people of color and those with disabilities.
The crisis standards guide the allocation of scarce resources to patients based on factors such as their likelihood for survival. Arizona Department of Health Services Director Dr. Cara Christ on June 29 authorized hospitals in the state to activate the standards if needed.
The protocols in Arizona’s Crisis Standards of Care and an addendum to the standards are putting some Arizonans at risk for “imminent harm,” says the 20-page July 17 complaint to Roger Severino, director for the Office for Civil Rights at the U.S. Department of Health and Human Services.
The complainant asks the Office of Civil Rights to review the Arizona “Crisis Standards of Care” and addendum, “to ensure discriminatory decisions regarding the allocation of life-saving medical care do not occur in Arizona.”
Longstanding discrimination against people with disabilities and people from communities of color by the U.S. health care system had led to a higher rate of underlying health conditions and lower life expectancy among those groups, the complaint says. For that reason, the complaint says, triaging people based on life expectancy is inherently unfair.
Arizona Gov. Doug Ducey’s office is aware of the complaint, spokesperson Patrick Ptak wrote in an email.
“Our priority is ensuring all Arizonans have access to medical care, and that is the case,” Ptak wrote. “Arizona hospitals have capacity and are not triaging care — nor has any hospital at any point in the outbreak triaged care.”
The crisis standards offer the potential for some people with disabilities being “erroneously perceived as having a shorter life expectancy,” says the complaint, filed by the Arizona Center for Disability Law, the Arc of Arizona, the Arizona Center for Law in the Public Interest
and the Native American Disability Law Center.
Several other disability and civil rights groups signed on in support, including the American Civil Liberties Union of Arizona and the Bazelon Center for Mental Health Law.
In addition to disability and civil rights groups, the complaint was filed by two individuals, both Arizona residents — Donna Jeffrey, 47, who has muscular dystrophy, and Joseph “Joey” Zachary, 27, who has cerebral palsy. Both have outlived medical providers’ original estimates and are worried that if they are hospitalized with COVID-19, their life expectancy would be similarly misjudged.
The Arizona Crisis Standards of Care and an addendum to the document “place many people with disabilities, older adults, and people from communities of color, at significant risk of harm, and possibly death,” says the complaint, filed to the U.S. Department of Health and Human Services July 17.
“These protocols offer the potential for systemic and systematic discrimination against vulnerable populations across Arizona in the provision of healthcare, including those represented by the individuals and organizations that are party to this complaint.”
Although the original crisis standards document and addendum contain general prohibitions against using race or age to justify de-prioritizing care, the complaint argues that the addendum contains several provisions that could lead to discrimination against people with disabilities, older Arizonans and individuals from communities of color.
Factors such as an evaluation of oneto five-year mortality could easily lead to discrimination against communities of color because, for example, Black people statistically have a shorter life expectancy than white people, the complaint states.