COVID-19 pandemic shines a light on medical ethics

John Wood, Order of New Brunswick recipient lives With Duchenne Muscular Dystrophy 

(Photo: Savannah Awde/Legislature Bureau]

Persons with disability across the globe have been keeping an eye on trends in various countries with regard to how clinicians on the front lines of the COVID-19 pandemic are treating, or in some cases, not treating persons with pre-existing disabilities that may impact survival.

Has this pandemic brought us to the point where a doctor might decide which life is more worth saving if one becomes infected with COVID-19? 

There’ve been various reports on social media that people with learning disability and older people with various comorbidities are having DNR orders applied to them with little discussion with family or other designated caregivers. Various reports out of Ontario and one document in particular, The Clinical Triage Protocol for Major Surge in COVID Pandemic, are disturbing at best. 

Robert Lattanzio, executive director of Ontario’s ARCH Disability Law Centre, a specialty legal clinic that practices exclusively in disability rights law, said the document provides three levels of triage for health-care providers based on demand and resources. Using the “frailty scale,” the framework doesn’t just look at who would benefit most from the care, but also calls on health professionals to consider factors like the quality of life of those with a disability, he said. “That is where we cross a line that we cannot cross,” he said.

How at risk of not receiving timely treatment are persons in nursing homes, group homes, independent living residences? Are GPs conferring with patients and encouraging the signing of DNR orders for those who are at greater risk of complications and death? I am inclined to think not.  

In fact, any anxieties I might have had have been assuaged, as Premier Blaine Higgs has assured citizens of New Brunswick that persons with disability will receive the same level of care as all others  with regard to treatment should they contract the COVID-19 virus. That is absolutely as it should be.

Will the COVID-19 pandemic bring about or force changes in attitudes as to how persons with disability, the frail and the elderly are treated? I certainly hope there are huge changes that will improve their lot in life. What I’d also like to see is universal basic income. Let’s just get that done. In other countries, it’s already been shown to break into the poverty cycle by allowing the poor and the working poor to accumulate a float/savings to support costs of improvements to quality of life and improved health.

In staying home, we are protecting others, notably the health and wellness of doctors and nurses who put their own lives on the line treating COVID-19 patients. The quality of the life of persons with disability is front and center as the health care community is focused on treating those infected with COVID-13. Many clinicians often have a years long relationship with patients who live with cerebral palsy, spina bifida, MS, MD, Parkinson’s, dementia and so on; they’ll be doing all that they can do to ensure quality care.

Recently, I received a letter from the Vice-President of our Extra Mural Program which outlines their protocols when making home visits. In the event that testing is required, the visiting clinician will arrange it. Since my last visits from Extra-Mural were rehabilitative in nature, I will not be requiring a consult as I have no active medical complaint that would require attention. I’m gratified to know that they are out there caring for patients during these challenging times.

As the days and weeks have passed during my confinement, I am really doing nothing differently than I had done before. Now, as then, my goal is to keep myself healthy by staying well hydrated and eating well. Given that there’s not been and will not be a lot of people traffic in my home, I am confident that my environment is safe.

It’s not likely that I will find myself in a position that so many persons with disability find concerning   — the ‘what if’ question that the pandemic poses with regard to treatment  should they become ill. Thankfully, we have the Human Rights Act that protects us broadly. Will it be taken narrowly in these times to ensure that, for example, the vent dependent, spastic quadriplegic child who presents with  a few symptoms of COVID-19 will receive the same level of care that a 12 year old non-disabled presenting with those same symptoms receives? Our Premier has ensured that it will. Persons with disability have nothing to fear.

Human rights, set down internationally, and put into our domestic law through the Human Rights Act, belong to every single person in the Canada, whether they have disabilities or not, whether they fall into COVID-19 vulnerability or not.

Such legal standards and protections will make it easier for medical care providers to do what they know they need to do. That being so, I am confident that families who are concerned about whether their relative with pre-existing, life altering disability can relax. Their loved one’s care will be equal access.  Sit. Stay. Safe.

Carla MacInnis Rockwell is a freelance writer and disability rights advocate living outside Fredericton, NB with her geriatric Australian silky terrier and a rambunctious Maltese. She can be reached via email at carmacrockwell@xplornet.ca