{"id":22286,"date":"2020-03-31T19:58:57","date_gmt":"2020-03-31T19:58:57","guid":{"rendered":"http:\/\/cmshub.wpengine.com\/?p=309887"},"modified":"2024-11-03T15:16:49","modified_gmt":"2024-11-03T15:16:49","slug":"alabamas-ventilator-rationing-plan-discriminates-against-disabled-ill-patients-advocacy-groups-say","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/alabamas-ventilator-rationing-plan-discriminates-against-disabled-ill-patients-advocacy-groups-say\/","title":{"rendered":"Alabama\u2019s Ventilator Rationing Plan Discriminates Against Disabled & Ill Patients, Advocacy Groups Say"},"content":{"rendered":"

A plan created in Alabama in 2009 called the State of Alabama Emergency Operations Plan<\/a> has ominous implications now that we\u2019re in the midst of the COVID-19 crisis.<\/span>The plan outlines how hospitals should prioritize patients in the case of a mass-casualty respiratory emergency. If the number of patients requiring ventilator access exceeds the number of ventilators available, tough decisions will need to be made. Ventilator access in the state could be denied to patients with a variety of medical conditions<\/a>, including cardiac arrest, severe trauma, dementia, metastasized cancer, severe burns, end-stage organ failure, immunological disorders such as AIDS, and severe mental retardation.<\/span>But that\u2019s only the first step. If the pandemic continues to overload ventilator availability despite these restrictions, not only will some patients be denied ventilator access, but patients who are already using one may be pulled off<\/a> if they are not improving fast enough, so it can be given to someone else who is in better general health.<\/span>\"\"<\/span>Photo: Adobe Stock\/ Halfpoint<\/span>
\n<\/span>\u201cIt is cruel that our constituents in Alabama seeking medical treatment during this pandemic may not receive the care they need or they may be left to suffer or die because they are seen as less than or other,\u201d said<\/a> Gena Richardson, the Executive Director of The Arc Alabama<\/a>, a nonprofit group that advocates for people with intellectual and developmental disabilities. \u201cThe lives of millions of people with disabilities across the nation are at stake \u2013 and their lives have value.\u201d<\/span>At the time of this writing, there are 1,344 ventilators available statewide in Alabama, and about 546 are in use on an average day. That means there are roughly 800 ventilators<\/a> in the whole state to handle the anticipated onslaught of coronavirus cases.<\/span>The Plan<\/span>\"\"<\/span>Photo: Adobe Stock\/loris86me<\/span>
\n<\/span>This emergency plan was not created in response to COVID-19 \u2014 it was created a decade ago. But now that the coronavirus pandemic is here and the plan may actually be thrust into action, some advocacy groups are crying foul. The plan is only to be triggered into action during a mass casualty event that is declared a public health emergency by the governor. Alabama Governor Kay Ivey declared coronavirus as such on March 13th.<\/span>\u201cShould conditions become extremely grave due to widespread outbreaks with many people seriously affected, availability of ventilator care and Intensive Care Unit (ICU) care may become extremely limited in any locale,\u201d the document states<\/a>. \u201cUnder such circumstances, measures of last resort herein described may be employed by each hospital after thorough evaluation and consultation with available external sources to confirm that partner hospital resources, usual supplier resources, and resources obtainable through the collaborative efforts of the Department of Public Health through AIMS are all exhausted.<\/span>\u201cAll efforts should then be directed to provide aggressive treatment to those with the greatest chance of survival even if that requires removal of supportive care from others.\u201d<\/strong><\/span>
\n<\/span>The Tiers<\/span>\"\"<\/span>Photo: Adobe Stock\/LIGHTFIELD STUDIOS<\/span>The plan has three tiers, designed by two emergency doctors<\/a> who lived in Minnesota in 2008. The Alabama Department of Public Health (ADPH) explained to Newsweek<\/a> that the plan was created \u201cwith input from multiple medical, legal religious, academic and ethics professionals.\u201d<\/span>Tier 1 is implemented at the state level, and is triggered by the governor announcing a mass casualty event that is public health emergency (which already happened0. The first tier utilizes an assessment plan that looks at a patient\u2019s SOFA (Sequential Organ Failure Assessment) score to prioritize ventilator treatment. As stated above, some of the medical conditions that could be excluded from ventilator use include cardiac arrest, severe trauma, dementia, metastasized cancer, severe burns, end-stage organ failure, immunological disorders such as AIDS, and severe mental retardation.<\/span>
\n<\/span>\"\"<\/span>Photo: Alabama Department of Public Health<\/a><\/span>Tiers 2 and 3 are up to individual hospitals to enact, based on the specific situations that arise as resources are exhausted. In Tier 2, a hospital can decide to selectively withdraw ventilator support<\/a> for patients who have failed to respond to mechanical ventilation and other support measures such as antibiotics and fluids.<\/span>\"\"<\/span>Photo: Alabama Department of Public Health<\/a><\/span>Tier 3 may go into effect if efforts operating under Tier 2 have not been enough and those resources are still exhausted. In Tier 3, even more rigorous restrictions for ventilator access will be set in place.<\/span>
\n<\/span>The Complaint<\/span>\"\"<\/span>Photo: Adobe Stock\/Kiryl Lis<\/span>The Alabama Disabilities Advocacy Program (ADAP) filed a complaint on March 24th with the U.S. Department of Health and Human Services Office for Civil Rights (OCR), saying that the plan violates the Americans with Disabilities Act (ADA)<\/a> and other laws because it discriminates against people with intellectual and cognitive disabilities. They filed on behalf of the Alabama citizens who could die if they are refused health care because of their disabilities. They\u2019re asking that the office take immediate action<\/a> in this situation.<\/span>\u201cIn this time of crisis, we cannot devalue the lives of others in our community based on their disabilities,\u201d said<\/a> the Director of the Alabama Disabilities Advocacy Program, James Tucker, in a statement. \u201cIt\u2019s morally wrong, and it violates the law. We implore OCR to rein in and provide urgently needed guidance to the healthcare professionals who are prepared to relegate members of our community to die.<\/span>\u201cIf OCR fails to act swiftly to clearly and firmly articulate the violation of civil rights implicated by the Alabama ventilator rationing plan, there will be no way to undo the lethal outcome of the plan should it go into effect.\u201d<\/span>
\n<\/span>At the time of this writing, the U.S. Civil Rights Office has opened multiple civil rights investigations<\/a> to ensure that medical providers in states like Alabama aren\u2019t able to discriminate on the basis of disabilities, race, age, or other factors during the coronavirus emergency.<\/span>Source<\/a><\/p>","protected":false},"excerpt":{"rendered":"

A plan created in Alabama in 2009 called the State of Alabama Emergency Operations Plan has ominous implications now that we\u2019re in the midst of the COVID-19 crisis.The plan outlines how hospitals should prioritize patients in the case of a mass-casualty respiratory emergency. If the number of patients requiring ventilator access exceeds the number of […]<\/p>\n","protected":false},"author":2,"featured_media":22287,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[5137],"tags":[],"class_list":["post-22286","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-world-news"],"_links":{"self":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/22286","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/comments?post=22286"}],"version-history":[{"count":1,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/22286\/revisions"}],"predecessor-version":[{"id":45669,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/22286\/revisions\/45669"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/media\/22287"}],"wp:attachment":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/media?parent=22286"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/categories?post=22286"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/tags?post=22286"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}