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HAPPENING NOW! "Disability, COVID-19, and Triage: Exploring Resource Allocation and the Framing of Disability," w/ @CohenProf, @GovindPersad, @OmarSHaqueMDPhD, Leslie Francis & Michael Ashley Stein of @HLSPOD. https://petrieflom.law.harvard.edu/events/details/book-launch-disability-health-law-and-bioethics
Join the conversation by tagging tweets with #disabilitycovidtriage. We’ll tweet highlights in the thread right here 
Before we start: Register for our next event here https://petrieflom.law.harvard.edu/events/details/ppe-guidelines-and-access-ethical-dilemmas-for-healthcare-during-the-covid-19-pandemic
Check out our COVID-19 resources here: https://petrieflom.law.harvard.edu/resources/covid-19
And here's the link to the book we're launching with this event today: https://www.cambridge.org/core/books/disability-health-law-and-bioethics/32BC2A0D735ADC6E15345467C6F07221
First up, @GovindPersad. He starts by outlining criteria that are legal in pandemic triage vs. not legal. #disabilitycovidtriage
However, @GovindPersad says these criteria are up for debate. For example, considering quality of life for triage might not be legal, but it could be ethical. #disabilitycovidtriage
Arguments for saving more lives, from Derek Parfit and Frances Kamm, via @GovindPersad. #disabilitycovidtriage
Why are the criteria outlined not only ethical but legal to consider, @GovindPersad asks. Read more here: https://blog.petrieflom.law.harvard.edu/2020/04/13/triage-disabilities-coronavirus-ethics-law/ #disabilitycovidtriage
"While disability law prohibits inaccurate stereotyping, it permits evidence-based medical judgments even if they disadvantage people with disabilities," @GovindPersad writes. #disabilitycovidtriage
On ventilator triage, @govindpersad says the goal should be protecting people who don't have a good chance of survival from COVID-19 from getting the virus, not allocating scarce resources regardless of chance of survival. #disabilitycovidtriage
"Physical distancing and postponement of many medical procedures aim at saving more lives, including more of the lives of people with disabilities, even while disadvantaging some patients with specific disabilities," @GovindPersad writes.
"If we endorse these, we should endorse evidence-based triage as another way of saving more lives," @GovindPersad concludes in his blog post providing more detail on his comments delivered today. https://blog.petrieflom.law.harvard.edu/2020/04/13/triage-disabilities-coronavirus-ethics-law/ #disabilitycovidtriage
Now @francislprof is discussing why the "maximize lives saved approach" described previously by @GovindPersad arguably does violate the ADA. #disabilitycovidtriage
. @francislprof counter's @GovindPersad stance that equality requires maximizing lives saved. This aggregates people into overall figure of lives saved. Not individual, collective. Another model of equality disaggregates, respecting each as an individual.
Now @francislprof distinguishes accommodations vs. modifications. Modifications benefit all, though they can be unreasonably burdensome. Accommodations can benefit some but not others. #disabilitycovidtriage
Disability rights activists are not asking for individual privileging re: ventilator allocation, they're asking for evidence based protocols for survival prospects -- modifications, not accomodations, @francislprof says.
A reasonable modification for health care workers is not to perform highly risky resuscitation on patients where prospects are bleak. @francislprof says this example for health care workers can highlight a paradigm for discussing broader #disabilitycovidtriage questions.
Are individuals with intellectual disabilities being given easy-to-understand instructions? What are the effects of isolation on autistic individuals? Michael Ashley Stein of @HLSPOD raises these questions that are less frequently asked regarding #disabilitycovidtriage
Resources are always limited, Stein says. But how much of a resource we allocate reflects political priorities and social norms.
What type of a society do we want to live in? Who do we value and who do we not value? How do we get to a society where there is only us, not us and them? Stein says the COVID-19 pandemic raises these questions. #disabilitycovidtriage
. @OmarSHaqueMDPhD sides with @francislprof on earlier debate: to treat people as individuals, you have to look at their unique situations and needs, he says. #disabilitycovidtriage
. @OmarSHaqueMDPhD says clinicians may be biased against individuals with disabilities, for example, practicing clinical paternalism, believing "fragility bias"/underestimating resilience, "saintly bias," and "catastrophe bias" - perception of more suffering #disabilitycovidtriage
"When we say evidence-based, that doesn't necessarily mean it's moral," @OmarSHaqueMDPhD says. #disabilitycovidtriage
What would it mean to treat people truly as equals? @OmarSHaqueMDPhD asks. He says considering individuals' contributions/impact on society undermines equality #disabilitycovidtriage
Why not prioritize lives that are most vulnerable, those who are doubly discriminated against, @OmarSHaqueMDPhD asks. #disabilitycovidtriage
. @CohenProf starts with a legalistic question about the definition of disability - what to make of many health concerns that might affect likelihood of #COVID-19 survival but that do not qualify as disabilities per the ADA?
. @francislprof says the ADA Amendments Act was designed to extend the definition of disability, or how we construe the interpretation of disability #disabilitycovidtriage
. @CohenProf asks about antibody testing. Stein says unemployment among people with disabilities a more pressing issue: "let's get people with disabilities with jobs first, and then think about COVID testing."
Thanks for joining us for this livestream! We will post the link to the video in this thread once it's available. And before you go...
Register for our next event! April 22, Ethical Dilemmas in Mask and Equipment Shortages: Health Care During the COVID-19 Pandemic https://petrieflom.law.harvard.edu/events/details/ppe-guidelines-and-access-ethical-dilemmas-for-healthcare-during-the-covid-19-pandemic
