Stramondo, Joseph A.. Tragic Choices: Disability, Triage, and Equity Amidst a Global Pandemic
2021, The Journal of Philosophy of Disability. 1: 201–210.
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Added by: Chris Blake-TurnerAbstract:
In this paper, I make three arguments regarding Crisis Standards of Care developed during the COVID-19 pandemic. First, I argue against the consideration of third person quality of life judgments that deprioritize disabled or chronically ill people on a basis other than their survival, even if protocols use the language of health to justify maintaining the supposedly higher well-being of non-disabled people. Second, while it may be unavoidable that some disabled people are deprioritized by triage protocols that must consider the likelihood that someone will survive intensive treatment, Crisis Standards of Care should not consider the amount or duration of treatment someone may need to survive. Finally, I argue that, rather than parsing who should be denied treatment to maximize lives saved, professional bioethicists should have put our energy into reducing the need for such choices at all by resisting the systemic injustices that drive the need for triage.Yearby, Ruqaiijah. Race Based Medicine, Colorblind Disease: How Racism in Medicine Harms Us All2021, The American Journal of Bioethics. 21(2): 19–27.-
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Added by: Chris Blake-TurnerAbstract:
The genome between socially constructed racial groups is 99.5%-99.9% identical; the 0.1%-0.5% variation between any two unrelated individuals is greatest between individuals in the same racial group; and there are no identifiable racial genomic clusters. Nevertheless, race continues to be used as a biological reality in health disparities research, medical guidelines, and standards of care reinforcing the notion that racial and ethnic minorities are inferior, while ignoring the health problems of Whites. This article discusses how the continued misuse of race in medicine and the identification of Whites as the control group, which reinforces this racial hierarchy, are examples of racism in medicine that harm all us. To address this problem, race should only be used as a factor in medicine when explicitly connected to racism or to fulfill diversity and inclusion efforts.Comment (from this Blueprint): Yearby argues that appeals to racial categories—social, but especially biological—in medicine harm people from all races, including those from dominant racial groups, like Whites. Yearby first gives evidence for the claim that there is no biological reality to race. She then argues that the continued use of racial categorization in medicine—for instance, as a basis for different standards of care—leads to worse outcomes for all. For example, because Whites are often the de facto standard group in healthcare, their worse health outcomes are sometimes overlooked. Yearby ends by making suggestions for improving the categorization of people in healthcare.
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Comment (from this Blueprint): Stramondo critiques triage protocols that were put into place, or at least proposed, during the COVID-19 pandemic. Stramondo argues that protocols that prioritize quality of life involve ableist commitments. While chance-of-survival protocols might do better here, he argues that they are also vulnerable to creeping ableism. Stramondo’s paper is valuable not only for its perspective on triage protocols, but also for highlighting some crucial theoretical contributions by philosophers of disability and by bioethicists. Stramondo also argues not to cede too much ground to fatalism in thinking about triage protocols; bioethicists should also, and perhaps primarily, resist the framing of triage as inevitable, rather than a product of various privileged interests.