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NEWS RELEASE – FOR IMMEDIATE RELEASE – Six Bio-Ethicists on Ontario Government’s “Bioethics Table” Confirm Ongoing Concerns Raised by Disability Organizations regarding the Discriminatory and Secret Plans for the Triaging of Critical Care

Accessibility for Ontarians with Disabilities Act Alliance
ARCH Disability Law Centre

April 19, 2021 – Serious objections that have been raised by disability groups for over one year regarding Ontario’s plans for triaging life-saving critical care have been validated and echoed by a number of the very individuals that were advising the Ontario Government on it. In a revealing article by six bio-ethicists that advised the Government on what should be included in Ontario’s directions for rationing life-saving critical care, alarm bells continue to be rung with serious concerns that they raise including: the lack of transparency and public engagement in developing the Triage Protocol, the failure to consider social determinants of health, the prioritization of utilitarianism over human rights, and the reliance on problematic clinical tools that compound health inequities.

Last year, in April 2020, a Triage Advisory Committee (TAC) was formed by ARCH Disability Law Centre to come together in order to consult with and bring forward concerns of disability communities in Ontario flowing from the then newly leaked March 28, 2020 version of Ontario’s critical care Triage Protocol. The TAC is made up of representatives from various disability organizations and academics which includes the Accessibility for Ontarians with Disabilities Act (AODA) Alliance; ARCH Disability Law Centre; Canadian Down Syndrome Society; Centre for Independent Living in Toronto; Citizens With Disabilities – Ontario (CWDO); Community Living Ontario; Disability Law Intensive Program – Osgoode Hall Law School, York University; Lupus Canada; Muscular Dystrophy Canada; and Scholl Chair in Health Law and Policy, Faculty of Law, University of Toronto.

Over the last 12 months, and through ARCH and the AODA Alliance, TAC has tried to express its concerns repeatedly to the Bioethics Table, to the Ontario Government, and to the public. Despite this, the Ontario Government has failed to meet with us or to ensure that Ontario’s critical care triage protocol and plans are free of unlawful discrimination contrary to the Ontario Human Rights Code and the Canadian Charter of Rights and Freedoms.

The Ontario Government’s continued assertion that it has not authorized any Triage Protocol is especially of concern when the latest version of the critical care Triage Protocol, dated January 13, 2021, has been sent to all Ontario hospitals and subsequent training has been offered to hospitals and doctors that urges doctors and hospitals to use it. This Triage Protocol includes several problematic clinical assessment tools that discriminate against persons with disabilities and risks physicians making guestimates on who should be refused life-saving critical care.

The Ontario Government has had 14 months to ensure that lawful and constitutional directions are in place to ensure that decisions on who is to be refused life-saving critical care are free of unlawful discrimination.

As the third wave of the COVID-19 pandemic continues to strain Ontario’s healthcare system in unprecedented ways, TAC urgently calls for the Ontario Government to:

  1. Now make public the current version of the critical care triage protocol, all reports and recommendations regarding critical care triage by its external Bioethics Table since September 11, 2020, the Government’s plan of action for rolling out critical care triage if needed, and the content and results of drills or simulations of critical care triage held at any Ontario hospitals.
  2. Remove unlawful discrimination, including disability discrimination, from the January 13, 2021 Critical Care Triage Protocol, and substantially reduce the one year likely survival threshold for assessing who gets priority for receiving critical care during a period of critical care triage.
  3. Uphold the current law and ensure that doctors will not be permitted to remove or withdraw life-saving critical care from a patient already receiving it, without that patient’s consent.
  4. Not give a financial blank cheque to doctors and hospitals in advance (indemnification), nor should the College of Physicians and Surgeons of Ontario give doctors a regulatory blank cheque, if they rely on disability-discriminatory directions.
  5. Immediately hold a public consultation on how critical care triage should be conducted.
  6. Ensure that Ontario’s critical care triage plan and protocol are properly prescribed by law, by introducing legislation on critical care triage for debate in the Legislature, rather than dealing with it by an internal memo to hospitals.

Contact:

AODA Alliance Chair David Lepofsky
Email: aodafeedback@gmail.com
Twitter: @aodaalliance

Robert Lattanzio, Executive Director
ARCH Disability Law Centre
Toll-free: 1-866-482-2724 extension 2233
Email: robert.lattanzio@arch.clcj.ca

For more background on this issue, check out:

  1. The AODA Alliance website’s health care page, detailing its efforts regarding critical care triage and generally, its to tear down barriers in the health care system facing patients with disabilities, and our COVID-19 page, detailing our efforts to address the needs of people with disabilities during the COVID-19 crisis.
  2. The ARCH Disability Law Centre website’s COVID-19 page offers more about ARCH’s work on the clinical triage protocol, including a September 15, 2020 published article, visitation ban policies, access to technology and other issues concerning the rights of persons with disabilities during the COVID-19 crisis.


April 19, 2021