As the Corona virus continues to spread rapidly throughout the world, we are beginning to see and worry about a scarcity of medical resources. This means that doctors and hospitals are having to address the very difficult question of who should be saved in the case of scarcity? The scary result of this is the apparent willingness to sacrifice both disabled and elderly people. We are the people who will die, not from corona, but from ableism.
Already, in some countries such as Italy, the sheer number of people needing emergency care has massively overpowered the infrastructure available, so triage guidelines have been developed, ostensibly to maximise the amount of lives saved. In these guidelines, age and general health have to be taken into account when assigning ventilators and deciding which people deserve to be saved. This means that a healthy 20-year-old will be saved over a disabled 20-year-old, or over anyone above the age of 65 years old. So even if you, as a disabled or elderly person, have stayed inside, self-isolated and done everything to prevent getting sick or spreading the virus, you will still end up being considered insufficiently valuable to be saved, whilst others, even if they have refused to stay at home and have therefore put themselves at risk, will be saved above you. Because their life is deemed more valuable. It is important to note here, that there is very little research to support the idea that strategies that assign resources to the youngest and healthiest people first, actually save more lives than a less biased, more randomised strategy.
Yet many hospitals already have these guidelines in place. In the Netherlands they have three phases, the third of which is the crisis phase, where terminally ill, elderly people, people with a lower life expectancy, and also those who require assistance and care inside and out of their homes, have lower priority on beds and equipment in ICUs. In the US, on top of this, some hospitals are now confiscating privately-owned ventilators from disabled people who use them to stay alive, in order to save healthy, young people. Similarly, many people with lupus in the US are no longer allowed to receive their medication because there is some evidence that it helps with corona. They have therefore been thanked for their sacrifice and been refused prescriptions, which are being used to save healthy patients with corona. These are just some examples of this legislation in action, but if you look throughout Europe and the US it is very easy to see the same guidelines being formed or already in place.
In news coverage and protocols around the world, it seems that this view is considered by many to be the logical response to such a crisis. In fact, some people have gone as far as claiming that killing off dependants would be good for the economy. For example, Jeremy Warner, writing for the UK Telegraph, said ‘from an entirely disinterested economic perspective, the COVID-19 might even prove mildly beneficial in the long term by disproportionately culling elderly dependents.’ This sentiment and lack of care about both the elderly and disabled has been echoed throughout media and across social media ever since the Corona crisis started. It started with the main message that we don’t need to worry because only those with existing conditions or those who are elderly will die from this illness. Which is only comforting if you do not place any value on these people’s lives, and of course is only aimed at a healthy public so is not very comforting for those of us who are more likely to die. This message has only worsened as media and social media have now moved into discussing the fact that disabled and elderly people should be the last to have access to medical resources.
But, actually, as a disabled person, in an online community of disabled people, many of us are not surprised by this legislation and how quick people are to sacrifice disabled and elderly people to save healthy individuals. For years there has been relentless villainising of disabled people in the media and by governments across Europe. In the UK, they have been described as lazy, good for nothing, fraudulent benefit claimants, made out to seem like they over-exaggerate or simply make up claims of disability or chronic illness for years. This has happened in order to justify a consistently lower sum of disability benefit to an ever-smaller group of people, an ideological austerity measure. And this relentless targeting has had serious effects: in the UK, 75% of those with disabilities who appeal the denial of their benefits, end up winning, which shows how little belief there is in disabled and chronically ill people, even by the system supposedly there to support them. This campaign to discredit disabled people means that we, as a community, know how little we are valued, and therefore were expecting, come a pandemic, that we were the group of people who would be sacrificed.
It is very clear to see how this narrative, that disabled people and the elderly are burdens, transfers into a sentiment that we are the least valuable to lose. If these groups are a drain on resources normally, then in a pandemic, when we must choose who gets access to limited resources, it is a very easy jump to make that those who are already a burden and a drain will become more of a burden. It then comes down to a lack of value or even a negative value having been, and still being, placed on these groups.
An argument that has been advanced is that economically, disabled people and the elderly do not pay taxes and so are not useful to society. Ignoring the obvious ignorance that many people in these groups have worked, or do work and pay taxes – think elderly, retired, contributed for 50 years or more; or think someone with MS, controlling it through medicine and won’t be much affected for many years yet) – this argument suggests that people’s only worth is in economic production and working a job. Most of us would doubtless agree that there is more value to a human than their economic activity, and the government choosing to sacrifice people based on their money-making potentialities is a very frightening idea. Using this as a criteria to decide which people should have access to medical care in ICUs implies a very cold outlook on the world, where capital is the only thing with real value, and we are just empty vessels transferring capital, stripped of all humanity: the neoliberal ideal of the homo economicus.
In a crisis like this, it takes a shockingly short amount of time before society’s underlying ableism is foregrounded. The speed at which we have gone from ‘let’s do groceries for the disabled and elderly because we love them’ to guidelines explicitly made to prevent disabled people and the elderly from getting necessary medical support, based only on prejudices about the value of their lives, is very alarming. And the vocal celebrations by some, of the fact we may be able to cull some of the disabled and elderly, thereby cleansing society of its useless dependents, links very closely, in my head, to eugenicist ideas – something people like to think is in the past. The idea that by sacrificing some, clearing the beds of those who are burdens, we would have a better, wealthier society, filled with the healthy and good of the world, shows us that, in reality, eugenic policies and guidelines are far closer than we might like to think. When the government starts choosing which lives to save, based on age and health levels, they are demonstrating how ingrained it is to see disabled lives as disposable and less valuable. The fact that very few people are questioning or even talking about this shows that we are okay with it.
Let’s also not forget, intersecting this, the fact that environmental racism means many conditions disproportionately affect communities of colour, particularly lung-based illnesses such as asthma. Which means, even assuming for the moment that no racial bias existed in medicine, people of colour are disproportionally part of another group that is seen as disposable. The more intersections we bring in the clearer it becomes that basing access to medical resources on health and age levels is a decision filled with prejudice, disproportionately affecting already marginalised groups.
For those unsure whether there are other ways to deal with a lack of medical resources, some hospitals have chosen not to follow such prejudiced guidelines and are either using a first come first admitted basis, or even a lotto-based admission. It will always be tragic when, in a crisis situation like this, there is not enough equipment. Hospitals in many countries have been cut down to the bare bones due to austerity, and people are now reaping the consequences of that. However, throughout this tragedy, disabled and elderly people’s humanity must be preserved. They should not be the first groups to be sacrificed but should be valued as all members of society should be. Their lives are not and should not be disposable.
The idea of culling people based on age or disability is abhorrent, but seems to be acceptable to many. What if different rules were applied and we could look at what someone might have contributed in their short or long life? Would people feel differently then? Not that it is okay to say you can cull anyone, but I suspect people would think twice if asked to support the refusal of support for an old war veteran in favour of a young abuser? Or an elderly surgeon, in favour of a young county lines drug boss? Or a young disabled charity worker in favour of an able bodied rapist. Who is to know any of that at the point of administering life saving treatment – yet that may well be the end result of such blanket policy? It is all so arbitrary – but at least by leaving it that way, and rolling a dice, it is chance and not human discrimination that dictates what is done. And that removes the guilt and the sense of wrong-doing from everyone’s consciences