Down Syndrome Ireland has raised concerns with the Department of Health over concerns that their coronavirus guidelines may lead to certain vulnerable groups being unable to access essential care.
The issue was sparked in response to the government department’s document on the ethics of prioritising patients, which states that when there are too many patients to treat, and a medical professional must ration care, they must take into account a variety of factors, including the total number of potential life years saved, and long-term functional status should patients survive. The document goes on to say that “Consideration of the patient’s pre-morbid health status, their will and preferences (if known), the presence of co-morbidities and their frailty status (independent of age) are all relevant in this context.”
DSI has pointed out that this phraseology is “too vague” and leaves “a lot of room of interpretation”, which could lead to discrimination against those with Downs Syndrome.
Nicola Hart, head of DSI’s member services, said: “In the absence of a clear working definition or scale, frailty is a subjective term. We know that Down syndrome could be considered a comorbidity, and anyone requiring support for daily living can be potentially classified as frail, depending how this is measured.”
Hart went on to insist that though Down Syndrome people sometimes needed additional support, they should not suffer discrimination because of their condition.
DSI has requested that the government department clarify their position and attempt to reassure those with disabilities and their families. They allege that they have already received a response from the Department of Health and are awaiting further info.
Earlier in the month, the UK’s National Institute for Health and Care Excellence (NICE) amended its guideline on the word “frailty” over similar concerns, explicitly clarifying that those with long term disabilities like downs syndrome, cerebral palsy or autism will not fall under the “frailty” category. Similarly, the US Department of Health and Human Services explicitly states that State-funded healthcare providers are not permitted to refuse care to patients on the basis of pre-existing disability.