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Jan 21 • 4 tweets • 4 min read
Gov commissioned report shows serious challenges pandemic for p w #Disability "some people told her they were being encouraged to explore #MAID #euthanasia." And this was not going to happen w #BillC7, MPs & senators & DwD advocates claimed... 1/ kitchener.ctvnews.ca/it-makes-my-li…
2/ Full report: liveworkwell.ca/sites/default/…
3/ excerpt report
4/ authors report include @dstienstra @valgrandmaison
@lauragpin @RodenburgErin et al @uofg @Live_Work_Well

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More from @TrudoLemmens

Trudo Lemmens Profile picture
Dec 8, 2020
L'association des medecins psychiatres de Quebec publishes paper “Access to medical assistance in dying for people with mental disorders”. Complex issue cannot be discussed fully. But timing no coincidence, so let's look at some deeply troubling issues (1) bit.ly/37Aqlxs
(2) Authors clearly know they feed into a process of Bill C-7 & endorse inclusion of MH; but Bill’s provisions DO NOT provide a reliable, safe basis for what even they recommend as minimal standards under which MAID for MD could be practiced
(3) 'in their view', as this is presuming that the reports’ recommendations are ethically sound/unproblematic, legally coherent, and evidence-based. Not so, imho. Let’s look at some components.
Read 31 tweets
Trudo Lemmens Profile picture
Apr 10, 2020
Excellent paper @aneeman re equality for people w #disability in context of #COVID19Pandemic triage: it requires more than rejecting irrational prejudice & more than focusing only on short-term survival @aodaalliance @CACL_ACIC @ARCHDisability thehastingscenter.org/when-it-comes-…
(2) "Should people with disabilities be penalized for impairments that may mean they require more resources to achieve the same result? Should hospitals be able to consider long-term survival? And if we accept short-term survival, do existing instruments need modifications...?"
(3) A public building is not just prohibited from posting a “No Wheelchair Users Allowed” sign–it is also required to ensure that a ramp is present. These are not acts of charity; rather, they are requirements to avoid discrimination under a civil rights law."
Read 8 tweets
Trudo Lemmens Profile picture
Apr 8, 2020
@CMA_Docs comes out with utilitarian "Framework for Ethical Decisionmaking During the Coronavirus Pandemic" embracing considerations of 'length of life' remaining, seemingly deprioritizing elderly & people w disabilities or chronic illness (1) policybase.cma.ca/en/viewer?file…
(2) As excuse for largely taking over recommendations & text NEJM article, @CMA_Docs suggests it looked at "documents, reports and policies produced by our Italian colleagues and ethicists and physicians from Canada & around the world, as well as provincial level frameworks"
(3) with its excuses for not holding any "deliberations and consultations with numerous stakeholders, including patients and the public". As if there is no other option than to consult for 'months' ...
Read 16 tweets
Trudo Lemmens Profile picture
Apr 1, 2020
(2) Call for attention to 'equity' & proper concern for already disadvantaged laudable: But there appears a troubling disconnect in this article between emphasis on 'equity' and attention for "people facing poverty, discrimination, language barriers and historical trauma" and ...
(3) suggestion that 'palliative care thus becomes the compassionate option to counterbalance this inequity". Palliative care should be available as matter of principle to all. Not as a token to substitute for care provided in priority to others when ...
(4) triage guidelines presented as 'value neutral' clinical decision making tools fail to address or account for these inequities & perhaps even enhance them by categorizing people w disabilities in category of lowest priority
Read 8 tweets
Trudo Lemmens Profile picture
Mar 30, 2020
Draft @ONThealth triage doc re COVID-19 claims to embrace utility, proportionality & fairness as guiding principles @jyangstar reports. But what notion of 'fairness' remains illusive, so I point out. @UTLaw @UofT_dlsph (1) thestar.com/news/canada/20…
(2) v Important to have practical & transparent basis for triage decision making, so positive to have guidance document. But ethical principles should not be used to back up decisions which are presented as clinical & value neutral when they are not
(3) Fairness in document appears to be a formalistic equality. Doc should explicitly refer to need to avoid discrimination on basis of disability & ensure pre-existing inequities are not augmented. Fairness could indeed be seen as requiring effort to do the opposite.
Read 7 tweets

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