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COVID-19 pandemic, the scarcity of medical resources, community-centred medicine and discrimination against persons with disabilities
  1. Nicola Panocchia1,2,
  2. Viola D'ambrosio1,3,
  3. Serafino Corti2,4,
  4. Eluisa Lo Presti5,
  5. Marco Bertelli5,6,
  6. Maria Luisa Scattoni7,
  7. Filippo Ghelma5,8
  1. 1 Department of Nephrology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
  2. 2 Charter of Rights for People with Disabilities in Hospital, Roma, Italy
  3. 3 Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Roma, Italy
  4. 4 Disabilities Department, Fondazione Istituto Ospedaliero di Sospiro, Sospiro, Italy
  5. 5 Association for the Study of Medical Assistance to People with a Disability (ASMeD), Milano, Italy
  6. 6 CREA (Research and Clinical Centre), San Sebastiano Foundation, Misericordia di Firenze, Florence, Italy
  7. 7 Research Coordination and Support Service, Istituto Superiore di Sanità, Roma, Italy
  8. 8 Department of Disabled Advanced Medical Assistance (DAMA), ASST Santi Paolo e Carlo, Milano, Italy, Milano, Italy
  1. Correspondence to Dr Nicola Panocchia, nephrology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, ROMA, Italy; nicola.panocchia{at}policlinicogemelli.it

Abstract

This research aims to examine access to medical treatment during the COVID-19 pandemic for people living with disabilities. During the COVID-19 pandemic, the practical and ethical problems of allocating limited medical resources such as intensive care unit beds and ventilators became critical. Although different countries have proposed different guidelines to manage this emergency, these proposed criteria do not sufficiently consider people living with disabilities. People living with disabilities are therefore at a higher risk of exclusion from medical treatments as physicians tend to assume they have poor quality of life, whereas access to medical treatment should be based on several parameters, including clinical data and prognosis. However, the COVID-19 pandemic shifts the medical paradigm from person-centred medicine to community-centred medicine, challenging the main ethical theories. We reviewed the main guidelines and recommendations for resources allocation and examined their position toward persons with disabilities. Based on our findings, we propose criteria for not discriminating against people with disabilities in allocating resources. The shift from person-centred to community-centred medicine offers opportunities but also risks sacrificing the most vulnerable people. The principle of reasonable accommodation must always be considered to guarantee the rights of persons with disabilities.

  • disability
  • COVID-19
  • allocation of health care resources
  • clinical ethics

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There are no data in this work.

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Data availability statement

There are no data in this work.

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Footnotes

  • Contributors NP: conception and design of paper; drafting the article or revising it; providing intellectual content of critical importance to the work described; and final approval of the version to be published. VD: conception and design of study; drafting the article or revising it; and final approval of the version to be published. SC, ELP, MB, MLS and FG: drafting the article or revising it; providing intellectual content of critical importance to the work described; and final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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