With coronavirus cases continuing to climb and hospitals facing the prospect of having to decide how to allocate limited staff and resources, the Department of Health and Human Services is reminding states and health care providers that civil rights laws still apply in a pandemic.
As we work to maintain the health and safety of people with disabilities - as well as their families and support professionals - throughout the COVID-19/coronavirus pandemic, it is imperative that we uphold individuals’ rights, as well as the core principles of equity, self-determination, and true belonging in community.
An ethically sound framework for health care during public health emergencies must balance the patient-centered duty of care—the focus of clinical ethics under normal conditions—with public-focused duties to promote equality of persons and equity in distribution of risks and benefits in society—the focus of public health ethics. Because physicians, nurses, and other clinicians are trained to care for individuals, the shift from patient-centered practice to patient care guided by public health considerations creates great tension, especially for clinicians unaccustomed to working under emergency conditions with scarce resources.
The scale and severity of the COVID-19 pandemic clearly rises to the level of a public health threat that could justify restrictions on certain rights, such as those that result from the imposition of quarantine or isolation limiting freedom of movement. At the same time, careful attention to human rights such as non-discrimination and human rights principles such as transparency and respect for human dignity can foster an effective response amidst the turmoil and disruption that inevitably results in times of crisis and limit the harms that can come from the imposition of overly broad measures that do not meet certain criteria.
There is no doubt that everyone—no matter their race, economic, or immigration status, gender, age, or ability—will feel the impact of COVID-19 in some way. But people who are already targeted, marginalized, and underserved will feel the pain more than others.
As we advance changes in response to the current COVID-19 pandemic, the Coronavirus Equity Considerations report examines the systemic inequities that have exacerbated impact and ensures that we begin to enact transformational societal shifts to address the root causes of vulnerabilities and systems failure.
Long before health officials had confirmed the first cases of COVID-19 in the United States, acts of discrimination and xenophobia against Asian Americans were rising rapidly. As the number of confirmed cases increase exponentially, racist hate crimes targeting Asian Americans are also on the rise, escalated by racist language used by public officials and members of the media when discussing COVID-19.
Chinese and Chinese-Americans in San Francisco were scapegoated for all epidemic outbreaks throughout the mid-late 19th and early 20th century. To white San Franciscans, Chinatown represented a dangerous space of emergence for both disease and immorality, and the neighborhood was consequently targeted by health officials. Public health was also utilized as a reason to restrict Chinese immigration.
