Opinion Paper

COVID-19, disability and the context of healthcare triage in South Africa: Notes in a time of pandemic

Emma L. McKinney, Victor McKinney, Leslie Swartz
African Journal of Disability | Vol 9 | a766 | DOI: https://doi.org/10.4102/ajod.v9i0.766 | © 2020 Emma L. McKinney, Victor McKinney, Leslie Swartz | This work is licensed under CC Attribution 4.0
Submitted: 08 June 2020 | Published: 18 August 2020

About the author(s)

Emma L. McKinney, Interdisciplinary Centre for Sports Science and Development, Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
Victor McKinney, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Leslie Swartz, Department of Psychology, Faculty of Arts and Social Sciences, Stellenbosch University, Cape Town, South Africa


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Abstract

During disasters, when resources and care are scarce, healthcare workers are required to make decisions and prioritise which patients receive life-saving resources over others. To assist healthcare workers in standardising resources and care, triage policies have been developed. However, the current COVID-19 triage policies and practices in South Africa may exclude or disadvantage many disabled people, especially people with physical and intellectual impairments, from gaining intensive care unit (ICU) access and receiving ventilators if becoming ill. The exclusion of disabled people goes against the principles established in South Africa’s Constitution, in which all people are regarded as equal, have the right to life and inherent dignity, the right to access healthcare, as well as the protection of dignity. In addition, the triage policy contravenes the United Nations Convention on the Rights of Persons with Disabilities, which the South African government has signed and ratified. This article raises debates about whose lives matter and whose lives are ‘worth’ saving over others, and although the focus is on South Africa, the issues may be relevant to other countries where life-saving resources are being rationed.

Keywords

COVID-19; disabled people; triage policies; ventilators; ICU admission; ethics of care; accessibility; South Africa

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