The following letter (English and French) was sent to the provincial and territorial ministers of health by Minister Qualtrough and Minister Hajdu. This letter includes another letter at the end, that 61 disability organizations sent to Minster Qualtrough and Minister Hajdu stating that triage practices must change.
Dear Minister:
We are writing to draw your attention to specific challenges being experienced, as well as concerns being raised by Canadians with a disability, with respect to our public health care system in this time of COVID-19 pandemic. We know you would agree that persons with disabilities are particularly vulnerable and have unique needs as we go through this public health crisis, and we are sincerely grateful to provincial and territorial governments for your equal commitment to disability inclusion.
While provincial and territorial governments have been leading preparations for health care organizations to respond to the COVID-19 pandemic, we are taking this opportunity to share legitimate concerns that have been brought to our attention.
From the onset, we have been considering the interests and needs of persons with disabilities in our decisions and measures adopted in response to the pandemic. We do this by putting a disability lens on decision-making, namely ensuring that our actions are based on the Canadian Charter of Rights and Freedoms and on Canada’s international human rights obligations, including those under the United Nations Convention on the Rights of Persons with Disabilities, and consulting national disability organizations, stakeholders and other levels of government.
Despite our collective efforts, persons with disabilities across the country are worried and expressing that their unique needs are not being taken into consideration, and that they are not being treated equitably. To this end, we have recently established a COVID-19 Disability Advisory Group comprised of experts in disability inclusion. This group will provide advice on the lived experiences of persons with disabilities during this crisis; disability-specific issues; challenges and systemic gaps; and strategies, measures and steps to be taken in response.
Along this vein, we wish to draw your attention to the following four issues that have been brought to the attention of our government regarding the equitable and accessible provision of medical treatment and care for persons with disabilities in this time of pandemic response:
- considering disability-specific prevention strategies;
- working with hospitals to make an exception to any blanket prohibition of visitors when a person with a disability requires assistance with vital services like communication, caregiving or supported decision-making;
- ensuring COVID-19 testing sites are accessible; and
- addressing concerns that triage guidelines will deny people with disabilities care.
With respect to this last issue, you will find attached a letter that the Prime Minister and selected ministers have received this week from 61 disability organizations, expressing their concerns regarding the planning that is underway in acute care settings to deal with a potential scenario in which available health care resources are inadequate to meet needs related to COVID-19.
More specifically, these organizations are calling on governments to ensure that guidelines for the provision of health care in such a scenario respect the human rights of all persons, including persons with disabilities.
We know that Canadian health care practitioners, who are on the front lines in this pandemic, are governed by a professional code of ethics that requires them to treat their patients with dignity, respect the equal and intrinsic worth of all persons, and never participate in or support practices that violate basic human rights.
This letter is an important reminder to all of us that guidance developed by health authorities should take into account the specific needs and situations of all vulnerable populations, especially persons with disabilities. We are further reminded to take a rights-based approach to all the work we do, including with guidelines and protocols, to ensure equal and safe access to health care for all Canadians.
We appreciate your support in sharing this perspective with officials within your jurisdiction. We are closely monitoring the implications of the pandemic for persons with disabilities and look forward to our ongoing discussions with you as the pandemic evolves.
Yours sincerely,
The Honourable Carla Qualtrough, P.C., M.P.
Minister of Employment, Workforce Development and Disability Inclusion
The Honourable Patty Hajdu, P.C., M.P.
Minister of Health
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Monsieur le Ministre, Madame la Ministre,
Nous vous écrivons afin de porter à votre attention les préoccupations et les problèmes particuliers soulevés par les Canadiens ayant un handicap en ce qui concerne notre système public de soins de santé en période de pandémie de COVID-19. Vous conviendrez que les personnes en situation de handicap sont particulièrement vulnérables et qu’elles ont des besoins uniques durant cette crise de santé publique. Nous sommes particulièrement reconnaissants envers les gouvernements provinciaux et territoriaux pour leur engagement égal en faveur de l’inclusion des personnes en situation de handicap.
Alors que les gouvernements provinciaux et territoriaux dirigent les préparatifs des organismes de soins de santé pour répondre à la pandémie de COVID-19, nous profitons de cette occasion pour vous faire part de préoccupations légitimes qui ont été portées à notre attention.
Depuis le début, nous avons tenu compte des préférences et des besoins des personnes en situation de handicap dans nos décisions et mesures adoptées en réponse à la pandémie. Pour ce faire, nous adoptons le point de vue des personnes en situation de handicap dans le processus décisionnel. Nous nous assurons que nos actions sont fondées sur la Charte canadienne des droits et libertés et sur les obligations internationales du Canada en matière de droits de la personne, notamment celles qui découlent de la Convention des Nations Unies relative aux droits des personnes handicapées. Nous consultons également les organisations nationales de personnes en situation de handicap, les intervenants et les autres ordres de gouvernement.
Malgré nos efforts collectifs, les personnes en situation de handicap de partout au pays sont inquiètes et affirment que leurs besoins uniques ne sont pas pris en considération, et qu’elles ne sont pas traitées de manière équitable. Par conséquent, nous avons récemment créé un comité consultatif sur les questions touchant les personnes en situation de handicap pendant la pandémie de COVID-19 composé d’experts de l’inclusion des personnes en situation de handicap. Ce groupe offrira des conseils sur les expériences vécues par des personnes en situation de handicap pendant cette crise; sur les questions spécifiques au handicap, sur les défis et les lacunes systémiques; ainsi que sur les stratégies, les mesures et les étapes à suivre pour y répondre.
Dans cette foulée, nous souhaitons attirer votre attention sur quatre enjeux qui ont été portés à l’attention de notre gouvernement en ce qui concerne l’équité et l’accessibilité de l’offre de traitement médical et de soins aux personnes en situation de handicap en cette période de pandémie :
- tenir compte des stratégies de prévention spécifiques au handicap;
- collaborer avec les hôpitaux pour faire une exception à toute interdiction générale de visite lorsqu’une personne en situation de handicap a besoin d’aide pour des services vitaux comme la communication, les soins ou la prise de décision assistée;
- veiller à ce que les sites de test pour la COVID-19 soient accessibles;
- répondre aux préoccupations selon lesquelles les directives de triage priveront les personnes en situation de handicap de soins.
En ce qui concerne le dernier point, vous trouverez ci-joint une lettre que le premier ministre et certains ministres ont reçue de 61 organismes œuvrant auprès des personnes en situation de handicap. Dans cette lettre, ces organismes expriment leurs préoccupations à l’égard de la planification en cours dans les établissements de soins de courte durée afin de faire face à un scénario potentiel dans lequel les ressources disponibles en matière de soins de santé sont insuffisantes pour répondre aux besoins liés à la COVID-19.
Plus précisément, ces organismes demandent aux gouvernements de veiller à ce que les directives relatives à la fourniture de soins de santé dans un tel scénario respectent les droits de la personne de tous les citoyens, y compris les personnes en situation de handicap.
Nous savons que les professionnels de la santé canadiens, qui sont en première ligne de la lutte contre la pandémie, sont régis par un code d’éthique professionnel qui leur impose de traiter leurs patients avec dignité, de respecter la valeur égale et intrinsèque de toutes les personnes, et de ne jamais participer ou soutenir des pratiques qui violent les droits fondamentaux de la personne.
Cette lettre nous rappelle tous qu’il est important de garantir que toute orientation élaborée par les autorités sanitaires doit tenir compte des besoins particuliers et des situations de toutes les populations vulnérables, en particulier les personnes en situation de handicap. Il nous est, en outre, rappelé d’adopter une approche fondée sur les droits dans l’ensemble du travail que nous faisons, y compris les lignes directrices et les protocoles, afin de garantir l’égalité et la sécurité des soins de santé pour tous les Canadiens.
Nous vous saurions gré de bien vouloir partager cette perspective avec les hauts fonctionnaires de votre juridiction. Nous suivons de près les répercussions de la pandémie pour les personnes en situation de handicap et nous nous réjouissons de nos discussions en cours avec vous au fur et à mesure de l’évolution de la pandémie.
Nous vous prions d’agréer, Monsieur le Ministre, Madame la Ministre, l’expression de nos sentiments les meilleurs.
L’honorable Carla Qualtrough, C.P., députée
Ministre de l’Emploi, du Développement de la main-d’œuvre et de l’Inclusion des personnes handicapées
L’honorable Patty Hajdu, C.P., députée
Ministre de la Santé
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April 7th, 2020
The Right Honourable Justin Trudeau, P.C., M.P. Prime Minister of Canada Office of the Prime Minister Ottawa, ON K1A 0A2
The Honourable Patti Hajdu, P.C., M.P. Minister of Health House of Commons Ottawa, ON K1A 0A6
The Honourable Carla Qualtrough, P.C., M.P. Minister of Employment, Workforce Development & Disability Inclusion House of Commons Ottawa, ON K1A 0A6 All
Provincial and Territorial Premiers, and All Provincial and Territorial Ministers of Health
Dear Prime Minister Trudeau, Hon. Ministers Hajdu and Qualtrough, Provincial and Territorial Premiers, and Provincial and Territorial Ministers of Health,
RE: COVID-19 Triage Protocols & the Rights of People with Disabilities.
As COVID-19 spreads across our communities, medical resources are being overwhelmed. Consequently, healthcare providers are preparing to implement triage systems to prioritize the provision of care. In fact, we are already seeing such triage systems being implemented in some jurisdictions. Decisions are being made about who will get access, who will live, and who is likely going to die.
These are impossibly difficult decisions, but they will be and must be made.
People with disabilities and Deaf people are at special risk – some are vulnerable to COVID-19, and all are vulnerable to discriminatory triaging.
Organizations representing and supporting people with disabilities, Deaf people, and their families, know that disability itself is already being used as an indicator in deciding who will gain access to needed health care, and who will not. Many people with disabilities and Deaf people fear for their lives. These practices must be stopped immediately.
We urgently need rights-based, non-discriminatory guidelines for provision of health care in this pandemic.
We are calling on the federal Minister of Health and her provincial/territorial counterparts, as well as health care regulators to take urgent action in issuing guidance about triaging health care. That guidance must be grounded in the rights recognized in the Canadian Charter of Rights and Freedoms and the UN Convention on the Rights of Persons with Disabilities that recognize the equal right to life and to equal benefit of the law, without discrimination based on disability.
Guidance to health care providers must respect the human rights of all people, including persons with disabilities and provide that:
- Assumptions about the current or future quality of life a person with a disability, are not a valid reason to deny access to health care for COVID-19.
- Existing disability-related conditions unrelated to the chance to benefit from treatment must not play any part in decisions about access to health care.
- The need for and use of disability-related supports and anticipated future costs of those supports must not play any role in assessing for access to treatment.
- A person’s need for support to make health care decisions must not be used as a reason to limit or deny access to needed treatment.
- Guidelines for assessing, providing, and evaluating health care must be developed with organizations of people with disabilities and their families.
- The assessment, provision, and evaluation of health care must be conducted with full accessibility and equality of communication, including the provision of qualified professional Sign language interpreters for people who are Deaf and Deaf-blind.
We, the undersigned Canadian disability rights organizations, Deaf organizations and supporters, urge the Canadian federal government to urgently recommend that all provinces and territories integrate these guidelines into their policies for providing medical treatment during the COVID-19 pandemic.
Abilities Centre
Ability New Brunswick
Ability Online
Accessible Okanagan
Active Living Alliance for Canadians with a Disability
Alliance for Equality of Blind Canadians
Barrier Free Canada
Brain Injury Canada
Breaking Down Barriers
British Columbia Aboriginal Network on Disability Society
British Columbia Parents of Complex Kids
Canadian Association for Community Living / Association canadienne pour l’intégration communautaire
Canadian Association of Social Workers
Canadian Association of the Deaf – Association des Sourds du Canada
Canadian Autism Spectrum Disorders Association
Canadian Council for Rehabilitation and Work
Canadian Council of the Blind
Canadian Disability Participation Project
Canadian Disability Policy Alliance
Canadian Down Syndrome Society
Canadian Hard of Hearing Association
Canadian Labour Congress
Canadian Paraplegic Association (Nova Scotia)
Canadian Spinal Research Organization
Canadian Union of Pubic Employees
CNIB Foundation
Council of Canadians with Disabilities
Communication Disabilities Access Canada
David Shannon Law Office
DeafBlind Ontario Services
Deafness Advocacy Association Nova Scotia
Deaf Literacy Initiative
Deaf Wireless Canada Consultative Committee - Comité pour les Services Sans fil des Sourds du Canada
DisAbled Women’s Network of Canada / Réseau d'Action des Femmes Handicapées du Canada (DAWN-RAFH Canada)
Easter Seals Canada
Empower, The Disability Resource Centre
Every Canadian Counts Coalition
Inclusive Design Research Centre, OCAD University
Independent Living Canada
March of Dimes Canada
Moelle épinière et motricité Quebec
Multiple Sclerosis Society of Canada
Muscular Dystrophy Canada
National Educational Association of Disabled Students
Neil Squire Society
Ontario Brain Injury Association
Ontario Disability Employment Network
People First of Canada
Public Service Alliance of Canada
Resource Centre for Independent Living
Rick Hansen Foundation
Rocky Mountain Adaptive
Share Community Program
South Saskatchewan Independent Living Centre
Spinal Cord Injury Alberta
Spinal Cord Injury British Columbia
Spinal Cord Injury Canada
Spinal Cord Injury Manitoba
Spinal Cord Injury Newfoundland and Labrador
Spinal Cord Injury Ontario
Spinal Cord Injury Prince Edward Island
Spinal Cord Injury Saskatchewan
Victoria Disability Resource Centre