Idaho healthcare rationing sparks civil rights lawsuit

A civil rights group representing low-income elderly adults filed a lawsuit this week to fight against the state of Idaho’s quiet implementation of a policy to ration health care amid a surge in COVID-19 cases.

The complaint filed by Justice in Aging claims that age is used as a factor in the newly activated statewide “crisis standards of care” policy to determine if a person should receive health care service.

The suit hones in on the language in the state’s policy that appears to take into account the life expectancy of the patient.

“Older adults are facing serious risk of discrimination, resulting in death,” due to the policy, the complaint alleges.

“When the policy shifts to the difficult task of resolving ties (where two similarly situated persons need a scarce resource), facially discriminatory criteria gives preference to younger patients over older ones, including a criterion based on the theory that older persons have enjoyed more ‘life cycles’ and, essentially, had their opportunity to live,” the complaint reads, according to an Associated Press report.

A spokesperson for the Idaho Department of Health, Greg Stahl, claimed the policy was actually meant to assist caregivers in providing non-discriminatory care.

“The Patient Care Strategies for Scarce Resource Situations document is grounded in ethical obligations that include the duty to care, duty to steward resources, distributive and procedural justice, and transparency,” Stahl wrote in an email to The Associated Press. “It’s guiding principal (sic) is that all lives have value and no patients will be discriminated against on the basis of disability, race, color, national origin, age, sex, gender or exercise of conscience and religion.”

But the attorneys representing Justice for Aging beg to differ, pointing out that the language could potentially lead a 60-year-old man being given care preference over a 61-year-old man, despite there being little clinical difference between the ages.

“The tiebreaker language in Idaho is not limited to situations where there are large age differences between the two people needing care. By its terms, it would be applied in situations where there may be very little difference, such as a 60-year-old man and a 61-year-old man,” the complaint reads. “When they are so clinically similar as to require a tie-breaker, this would lead to absurd and ageist result of denying care to the 61-year-old man simply because he is as little as one year older.”

“Crisis standards of care such as Idaho’s, which make age a tiebreaker when there are limited medical resources are discriminatory,” explained Justice in Aging in a tweet. “Being older does not equate to less value.”

The group also believes that the policy could lead to racial discrimination.

“As #COVID19 surges in #Idaho and the state’s hospitals fill up the state is implementing Crisis Standards of Care that discriminate based on age. One element of the state’s scoring system could also lead to Black older adults being denied life-saving care,” the non-profit organization tweeted.

“The focus on ‘life years’ disproportionately jeopardizes older adults of color, such as those in Black11 and Native American12 communities, who suffer from lower life expectancies due to systemic discrimination in healthcare and social services,” the complaint reads.

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