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Major Disability Organizations Unite to Voice Serious Fears About Supposedly “Draft” Ontario Protocol for Rationing Critical Medical Care

A Patient’s Disability Should Never Be Used as a Reason to Deny Medical Care

Accessibility for Ontarians with Disabilities Act Alliance Update United for a Barrier-Free Society for All People with Disabilities
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April 8, 2020


In a powerful news release issued by the ARCH Disability Law Centre today, an open letter to the Ford Government was made public that is co-signed by dozens of disability organizations (including the AODA Alliance) and thousands of individuals. This open letter insists that if scarce medical treatments (like ventilators) must be rationed during the COVID-19 crisis, health care providers must never discriminate against a patient with disabilities by denying them needed medical care due to their disability, or due to the health care provider’s beliefs or stereotypes about the quality of life for a patient living with a disability.

The open letter raises serious concerns about a protocol for medical triage emanating from the Ontario Government, copies of which were obtained by some within the disability community. This is triggering real fear within the disability community. The ARCH news release, open letter, and list of organizational signatories are set out below.

In an important article on this topic in today’s Toronto Sun, also set out below, journalist Antonella Artuso reported that the Ford Government did not dispute the existence of the controversial protocol, but Health Minister Christine Elliot claimed it was only a draft. The article includes the following, referring to Health Minister Christine Elliot:

Elliott acknowledged the existence of the document Tuesday but said it still needs to go through final review by government cabinet.

“I know that there have been some concerns that have been expressed by people with certain disabilities, that they would be cut out of treatment if we got to that point,” Elliott said. “I would never allow that to happen. People with disabilities are treated in the same way as everyone else, as they should be.”

This type of document, one that provides guidance on who should get advanced life-saving care, would only come into effect if all else failed, she said.

Four the AODA Alliance’s part, it is hard to believe that such a document would only be a draft if it is not marked as a draft, and if it is already in circulation. It is our experience that at all levels, the Ontario Government is typically preoccupied if not obsessed with such cautions and secrecy around their documents. We would expect this to be especially the case for something as serious and controversial as the protocol for medical triage.

It is good that the Minister said that she would not allow “people with certain disabilities” to be cut out of treatment. The Ford Government must immediately and very publicly retract the protocol, whether or not it is a draft. It must publicly issue a directive that this protocol is not to be followed by health care providers.

The Government must quickly clear up the mixed messages that are no doubt floating around. It’s not just physicians in emergency rooms that need this cleared up. This is similarly vital for nurses and other health care professionals in hospitals and in the community. It’s vital for emergency medical technicians when they arrive at a scene in the community where a emergency patient has called for help. It’s similarly vital for nursing home administrators who can play a role in calling for emergency medical help for their residents.

It is also good that Minister Elliot said that the provincial Cabinet would have to approve any such protocol regarding medical triage. We call on the provincial Cabinet ministers and the Premier to pledge that they will ensure that any such protocol does not discriminate based on disability or permit such discrimination to take place, whether by doctors, nurses, EMTs or other health care providers.

It is vital that the Ford Government now open up the process for making its decisions and developing policy in this area. It cannot remain behind close doors, with the grassroots disability community excluded. We’ve been offering to help the Ontario Government address the urgent needs of people with disabilities during the COVID-19 crisis. It’s time for the Government to take up our offers.

Back on May 15, 2018, when running for office, Doug Ford wrote the AODA Alliance to set out his party’s election pledges on disability accessibility and inclusion. Among other things, he said these words, which now require him and his senior ministers to include us in their efforts during the COVID-19 crisis:

“Your issues are close to the hearts of our Ontario PC Caucus and Candidates, which is why they will play an outstanding role in shaping policy for the Ontario PC Party to assist Ontarians in need.”

Just over a month ago, on February 28, 2020, at a carefully staged media event, the Ford Government pledged that it is leading by example on accessibility for people with disabilities. Now would be a good time and place for the Government to start to do so.

When the immediate crisis passes, there should be an open and independent investigation of how this draft protocol came to be and why the voices of the grassroots disability community have been left out of discussions that so critically affect them.

This medical triage protocol was a top item discussed yesterday when the AODA Alliance and the Ontario Autism Coalition held a grassroots online Virtual Public Forum on what Government needs to do to protect the urgent needs of people with disabilities during the COVID-19 crisis. We urge one and all to watch it and spread the word about it. Over 900 people have already watched it. It remains available at any time to be watched on Youtube, with captioning and American Sign Language interpretation. The April 7, 2020 news release jointly issued by the AODA Alliance and the Ontario Autism Coalition summarizes some key recommendations coming from that virtual public forum.

Our virtual public forum has already secured media coverage including interviews with AODA Alliance Chair David Lepofsky on April 7, 2020 on News Radio 570 in Kitchener, and earlier today on News Radio 1310 in Ottawa.


Toronto Sun April 8, 2020

Originally posted at

Disabled to be denied COVID-19 care?
Antonella Artuso

A document that has left people with disabilities “scared” they’ll be denied an intensive care bed or ventilator during the COVID-19 pandemic is just a “draft,” Ontario Health Minister Christine Elliott says.

The Clinical Triage Protocol for Major Surge in COVID Pandemic a copy obtained by the Toronto Sun dated March 28 is not stamped with the word “draft” sets out guidelines for health-care professionals as a “last resort” when allocating life-saving resources during a shortage.

Advocates say the document makes unfair value judgments about the quality of lives lived by those in the disabled community in violation of their human rights, and has left many of them fearful that they won’t be entitled to the same level of care as everybody else.

“A person’s disability should absolutely never be used as a criterion for deciding whether they get critically needed health care,” David Lepofsky, chair of the AODA Alliance, said Tuesday. “And certainly a doctor’s or nurse’s or EMT’s subjective view of the quality of living with a disability compared to the quality of the life of somebody living without a disability should never be a factor in these decisions.”

Advocates for the disabled are planning to release an open letter to the Ontario government Wednesday in protest.

Elliott acknowledged the existence of the document Tuesday but said it still needs to go through final review by government cabinet.

“I know that there have been some concerns that have been expressed by people with certain disabilities, that they would be cut out of treatment if we got to that point,” Elliott said. “I would never allow that to happen. People with disabilities are treated in the same way as everyone else, as they should be.”

This type of document, one that provides guidance on who should get advanced life-saving care, would only come into effect if all else failed, she said.

Robert Lattanzio, executive director of ARCH Disability Law Centre, said the document provides three levels of triage for health-care providers based on demand and resources.

Using the “frailty scale,” the framework doesn’t just look at who would benefit most from the care, but also calls on health professionals to consider factors like the quality of life of those with a disability, he said.

“That is where we cross a line that we cannot cross,” he said.

Lattanzio said he’s not aware that the protocol is currently in place, but he’s hearing from members of the disabled community aware of it and “scared” that they won’t get the care they need if they go to hospital.

“There’s a heightened sense of fear in the midst of everything else that is going on,” Lattanzio said. “All of our lives are turned upside down but for our communities, for people with disabilities, they are in the fight for their lives.”

April 8, 2020 News Release from the ARCH Disability Law Centre For Immediate Release
Open Letter from Major Disability Organizations Calling on the Ontario Government to Ensure Persons are not Deprioritized from Accessing Critical Care Because of their Disability
TORONTO, April 8, 2020 An open letter to the Ontario Government from over 200 disability and community organizations and over 4,800 individuals raises grave concerns about the Clinical Triage Protocol for Major Surge in COVID Pandemic (Ontario Health), dated March 28, 2020, because it threatens to deprioritize access to critical care to some patients due in part to their disability a clear violation of the Ontario Human Rights Code.
The open letter, a link to which is provided below, explains that according to the Triage Protocol, people living with certain disabilities, such as Parkinson Disease, may be ranked as a lower priority when deciding who receives critical care. Similarly, the Triage Protocol indicates that in some circumstances, people who receive supports for daily living, such as those with moderate-to-severe cognitive impairments and the clinically frail elderly, are less likely to receive critical care.

“A person’s disability must not be used as a reason to deprioritize a person’s need for critical care, even during difficult periods of medical care shortages,” said lawyer Robert Lattanzio, Executive Director of the ARCH Disability Law Centre, a co-signatory to the letter. “Doctors, nurses, EMTs or other health care providers must ensure that their decisions are not informed by discriminatory assumptions or stereotypes about the ‘quality of life’ of a person with a disability. Increasingly, people with disabilities are fearful that this is what they are about to face. They desperately need the Government to make it loud and clear that this will not be tolerated.”

“Health care providers need clear, fair and ethically-sound direction in line with our human rights protections on what to do should decisions about scarce medical resources have to be made,” said Lattanzio. “We urge the Government to immediately withdraw this triage protocol, consult with disability communities, and ensure that any revised protocol includes a clear statement reaffirming human rights protections including the right to disability related accommodations and supports, and that disability will not be a factor in determining priority for critical medical treatment.”

Yesterday, this was one of the important issues discussed at a ground-breaking online Virtual Public Forum on what governments must do to meet the urgent needs of people with disabilities during the COVID crisis, available at

It is important to keep in mind that some people with disabilities bear the disproportionate risk of getting this disease, the greater risk of severe medical consequences from it, and moreover at a higher risk of being denied critical care when needed most.

To view the Open Letter go to
– 30 –
Robert Lattanzio, Executive Director
ARCH Disability Law Centre
Toll-free: 1-866-482-2724 extension 2233

April 8, 2020 Open Letter to the Ontario Government on the Medical Triage Protocol

OPEN LETTER: Ontario’s COVID-19 Triage Protocol
April 8, 2020
Hon. Doug Ford, Premier of Ontario
Legislative Building
Queen’s Park
Toronto, ON M7A 1A1
Hon. Christine Elliott, Deputy Premier and Minister of Health of Ontario College Park 5th Floor,
777 Bay Street, Toronto, ON M7A 2J3
Hon. Raymond Sung Joon Cho, Minister of Seniors and Accessibility of Ontario Ministry for Seniors and Accessibility
College Park, 5th Floor
777 Bay Street, Toronto, ON M5G 2C8

Dear Hon. Premier Ford, Hon. Deputy Premier and Minister Elliott, and Hon. Minister Cho: Re: Ontario’s Clinical Triage Protocol
We, the undersigned, share grave concerns regarding Ontario Health’s Clinical Triage Protocol for Major Surge in COVID Pandemic, dated March 28, 2020, which has yet to be released to the public. As disability organizations, we write in particular to underscore the disproportionate and adverse impact that the Triage Protocol will have on people with disabilities, and to make recommendations for reform.

The COVID-19 pandemic is disproportionately impacting persons with disabilities: our communities are more vulnerable to the virus and are being severely impacted by the necessary emergency response measures, like physical distancing, which interferes with the supports they need for daily living or is not altogether possible.

The Triage Protocol must respect the human rights of all persons, including persons with disabilities. Consultation with human rights experts and the marginalized communities of persons who are going to be disproportionately impacted by the Triage Protocol, must be conducted. Even though it is an emergency situation, the COVID-19 pandemic cannot be used as justification for discrimination.

To this end, we make the following specific recommendations:
(1) Persons with disabilities cannot be deprioritized for critical care on the basis of their disability
According to the Triage Protocol, some people will not get critical care because of their disability. For example, the Triage Protocol identifies particular disabilities, such as cognitive disabilities and advanced neurodegenerative diseases including Parkinson Disease, and Amyotrophic Lateral Sclerosis. Persons with these disabilities may in some stages of their disability be deprioritized in determinations about who receives critical care.

It is imperative that decisions about who receives critical care should be made using objective clinical criteria directly associated with mortality risks of COVID-19, and must not be based on stereotypes or assumptions about a person’s disability, and longer term mortality rates that are not directly related to COVID-19. It should also be made clear that by virtue of someone’s disability, they will not be deemed a lower priority and passed over for another patient who does not have a disability.

The Triage Protocol must clearly state that clinical judgment must not be informed by bias, stereotypes, or ableism
The Triage Protocol explicitly states that clinical assessments cannot take into consideration a patient’s socioeconomic privilege or political rank. As the health-care system has a long-entrenched history of ableism, the Triage Protocol must also explicitly state that implicit disability-based bias, stereotypes and ableist assumptions cannot factor into clinical judgment or assessment when allocating critical care resources. It must also make clear that decisions cannot be made on the basis of human-rights protected characteristics and intersecting identities. We understand that clinical judgment is an important part of the Triage Protocol, but there must be necessary safeguards to ensure that particular marginalized groups are not adversely impacted.

Persons with disabilities cannot be deprioritized for critical care based on the supports they receive for daily living
According to the Triage Protocol, persons with disabilities who receive accommodations or supports from others for daily living are in some circumstances less likely to receive critical care. This means that the Triage Protocol has the effect of deeming the lives of persons who require assistance as being less worthy, or assumes that they have a lesser quality of life. These kinds of criteria are discriminatory and devalue the lives of persons with disabilities. The Protocol invites value-based judgments on the basis of disability-related accommodations, which are a basic human right.

The Triage Protocol must clearly ensure that persons with disabilities receive necessary disability-related accommodations
The Triage Protocol does not have a clear statement that persons will receive necessary disability-related accommodations in the implementation of the Triage Protocol. Accommodations, such as interpretation, support or other services to access medical services, are a basic tenet of human rights law. Disability-related accommodations ensure that persons with disabilities have equal opportunity to receive, understand, and benefit from critical care.

We understand and appreciate that health care workers are working hard to care for all Ontarians, and a practical framework is required to help them make very difficult decisions about who gets critical care with some level of efficiency. We therefore support the development of a policy that respects human rights and has a fair procedure of decision making. We ask that any such framework not violate the basic human rights of persons with disabilities. The rationing of scarce resources in the health care system during this health crisis cannot be used as justification for discrimination.

This letter has been signed by 204 organizations and 4828 individuals, as follows:

1. ARCH Disability Law Centre
2. Access Independent Living Services
3. Accessibility for All
4. ACCKWA AIDS Committee of Cambridge, Kitchener, Waterloo & Area 5. Advocacy Centre for the Elderly
7. AIDS Committee of Windsor
8. ALS Society of Canada
9. Alzheimer Society Durham Region
10. Alzheimer Society Lanark Leeds Grenville
11. Alzheimer Society of Niagara Region
12. Alzheimer Society of Perth County
13. Alzheimer Society Timmins-Porcupine
14. Alzheimer Society Waterloo Wellington
15. AODA Alliance
16. Arthritis Society
17. Autism Ontario
18. Balance for Blind Adults
19. BarrierFree Saskatchewan
20. BC Aboriginal Network on Disability Society
21. Brockville and District Association for Community Involvement (BDACI) 22. Bellwoods Centres for Community Living
23. Black Coalition for AIDS Prevention
24. Black Legal Action Centre
25. Bob Rumball Canadian Centre of Excellence for the Deaf
26. Brampton Caledon Community Living
27. Breaking Down Barriers Independent Living Resource Centre 28. Bridges to Belonging
29. Brockville & Area Community Living Association
30. Camp Bowen Society for the Independence of the Blind and Deafblind 31. Canadian Association for Community Living
32. Canadian Autism Spectrum Disorder Alliance
33. Canadian Council on Rehabilitation and Work
34. Canadian Down Syndrome Society
35. Canadian Federation of the Blind of Ontario
36. Canadian Hard of Hearing Association
37. Canadian HIV/AIDS Legal Network
38. Centre for Independent Living in Toronto (CILT)
39. Chatham-Kent Legal Clinic
40. Chinese & Southeast Asian Legal Clinic
41. Christian Horizons
42. Citizen Advocacy Ottawa
43. Citizens With Disabilities – Ontario (CWDO)
44. Community Living Ajax – Pickering and Whitby
45. CNIB Foundation
46. Cochrane Temiskaming Resource Centre
47. Communication Disabilities Access Canada
48. Community Autism Centre Inc.
49. Community Living Ajax Pickering and Whitby
50. Community Living Algoma
51. Community Living Campbellford/ Brighton
52. Community Living Central York
53. Community Living Chatham-Kent
54. Community Living Dundas County
55. Community Living Essex County
56. Community Living Guelph Wellington
57. Community Living Kincardine & District
58. Community Living Kingston & District
59. Community Living North Bay
60. Community Living North Grenville
61. Community Living Ontario
62. Community Living Prince Edward
63. Community Living Quinte West
64. Community Living Toronto
65. Community Living Upper Ottawa Valley
66. Community Living Welland-Pelham
67. Community Living West Nipissing
68. Community living Windsor
69. Community Living York South
70. Community Living-Central Huron
71. Community Resistance Intimacy Project (CRIP)
72. Council of Canadians with Disabilities (CCD)
73. Council of Canadians, Peterborough and Kawarthas chapter 74. DANI
75. Deafblind Community Services
76. DEEN Support Services
77. Disability Alliance BC
78. Disability Justice Network of Ontario (DJNO)
79. DisAbled Women’s Network Canada (DAWN)
80. Dissociative Society of Canada
81. Down Syndrome Association of Peel
82. Down Syndrome Association of Toronto
83. Down Syndrome Caring Parents of Niagara
84. Down Syndrome Niagara
85. Downsview Community Legal Services
86. Durham Association for Family Resources and Support
87. Durham Family Network
88. Easter Seals Ontario
89. Elevate NWO
90. Empower Simcoe
91. Empowered Kids Ontario – Enfants Avenir Ontario
92. ensemble
93. Erich’s Cupboard
94. Ethno Racialized Disability Coalition Ontario (ERDCO)
95. Extend-A-Family
96. Extend-A-Family Waterloo Region
97. Facile Perth
98. Families for a Secure Future
99. Family Alliance Ontario
100. Family Respite Services
101. Family Support Network for Employment
102. Family Support Network (Newmarket/Aurora)
103. Family Support Network (Total Communication Environment) 104. Fetal Alcohol Spectrum Disorder Group of Ottawa
105. Good Things In Life
106. Guelph Independent Living
107. Guide Dog Users of Canada
108. Hamilton & District Injured Workers Group
109. Hamilton Community Legal Clinic
110. Hamilton Family Network
111. Hand Over Hand Community Organization
112. HIV & AIDS Legal Clinic Ontario (HALCO)
113. Hydrocephalus Canada
114. Independent Living Centre of Waterloo Region
115. Inclusive Design Research Centre, OCAD University
116. Income Security Advocacy Centre (ISAC)
117. Independent Living Canada
118. Independent Living Centre London and Area
119. Injured Workers Community Legal Clinic (IWC)
120. Intensive TLC
121. Joyce Scott Non Profit Homes Inc.
122. Kawartha Sexual Assault Centre
123. KMK Law
124. KW AccessAbility
125. KW habilitation
126. Lake Country Community Legal Clinic
127. L’Arche Canada
128. L’Arche Daybreak
129. L’Arche London
130. L’Arche Sudbury
131. Live & Learn Centre
132. London Down Syndrome Association
133. March of Dimes Canada
134. Marsha Forest Centre
135. Mary Centre of the Archdiocese of Toronto
136. Member Family Support Network TCE
137. Middlesex Community Living
138. Millennial Womxn in Policy
139. Montage Support Services
140. MPN Ontario Patient Support Group
141. Muscular Dystrophy Canada
142. National Coalition of People who use Guide and Service Dogs 143. National Educational Association of Disabled Students (NEADS) 144. National Network for Mental Health (NNMH)
145. Network of Women with Disabilities NOW
146. New Vision Advocates
147. No More Silence
148. Older Women’s Network / Living in Place Campaign
149. Ontario Association for Developmental Education
150. Ontario Association of Independent Living Service Providers 151. Ontario Association of the Deaf
152. Ontario Autism Coalition
153. Ontario Disability Coalition
154. Ontario Federation for Cerebral Palsy
155. Ontario Health Coalition
156. Ontario Independent Facilitation Network
157. Options Northwest Personal Support Services
158. Ontario Parents of Visually Impaired Children VIEWS for the Visually Impaired 159. Ottawa Carleton Association for Persons with Developmental Disabilities 160. Ottawa Independent Living Resource Centre
161. P.A.D.D. Parents of Adults who have Developmental Disabilities 162. PACE Independent Living
163. Pacific Training Centre for the Blind
164. Parkdale Community Legal Services
165. Parkdale People’s Economy
166. Participation Lodge Grey-Bruce
167. Peterborough Community Legal Centre
168. Peterborough Health Coalition
169. PHSS-Medical & Complex Care in Community
170. PooranLaw Professional Corporation
171. Prisoners with HIV/AIDS Support Action Network
172. Project 321 Peel Down Syndrome Association
173. Project Autism
174. PWA (Toronto People With AIDS Foundation)
175. Realize
176. RISE: Resource Centre for Independent Living
177. Scleroderma Society of Ontario
178. Shannon Law Office
179. Students for Barrier-free Access
180. Sudbury Community Legal Clinic
181. Tangled Art + Disability
182. The AIDS Committee of Durham Region
183. The AIDS Network
184. The Canadian Arthritis Patient Alliance
185. The FASD E.L.M.O. Network
186. The George Hull Centre for Children and Families
187. The Legal Clinic (Perth, Sharbot Lake, Brockville)
188. The Neighbourhood Group
189. The Organization of Canadian Tamils With Disabilities (OCTD) 190. The Participation House Project, Durham Region
191. Toronto Family Network
192. Toronto Yachad – The Canadian Jewish Council for Disabilities 193. Total Communication Environment
194. Traverse Independence
195. Universities Allied for Essential Medicines (UAEM)
196. Viability Employment Services
197. Vibrant Health Care Alliance
198. Vision Loss Rehabilitation Ontario
199. Waterloo Regional Down Syndrome Society (WRDSS)
200. Windsor-Essex Family Network
201. Workers United Canada Council
202. Working For Change
203. York Region Lifetime Independent Facilitation
204. YWCA Hamilton
The original letter sent to the above noted recipients included a full list of individual signatories.