Chapter 6: Disability

Disabled people are a group that have unique needs in a pandemic. For this reason, NEAC have chosen to provide a chapter solely focused on the ethical considerations of and for disabled people in a pandemic.

This publication acknowledges that a pandemic can affect an individual’s autonomy and their ability to access important resources. However, a pandemic should not exacerbate inequities faced by disabled people. Because disabled people are of equal value and have the same rights as all other New Zealanders, we urgently need to develop and implement measures to address the challenges this group faces before, during and after a pandemic and ensure they received equitable access to appropriate treatments in the future.

This chapter is informed by the life experiences of disabled people and communities throughout the COVID-19 pandemic. During consultation with the public in 2020, NEAC heard time and again from the public that pandemics can exacerbate existing inequities and different approaches are required to achieve equity.

Responses to any pandemic must not neglect disabled people. The responses must follow legal standards, principles of distributive justice and societal norms of protecting vulnerable populations (which are core commitments of public health) to ensure that inequities are not exacerbated. They should also provide a pathway for improvements to ensure equitable access to appropriate treatments.377 This is at the heart of the principles guiding Aotearoa New Zealand’s response to a pandemic.

While this chapter can be read in conjunction with the whole document, it can also be read as a standalone chapter. It takes into account existing obligations and expectations, including but not limited to: NEAC’s framework on Ethics and Equity: Resource allocation and COVID-19, 378 the Health and Disability System Review – Final report – Pūrongo Whakamutunga, 379 Te Tiriti o Waitangi, the Convention on the Rights of Persons with Disabilities (CRPD) and ensuring disabled people are involved in decision-making that impacts them.380

NEAC’s framework on resource allocation addresses equity in COVID-19 resource allocation and prioritisation. As a high-level guidance document for the health and disability sector, it is designed to help health workers and policy makers consider ethics when deciding how to allocate resources. The framework sets out ethical and Te Tiriti o Waitangi principles that medical staff, service planners and policy makers should consider when responding to pandemics. It adds an equity lens to decision-making and assesses how equity sits alongside other ethical principles and Te Tiriti o Waitangi.

Equity as a concept recognises that different people have different levels of advantage and so require different approaches and resources to attain equitable health outcomes. In a resource allocation setting, this means that health workers and policy makers should consider how resources can be allocated to mitigate the adverse consequences of pandemic response measures while avoiding or minimising growth in inequity from those measures.

Terminology

Disability

Many words and terms can be used to identify disability. This document upholds the definition of disability in article 1 of the CRPD that ‘those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others … ” .

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