Unfortunately, Ontario is in its third wave of COVID-19. During its April 7 press conference to announce a stay-at-home order, the Ontario government emphasized that ICU admissions are increasing faster than the “worst-case scenario” predicted by their experts. The government also said it has not sanctioned any triage protocol should doctors be forced to decide who gets access to critical care and who does not. And last night, Ontario Health ordered hospitals to postpone non-urgent surgeries because of the growing caseload of COVID-19 patients.
The Ontario Human Rights Commission (OHRC) urgently calls on the government to clarify the status of the Adult Critical Care Clinical Emergency Standard of Care for Major Surge protocol (the Emergency Standard of Care) that was circulated to hospitals in January. The government must also confirm that the Health Care Consent Act prevails to protect the rights of patients and families at this time. Further, government should require hospitals to promptly collect data on vulnerable groups most affected by the pandemic, including older people, people with disabilities, Indigenous peoples and Black and other racialized people admitted to ICUs and whenever critical care is withheld or withdrawn.
Over the past year, the OHRC has repeatedly raised concerns about various versions of the triage protocol and the Emergency Standard of Care, including writing to the government last November and December. On March 1, the OHRC highlighted concerns that the Emergency Standard of Care document and supplementary materials (such as an online short-term mortality risk calculator) included potentially discriminatory content, and called on the government to not implement Emergency Standard of Care without sufficient public input or consultation. The OHRC also called on the government to publicly release and consult human rights stakeholders, including the OHRC, on the latest versions of the proposed critical care triage framework to make sure that this document and the Emergency Standard of Care, were consistent with and uphold the Ontario Human Rights Code. We asked the government to do this before a potential third wave overwhelmed Ontario’s health-care system. Regrettably, that did not happen.
As the pandemic continues, the need to reflect human rights principles and respect human rights obligations in every response is greater than ever before. We must ensure that vulnerable groups disproportionately affected by the pandemic are not further disadvantaged by measures taken to manage critical care services in the days and weeks to come.