She is correct. To allow discrimination against the disabled, even when there isn’t enough to go around, is simply wrong. Disability advocates are mobilizing to defend this position — on Thursday, the American Association of People with Disabilities sent a letter to Congress urging “a statutory prohibition on the rationing of scarce medical resources on the basis of anticipated or demonstrated resource-intensity needs.”

Though some insist otherwise, we should maintain a broad approach of “first come first served” when it comes to lifesaving care, even scarce medical resources like ventilators. We certainly should not remove ventilators from those who are already using them in the name of allocating more “efficiently.”

This is a sacrifice — but not so great as some might imagine. Maintaining nondiscrimination does not require hospitals to treat those who would die anyway. Even under nondisaster situations, clinicians can withhold care that is deemed futile — medically ineffective. But those who can be helped should not be given lower priority because of pre-existing disabilities, even those that will require more scarce resources.

I recognize that this approach imposes a cost. By maintaining “first come first served” for the provision of nonfutile lifesaving care, we may save fewer lives than through ruthlessly efficient optimization. If someone needs twice the average amount of time on a ventilator, maintaining that we shouldn’t turn them away — or deprive them of a ventilator they are already using — means that we are potentially costing the lives of two people who come into the I.C.U. after them.

But even in a crisis, can we not ascribe some value to maintaining our principles? I argue yes — though it may cost lives. This is an unorthodox position, and one that may earn me the ire of the esteemed bioethicists who crafted the rationing protocols now on the verge of deployment.

But I fight for it, because I believe that nondiscrimination is not just a tool to accomplish an end — it also is an end in and of itself. Federal authorities, like the Health and Human Services Office of Civil Rights, must defend the equality of disabled Americans, even now.

At its core, these debates are about value — the value we place on disabled life and the value we place on disability nondiscrimination. When Congress passed the Americans With Disabilities Act 30 years ago, did it do so as a form of charity limited to times of plenty? Or was our country serious about disability as a civil rights issue? Charity can end when resources are scarce — civil rights must continue, even if doing so imposes a cost in time, money and even lives. People with disabilities have an equal right to society’s scarce resources, even in a time of crisis.

Ari Ne’eman is a visiting scholar at the Lurie Institute for Disability Policy at Brandeis University and a doctoral student in health policy at Harvard University. He is at work on a book on the history of American disability advocacy.

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