At Law-Oregon's Denial: Disabilities and Quality of Life
Menzel, Paul T.
Hastings Center Report. 1992 Nov-Dec; 22(6): 21-25.
Rationing that considers quality of life must be allowed to go forward even if at times it happens to disadvantage some persons with disabilities. Indeed, it is questionable whether we could ever devise a system of priority-setting that was not informed in some measure by assessments of quality of life. Disadvantage, however, is not the same thing as the invidious discrimination the ADA [Americans with Disabilities Act 1990] seeks to preclude. We can live with some outcomes disadvantageous to some persons with disabilities -- so long as quality of life measures adequately take into account the judgments of those who experience disabling conditions at first hand, and so long as any such disadvantages are significantly driven by medical outcomes data and not disability per se. Nevertheless, the flags that the Department of Health and Human Services saw in the Oregon plan for reforming Medicaid and eventually more of its health care system were real danger flags. Properly qualified and interpreted, the questions about consistency with the ADA that the department has asked raise important fundamental issues about the fairness of different methods of measuring quality of life for use in allocating health services. It is disturbing to see across-the-board opponents of any and all rationing apparently get some of the administration's ear, and it must have been terribly maddening for Oregon officials not to have been consulted earlier about the department's potential objections, but the administration has reinserted an appropriate consideration of the disadvantaged individual back into what might have become Oregon's too narrow reflection of dominantly "communal" values.
Costs and Benefits; Decision Making; Disability; Discrimination; Economics; Financial Support; Government; Government Financing; Health; Health Care; Health Care Delivery; Health Services; Indigents; Law; Legislation; Life; Methods; Public Participation; Public Policy; Quality of Life; Resource Allocation; Selection for Treatment; Social Discrimination; Standards; State Government; Value of Life; Values;
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