People with Down's syndrome, cerebral palsy and autism could be left to die of coronavirus under new guidelines in the United States.
Measures have been suggested for doctors on who to prioritize for treatment as the country grapples with an outbreak seemingly out of control.
Disability advocates say they are 'disturbed' by the guidelines published by the state of Alabama on rationing ventilators should the pandemic stretch their resources.
New guidance published Alabama officials says that ‘persons with severe mental retardation, advanced dementia or severe traumatic brain injury may be poor candidates for ventilator support.'
It goes on to say that ‘persons with severe or profound mental retardation, moderate to severe dementia, or catastrophic neurological complications such as persistent vegetative state are unlikely candidates for ventilator support.'
Similar guidance has been issued in Washington and Arizona, with medics in the latter state instructed to ‘allocate resources to patients whose need is greater or whose prognosis is more likely to result in a positive outcome with limited resources.'
Disability advocacy groups have filed complaints against the US Department of Health and Human Services (HHS) for further clarification on the guidance.
They are are seeking assurances that disabled people will not be discriminated against when it comes to receiving emergency care.
Those same groups say many of the 7million Americans who live with such disabilities are already at higher risk of Covid-19 because they often live in group homes – a known hotspot for deadly outbreaks of the virus.
HHS spokesman Roger Severino has insisted that US civil rights laws ‘protect the equal dignity of every human being from ruthless utilitarianism,' but experts have questioned whether those laws will still be applied during a nationwide medical crisis.
Ari Ne'erman, a scholar at the Lurie Institiute for Disability Policy at Brandeis University in Waltham, Massachusetts, said: "What we're seeing here is a clash between disability rights law and ruthless utilitarian logic.
"What this is really about at the end of the day is whether our civil-rights laws still apply in a pandemic. I think that's a pretty core question as to who we are as a country."
News website Tuscon.com also highlighted the tragic death of Emily Wallace, a 67 year-old woman with Down's syndrome who was infected with Covid-19 at her Georgia care home, and later died.
Wallace previously hit the headlines after she and husband Richard became the first couple with Down's syndrome in Georgia to marry, with the pair living happily until Richard's death in 2018.
She then moved into a care home, where she was infected by a care worker who had previously caught the virus.
Wallace already had a ‘do not resuscitate' order in place, meaning medics did not attempt to try and save her.
Professor Michael Berube, whose son Jamie, 28, has Down's syndrome, said: "It would be a very rare person who sees a person with Down's syndrome as innately as valuable and as able to contribute to society as anybody else.
"In two weeks, when the resources get truly stressed out, we'll see how much of this draconian stuff goes into practice."