COVID-19 pandemic is a difficult challenge for everyօne and for healthcare systems of all the countries. Though it can cause heavy consequences indiscriminately for everyone, overcoming the pandemic creates additional difficulties for vulnerable groups by posing a greater threat to their well-being, health and life.
The number of COVID-19 cases registered in Armenia in recent days, including in special institutions under state control, sharply increases the risk that RA healthcare system means will not suffice to provide citizens with proper medical aid. On 22 May 2020, during the discussion with the Public Council, RA Minister of Health mentioned that as a result of increase in the overload, there might be a shift to deep sorting in the treatment of coronavirus patients. This approach has already been applied in a number of countries to provide targeted use of limited resources, when the unpredictable increase in the number of patients in serious and in critical conditions entailed a situation, where healthcare institutions had to give preference of medical service delivery to persons with a higher chance of survival.
When considering the chance of survival, one should bear in mind that no general feature predicts the outcome of the disease. Thus, if death cases are mainly registered among elderly patients, it does not mean that the outcome of the disease is predetermined for all the elderly patients. Moreover, there are known cases, also in Armenia, when the elderly and persons with chronic diseases recovered, and persons with no chronic disease were in a serious state or died.
Realizing the volume of the challenges and the difficulty of the decisions that the RA Government and, in particular, RA Ministry of Health are to take in this difficult situation, and taking into account the experience already recorded in other countries, we find it important to reaffirm the concerns in regard to the use of medical sorting (triage) in different countries and the procedure of implementation. We call on the RA Government and RA Ministry of Health:
❌Not to base on the stereotypical perception of the presumed duration and quality of the patient’s life when providing medical aid, which attributes less value to the life of the elderly or persons with disabilities;
❌To refrain from using medical sorting by further strengthening the potential of healthcare system and preventive measures of the spread of the virus, and most importantly, proper control over their implementation;
❌When providing medical aid, to provide everyone, including persons with disabilities, children and the elderly, with complete and accurate information on their disease, methods of treatment, consequences and expected results, in an accessible manner for them. Also, to provide reasonable adaptations, if necessary;
❌To provide unfailing implementation of all the measures, armament with the necessary items and equipment, urgent and regular testing and consistent control over health state of employees and residents (including persons with disabilities, children, the elderly and convicts) in institutions under state control;
❌Nevertheless, in case a decision is made to use medical sorting, when developing and applying its instructions, to refrain from discrimination on grounds of disability or other grounds and be consistent to make sure that a person’s disability not become a ground for not providing him/her with proper medical aid. The presence of disability does not presuppose that a person’s life is less important and thus, no disability should directly or indirectly become a ground for exclusion, and the degree of the necessary support should not contribute to exclusion;
❌To provide detailed documentation and justification in every case of not providing or ceasing the provision of medical aid as a result of medical sorting.
Helsinki Citizens’ Assembly-Vanadzor
Center for Rights Development NGO
PINK human rights NGO
Society Without Violence NGO
Community Consolidation and Support Center NGO
Human Rights Power NGO
Non-Discrimination and Equality Coalition
Human Rights House Yerevan
Center for Legal Initiatives NGO
Law Development and Protection Foundation
For Equal Rights NGO
Journalists’ Club “Asparez”
Union of Informed Citizens
Women’s Resource Center
“Agate” Rights Defense Center for Women with Disabilities NGO
Transparency International Armenia
“New Generation” Humanitarian NGO
Protection of Rights without Borders NGO
Progress of Gyumri CSDC NGO
Armenian Progressive Youth NGO
Institute of Public Policy NGO
Tigran Gasabyan (citizen)
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