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illnesses and trigger distress,8 people may leave mandatory isolation
and risk infecting others. People with substance use problems may
put themselves at risk of infection in order to access the substances
upon which they depend.9
Some have expressed concern that triage policies that make prog-
nosis a key factor would mean that people with pre-existing comor-
bidities would fare less well under these policies should they become
infected and require intensive care support, and it became necessary
to triage. People who have mental illnesses, particularly those who
are also homeless, are among those groups that tend to have medical
comorbidities at higher rates, and this might affect prognosis and tri-
age decision-making.10 Another suggestion is that unless appropriate
procedural safeguards are in place, subconscious stigma toward this
group—for example, with respect to perceptions of their quality of
life—might affect triage decisions made under pressure, further dis-
advantaging the population with mental illness.11
There are other kinds of possible vulnerabilities that people with
mental illnesses may face during the pandemic. One potential risk
is hostility from members of the public. In some cases, people with
mental illness may behave in ways that do not comply with evolving
community norms about personal distancing and social interaction.
Members of the public may perceive this as unpredictable or threat-
ening, and it may provoke hostile responses. Harassment, aggression,
and vigilantism toward people perceived as posing a risk of infection
to others is already being documented around the world during this
8. A Fiorillo & P Gorwood, “The consequences of COVID-19 pandemic on mental
health and implications for clinical practice” (2020) 63:1 European Psychiatry e32
at 1–2.
9. A Guirguis, “There is a vulnerable group we must not leave behind in our response
to COVID-19: people who are dependent on illicit drugs” (28 April 2020), online:
Pharmaceutical Journal <www.pharmaceutical-journal.com/news-and-analysis/
opinion/comment/there-is-a-vulnerable-group-we-must-not-leave-behind-in-
our-response-to-covid-19-people-who-are-dependent-on-illicit-drugs/20207926.
article?firstPass=false>.
10. Katie Savin & Laura Guidry-Grimes, “Confronting Disability Discrimination
During the Pandemic” (2 April 2020), online: The Hastings Center Bioethics Forum
<www.thehastingscenter.org/confronting-disability-discrimination-during-the-
pandemic/?fbclid=IwAR2ssY8aVhxj5284prI9S2WqZUM3VZvtSzJGQ6DeX4cB_
FhqmZ7vOv90msk>; Sean Fine, Mike Hager & Tom Cardoso, “Ontario draws
up health-care plan in event hospitals become overcrowded”, Globe and Mail
(3 April 2020), online: <www.theglobeandmail.com/canada/article-ontario-
hospitals-instructed-to-prioritize-life-saving-coronavirus/>.
11. Savin and Guidry-Grimes, supra note 10; Fine, Hager & Cardoso, supra note 10.
VULNERABLE
The Law, Policy and Ethics of COVID-19
- Titel
- VULNERABLE
- Untertitel
- The Law, Policy and Ethics of COVID-19
- Autoren
- Vanessa MacDonnell
- Jane Philpott
- Sophie Thériault
- Sridhar Venkatapuram
- Verlag
- Ottawa Press
- Datum
- 2020
- Sprache
- englisch
- Lizenz
- CC BY-NC-ND 4.0
- ISBN
- 9780776636429
- Abmessungen
- 15.2 x 22.8 cm
- Seiten
- 648
- Kategorien
- Coronavirus
- International