Ableism, COVID-19, and Eugenics

By Noah Strauss

The coroner’s initial report of George Floyd’s murder by the Minneapolis Police Department is full of lies, racism, and ableism. The report says, “no physical findings that support a diagnosis of traumatic asphyxia or strangulation. The combined effect of Floyd being restrained by the police, his underlying health conditions, and any potential intoxicants in his system likely contributed to his death. Floyd was 46 when he died. He had underlying health conditions, including coronary artery disease and hypertensive heart disease.” 

The report attempts to blame George Floyd’s death on his underlying disabilities. The health conditions in question, “coronary artery disease and hypertensive heart disease” are often the result of the trauma and stress of oppression. Blaming his death on underlying disabilities is an ableist trope that is deeply connected to racism. More than half of all people killed by police have a disability, and it is common for police to kill disabled people who may not respond to orders due to their disability. 1 in 4 people killed by police experience a mental health crisis. 40% of people killed by police are Black and Brown people with disabilities. 

This assumption and self fulfilling prophecy is present in the coroner’s report of George Floyd’s death. The coroner assumed that having an underlying disability would kill him anyway, and took it a step further and retroactively designated it as the cause of death. In addition to assassinating his character and discrediting his life, the coroner’s report treated George Floyd as disposable. 

Coroners in the US, unlike medical examiners, are not required to be medical doctors, and most do not have medical training. A coroner is an elected position, tying the job to municipal funding, as well as being susceptible to local politics, police, capitalism, and injustice. The vacuum of training in combination with an elected position can lead to collaboration with local police.

This is not the first time that government officials have used their positions to manipulate medical treatment and diagnosis. Ableist policies are based in capitalism, race pseudoscience, social Darwinism, and eugenics. Eugenics is the belief that human evolution can be crafted by the encouraged breeding of people who are considered the most desirable—the ‘fit’—and the discouraged breeding of those who are considered the least desirable—the ‘unfit.’

During the Holocaust, 300,000 disabled people were exterminated as a result of the T4 program. At the end of the war, liberating soldiers found a ledger called “The Hartheim Statistics.” It detailed the money saved by exterminating over 70,000 disabled people at one euthanasia center, down to the food that the people would have eaten if they had remained alive. These euthanasia centers were developed from state run institutions for disabled people, and the T4 program started following Hitler’s decree that doctors should give “merciful deaths.” 

The medical system has a long and tortured relationship with many marginalized communities. Black women, disabled folks, and transgender folks experience this most acutely, and even die due to doctors not taking symptoms seriously. When seeking treatment, doctors frequently will attribute symptoms to the presence of a disability, mental illness, or gender nonconformity, even when they are unrelated. For disabled people, this leads to highly subjective judgments of prognosis, quality of life, and life expectancy. 

Due to the COVID-19 pandemic, many states have released guidelines for rationing of medical treatment, care, and ventilators. A study of 30 state guidelines by the Center for Public Integrity found that 25 of them included language that would deprioritize Disabled people for ventilators and medical care. 20 states had not publicly provided guidelines, although the Department of Health and Human Services released a directive reminding states not to discriminate. Several states have faced lawsuits by disability advocates. Doctors do not wish to make these decisions themselves, leading hospital ethics review boards to create the policies. Hospital review boards very rarely have any disabled people on them.

Guidelines like this are based not only in subjective assumptions of quality of life, but in capitalist logic. These guidelines assume that Disabled folks will not live as long, and then deny them medical care, which guarantees they will not live as long. There is an implication that disabled lives are not worth living, and are of less value than able-bodied people.

It is no different for medical officials to decide now that disabled people will die anyway, and so are not worthy of treatment or life. On June 11, Michael Hickson, a Black disabled man with quadriplegia died of coronavirus in an Austin, Texas medical center after doctors withheld not only treatment, but food and water for six days. The doctors justified their withholding treatment by saying “As of right now, his quality of life, he doesn’t have much of one.” 

 Capitalism creates the conditions of scarcity that allow officials to justify disabled people always being the item cut from the budget. The evolution of state run institutions into euthanasia centers provides a lesson about the inherent cruelty of institutions and congregate care settings that segregate people from their communities. 43% of all coronavirus deaths are in nursing homes. 

The locations with the highest amount of cases of the coronavirus in the United States are nursing homes, jails, prisons, detention centers, and psychiatric hospitals. They are all places where it is impossible to adequately practice social distancing, and where standards of sanitation are low. All of these environments are effectively warehouses for people that this culture wishes to disappear. There is an inherently carceral logic to them. 
This month we celebrate the 30th anniversary of the passing of the Americans with Disabilities Act, a civil rights law that banned discrimination on the basis of disability. The ADA itself was a watershed moment, ensuring thousands of Disabled Americans are able to live full lives. However, we clearly have a long way to go to ensure the ADA is enforced, and Black and Brown people are not left behind. In Philadelphia, organizations like ADAPT and Disabled in Action are celebrating Disability Pride and working to prevent medical triage policies from discriminating against Disabled people. 

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