Black, Indigenous and People of Color, disabled people, higher weight people and older adults have historically experienced and continue to experience discrimination by medical professionals. In health care settings, members of these communities face pervasive negative biases and inaccurate assumptions about their value, quality of life, capacity to communicate and make decisions, and likelihood of survival.

During the COVID-19 pandemic, these biases can have serious and even deadly consequences. Such biases may be exacerbated when hospitals are faced with scarce resources and must make decisions about which critically ill patients should receive treatment. The “crisis standards of care” which are used by many states and hospitals to make these decisions, have too often reflected these biases. It is crucial that these standards be tailored to avoid unlawful discrimination.

This guide provides: (1) an explanation of what crisis standards of care are and how they may perpetuate discrimination; (2) the principles that should apply to crisis standards of care to prevent discrimination; (3) the civil rights laws that apply to the use of crisis standards of care; and (4) recommended strategies to ensure the non-discriminatory application of crisis standard of care guidelines.