'Make Way for the Younger Generation': Ageism during COVID-19
| Date: | 04 March 2021 |
By Rosalind Turkie, LLM Student International Health Law, University of Groningen, R.h.Turkie@student.rug.nl
The outbreak of coronavirus-19 (COVID-19) has not only had severe impacts on global health but also poses enormous social challenges, which raise human rights (HR) issues. Among other vulnerable groups, the older population has been disproportionately affected. Trending hashtags such as ‘Boomer Remover’, legislative proposals to ‘isolate the elderly’, and a generalized misconception that the virus only affects older persons, have brought to the fore the profound ageism in society. Are existing international norms protecting the rights of older persons effective enough?
Do We Need Reinforced Norms on the Rights of Older Persons?
The outbreak of coronavirus-19 (COVID-19)[1] has not only had severe impacts on global health but also poses enormous social challenges, which raise human rights (HR) issues.[2] Among other vulnerable groups, the older population has been disproportionately affected. Trending hashtags such as ‘Boomer Remover’, legislative proposals to ‘isolate the elderly’, and a generalized misconception that the virus only affects older persons, have brought to the fore the profound ageism in society.[3] Are existing international norms protecting the rights of older persons effective enough?[4]
Ageism
The World Health Organisation (WHO) defines ageism as ‘the stereotyping and discrimination against people on the basis of their age’.[5] It estimates that there are around 600 million people aged 60 years and over worldwide.[6] This figure is based on age as a biological fact. The notion of age, however, is also a socially constructed phenomenon. For example, the regulation of retirement age has ‘generat[ed] a consensus on when individuals become old, regardless of their actual abilities’, with the mark set at 65 within the European Union.[7] Ageist perceptions see this as one homogenous group with the same characteristics and capabilities, whereas the reality varies wildly. In fact, in the United States ‘39% of men [and 30% of women] aged 65-69 […] are in the workforce, not at home and retired’.[8]
This categorization of older persons into one homogenous group generates two different yet cumulative assumptions, which have become increasingly apparent during the pandemic. Firstly, age is frequently associated with infirmity, with diseases ‘often normalized, erroneously, as part of the ageing process’.[9] COVID-19 does pose higher risks for persons over 60, with the death rate 5 times higher for persons over 80.[10] This has reinforced the association between age and vulnerability.
Secondly, lockdown measures throughout the world were rationalized by the assertion that, in the absence of a vaccine, ‘all must protect themselves from COVID-19 […] to protect others’,[11] with WHO guidance indicating persons over 60 as one of the highest risk groups.[12] The economic fallout of the measures, pitting public health versus the economy, stimulates the perception that older persons are less economically valuable. [13]
Challenges to older persons’ human rights during COVID-19
The abovementioned cost-benefit analysis[14] reinforces ageist attitudes to the detriment of older persons’ HR. Some of the challenges they faced during the pandemic included reduced visitation rights for care residents, resulting in social exclusion and loneliness;[15] moreover, many older adults were isolated from online socializing and activities due to a lack of willingness to engage them in digitization, stemming from an ageist perception that they are incapable of learning new skills.[16] Finally, the proposed policy of ‘targeted lockdown’[17] and the prioritization of patients with better survival chances both raise serious ethical issues and interfere with fundamental HR.[18]
Adequacy of the legal framework
Currently, there is no internationally binding convention on the rights of older persons. Provisions of existing HR treaties offer some protection, such as the Convention on Elimination of Discrimination Against Women (CEDAW) and the Convention on the Rights of Persons with Disabilities (CRPD), which make a few references to age.[19] Age could fall under ‘other status’ in the grounds of prohibited discrimination under article 2(2) of the International Convention on Economic Social and Political Rights.[20] Soft law, such as the United Nations (UN) Principles on Older Persons[21] and the Open-Ended Working Group on Ageing,[22] addresses the issue more comprehensively.[23] The UN Secretary General issued a policy brief in May 2020 highlighting some of the challenges arising from the pandemic regarding older persons and their rights.[24] In 2015, the Organisation of American States (OAS) adopted a regionally binding treaty on older persons’ rights, intensifying the discussion as to why such an instrument is lacking at the international level, with older persons identified as ‘the only vulnerable population’ deprived of such protection.[25]
Existing soft law on ageism is often used as grounds to oppose another convention. However, the fragmented nature of the current framework undermines the effectiveness of a global response to age-related discrimination. This contributes to its normalization, reinforcing public perception of its acceptability.[26] Ageism has profound societal effects leaving older persons vulnerable to marginalization and mistreatment and must thus be addressed through reinforced norms and institutional structures to protect their rights. The success of other treaties on vulnerable groups argues strongly in favour of adopting a convention on older persons. Setting an international standard would serve as an important awareness-raising tool, a potential ‘global anti-ageist policy’.[27] Finally, it is essential that older persons have the opportunity to advocate for their own rights and act as stakeholder in policymaking, recognizing their rights to autonomy, consent, dignity and participation, which have been disregarded during the pandemic.
[1] A novel coronavirus was identified in Wuhan, China, on 7 January 2020. The WHO declared the outbreak a Public Health Emergency of International Concern (PHEIC) on 30 January 2020. WHO, ‘Timeline: WHO’s COVID-19 response’ <https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline?gclid=EAIaIQobChMIi7WkoabD7QIVU4XVCh136gRfEAAYASAAEgKU_PD_BwE#event-115> accessed 10 December 2020
[2] As of 6 December 2020, there were approximately 4 million new cases. WHO, ‘weekly epidemiological update-8 Dec 2020’ <https://www.who.int/publications/m/item/weekly-epidemiological-update-8-december-2020> accessed 10 December 2020
[3] E Peprah, “Challenging the ‘Boomer Remover’ Hashtag: Why We Fight for the Mental Wellness of Older Adults” (The Working Mind: Mental Health Commission of Canada Blog, 16 November 2020) (https://theworkingmind.ca/blog/challenging-boomer-remover-hashtag-why-we-fight-mental-wellness-older-adults) accessed 10 December 2020; FG Miller, ‘Lockdown of the elderly is misguided policy’ (2020) Journal of Medical Ethics <https://blogs.bmj.com/medical-ethics/2020/06/23/lockdown-of-the-elderly-is-misguided-policy/> accessed 10 December 2020
[4] The terminology ‘older persons’ is that used by the Committee on Economic, Social and Cultural Rights (CESCR): UN CESCR, ‘General Comment No 6 on The Economic, Social and Cultural Rights of Older Persons’ (1995) E/C/1996/22
[5] WHO, ‘Q&A Ageing: Ageism’ (02 November 2020) <https://www.who.int/westernpacific/news/q-a-detail/ageing-ageism> accessed 10 December 2020
[6] By 2050, this number will reach 2 billion (ibid)
[7] M Fredvang & S Biggs, ‘The Rights of Older Persons: Protection and Gaps under Human Rights Law’ Social Policy Working Paper 16 (The Centre for Public Policy, August 2012) available at < https://social.un.org/ageing-working-group/documents/fourth/Rightsofolderpersons.pdf> accessed 14 December 2020
[8] C Farrell, ‘A Pandemic Lockdown Just For Older People? No!’ (2020) Forbes Next avenue <https://www.forbes.com/sites/nextavenue/2020/07/03/a-pandemic-lockdown-just-for-older-people-no/?sh=28be3cc3457b> accessed 10 December 2020
[9] Fredvang & Biggs (n7).
[10] WHO, ‘Covid-19: vulnerable and high-risk groups’ (2020) <https://www.who.int/westernpacific/emergencies/covid-19/information/high-risk-groups> accessed 10 December 2020
[11] WHO, ‘Coronavirus disease 2019 (COVID-19) Situation Report – 51’ (11 March 2020) <https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf?sfvrsn=1ba62e57_10> accessed 10 December 2020
[12] Factors affecting the severity of COVID-19 symptoms are still being elucidated. The measures have thus far been directed, almost exclusively, at the protection of older persons. However, many of the measures also protect high-risk groups of all ages. See: ibid
[13] I Grzegorczyk & GB Wolff, ‘The scarring effect of COVID-19: youth unemployment in Europe’ (Bruegel Blog, 28 November 2020) <https://www.bruegel.org/2020/11/the-scarring-effect-of-covid-19-youth-unemployment-in-europe/> accessed 10 December 2020
[14] ‘A cost-benefit version of utilitarianism might begin with the claim that older people as a group cost society more in healthcare expenditures than younger people’: NS Jecker, Ending Midlife Bias: New Values for Old Age (OUP 2020) 255. See also the following article on retirement in the United Kingdom: P Inman, ‘Old people are an increasing burden, but must our young be the ones to shoulder it?’ (27 April 2019) The Observer <https://www.theguardian.com/science/2019/apr/27/ageing-retirement-work-taxation-social-care> accessed 10 December 2020
[15] M D'cruz & D Banerjee, “An invisible human rights crisis’: The marginalization of older adults during the COVID-19 pandemic – An advocacy review” (2020) Psychiatry Research 292, 3
[16] ibid 4
[17] The ‘targeted lockdown’ proposed to isolate only those aged 65+. See Miller (n3).
[18] Some progress was made in the second wave by allowing care-home visits and arranging for essential services to be delivered to older people, for example in France. See the French directive: Direction de l'information légale et administrative (Premier ministre), ‘Personnes âgées: comment protéger ses proches à domicile ou en Ehpad?’ (Service-Public, 17 November 2020) < https://www.service-public.fr/particuliers/actualites/A14451 > accessed 10 December 2020
[19] UN General Assembly (UNGA), Convention on the Rights of Persons with Disabilities (adopted 13 December 2006, entered into force 3 May 2008) 2515 UNTS 3 (CRPD), arts 25(b) and 28(2)(b); UNGA, Convention on the Elimination of All Forms of Discrimination against Women (adopted 18 December 1979, entered into force 03 September 1981) 1249 UNTS 13 (CEDAW), art 11
[20] International Covenant on Economic, Social and Cultural Rights (adopted 16 December 1966, entered into force 3 January 1976) 993 UNTS 3 (ICESCR), art 2(2)
[21] United Nations Principles for Older Persons, adopted pursuant to UNGA Res 46/91, Implementation of the International Plan of Action on Ageing and related activities, 16 December 1991, A/RES/46/91 https://www.refworld.org/docid/3b00f22548.html accessed 14 December 2020
[22] Open-Ended Working Group on Ageing (OEWG), established by UNGA Res 65/182, Follow-up to the Second World Assembly on Ageing, 21 December 2010, A/RES/65/182
[23] Other soft law instruments include the WHO, which issued its Global Strategy and Action Plan on Ageing and Health in 2016 to prepare for Decade of Healthy Ageing 2020-2030. Moreover, the Committee on Economic, Social and Cultural Rights (CESCR) makes a detailed analysis in its general comment No 6 on the applicability of the Covenant to older persons. Though not legally binding, these are considered highly authoritative interpretations and States tend to follow them. See: World Health Assembly, ‘The Global strategy and action plan on ageing and health 2016–2020: towards a world in which everyone can live a long and healthy life.’ (2016-2020) WHA69.3; WHO, ‘Decade of Healthy Ageing 2020-2030’ (2017); UN CESCR (n4)
Global strategy and action plan on ageing and health 2016–2020: towards a world in which everyone can live a long and healthy life.
[24] In his report, he highlighted four key priorities for action: ‘1. Ensure that difficult health-care decisions affecting older people are guided by a commitment to dignity and the right to health; 2. Strengthen social inclusion and solidarity during physical distancing; 3. Fully integrate a focus on older persons into the socio-economic and humanitarian response to COVID-19; 4. Expand participation by older persons, share good practices and harness knowledge and data.’ See: UN Secretary General Antonio Guterres, ‘Policy Brief: The Impact of COVID-19 on older persons’ (01 May 2020) <https://www.un.org/development/desa/ageing/news/2020/05/covid-19-older-persons/> accessed 10 December 2020
[25] I Doron & I Apter, ‘The Debate Around the Need for an International Convention on the Rights of Older Persons’ (2010) 50 The Gerontologist 586, 587
[26] As we have seen, this rapidly leads to the stigmatization of older persons, which is followed by their widespread exclusion from social structures. The WHO states that ‘ageism is the most socially normalized of any prejudice’, see WHO (n)
[27] Doron & Apter (n25) 589