People with disabilities such as may be denied lifesaving treatment if they catch coronavirus, campaigners warn.
Savage new medical guidelines in America recommend coronavirus patients with Down syndrome should be low priority for ventilators.
But people with conditions such as cerebral palsy and autism may also be left to die under new guidance issued to doctors in the US state of Alabama.
US disability advocates revealed Alabama officials told medical practitioners "persons with severe mental retardation, advanced dementia or severe traumatic brain injury may be poor candidates for ventilator support."
The guidance went one further adding: "persons with severe or profound mental retardation, moderate to severe dementia, or catastrophic neurological complications such as persistent vegetative state are unlikely candidates for ventilator support."
It is believed similar guidance on the triaging of patients has been issued in Washington, Utah, Tennessee and Arizona, as hospitals look to ration resources.
In Arizona medics are told to "allocate resources to patients whose need is greater or whose prognosis is more likely to result in a positive outcome with limited resources."
The guidelines have fuelled concerns about disability discrimination amid the coronavirus pandemic.
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Disability advocates filed complaints against the US Department of Health and Human Services (HHS) on Monday, asking for for further clarification.
Nonprofit groups, including Self Advocates in Leadership, Disability Rights Washington, and The Arc of the United States, wrote: “Health care professionals in the United States are already developing protocols for responding to COVID-19, including treatment rationing that will determine who will and will not have access to life-saving treatment,” the n, wrote in the complaint.
“While we recognise the need to plan and be prepared for this potential reality during these extraordinary times, the guiding principles that are adopted must be consistent with federal civil rights law."
On Wednesday US representatives and five senators also sent a letter to the Department of Health and Human Services, or HHS, and U.S. Attorney General William Barr, urging them to protect people with disabilities from being discriminated against during the outbreak.
In reply Roger Severino, director of the Office for Civil Rights at HHS, said: "HHS is committed to leaving no one behind during this emergency.
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“Persons with disabilities, limited English skills, or patients needing religious accommodations should not be put at the end of the line for health services during emergencies."
The concerns have been sparked at a time when the coronavirus crisis deepens across the US which now has more cases than in Mainland China.