25 - Health
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Draft Article 21
RIGHT TO HEALTH AND REHABILITATION74
States Parties recognise that all persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability. States Parties shall strive to ensure no person with a disability is deprived of that right, and shall take all appropriate measures to ensure access75 for persons with disabilities to health and rehabilitation services. In particular, States Parties shall:
a. provide persons with disabilities with the same range and standard of health and rehabilitation services as provided other citizens, including sexual and reproductive health services;
b. strive to provide those health and rehabilitation services needed by persons with disabilities specifically because of their disabilities;
c. endeavour to provide these health and rehabilitation services as close as possible to people's own communities;76
d. ensure that health and rehabilitation services include the provision of safe respite places, to use on a voluntary basis, and counselling and support groups, including those provided by persons with disabilities;
e. provide programs and services to prevent and protect against secondary disabilities, including amongst children and the elderly;77
f. encourage research and the development, dissemination and application of new knowledge and technologies that benefit persons with disabilities;78
g. encourage the development of sufficient numbers of health and rehabilitation professionals, including persons who have disabilities, covering all disciplines needed to meet the health and rehabilitation needs of persons with disabilities, and ensure they have adequate specialised training;
h. provide all health and rehabilitation professionals an appropriate education and training to increase their disability-sensitive awareness and respect for the rights, dignity and needs of persons with disabilities, in line with the principles of this Convention;79
i. ensure that a code of ethics for public and private healthcare, which promotes quality care, openness and respect for the human rights, dignity and autonomy of persons with disabilities, is put in place nationally, and ensure that the services and conditions of public and private health care and rehabilitation facilities and institutions are well monitored;
j. ensure that health and rehabilitation services provided to persons with disabilities, and the sharing of their personal health or rehabilitation information,80 occur only after the person concerned has given their free and informed consent,81 and that health and rehabilitation professionals inform persons with disabilities of their relevant rights;82
k. prevent unwanted medical and related interventions and corrective surgeries from being imposed on persons with disabilities;83
l. protect the privacy of health and rehabilitation information of persons with disabilities on an equal basis;84
m. promote the involvement of persons with disabilities and their organizations in the formulating of health and rehabilitation legislation and policy as well as in the planning, delivery and evaluation of health and rehabilitation services.85
74: Some members of the Working Group considered that grouping 'rehabilitation' with 'health' was inappropriate, and that it would be better dealt with in a separate article, because 'rehabilitation' includes more than 'medical rehabilitation', and should not be 'medicalised'. Rehabilitation includes medical, physical, occupational, communication and psycho-social services as well as training in everyday skills and mobility. The term 'rehabilitation' as used here includes those processes sometimes called 'habilitation' (the gaining of skills that people have not previously had, rather than the re-gaining of skills lost). The Ad Hoc Committee may wish to include an explanation of this nature in draft Article 3 on definitions. Rehabilitation for the purposes of work and education may be best covered in the relevant draft Articles on work and education.
75: Some Working Group members suggested that affordability, and access to health insurance by persons with disabilities without
discrimination on the basis of disability, should be addressed in the Convention.
76: There was general agreement in the Working Group that, as far as possible, health care and rehabilitation services should be decentralised, taking into account the degree of specialisation. Some members of the Working Group also suggested that community based rehabilitation programmes should be ensured, including the working in partnership with local communities and families to continue rehabilitation.
77: There were conflicting views amongst members of the Working Group on the issue of prevention of disability. For some, the Convention has to do with the rights of existing persons with disabilities, and should mention only the minimisation of the effects or progression of their disability, and the prevention of further, secondary disabilities. Others felt that the prevention of disability per se should be included.
78: Some members of the Working Group suggested there should be a specific mention of the fields of (bio)medical, genetic, and scientific research, and its applications, and its use to advance the human rights of persons with disabilities.
79: Part of the intent of this paragraph is to ensure that health and rehabilitation professionals providing services to persons with disabilities understand the on-going effect disabilities have on a person's life, as opposed to more immediate medical considerations.
80: Privacy issues have also been addressed in draft Article 14 on the right to privacy.
81: Free and informed consent has wider application in this draft Convention than this paragraph alone. The Ad Hoc Committee may wish to consider whether the following wording be included in this sub-paragraph or broadened to become a definition in draft Article 3.
"Informed decisions can be made only with knowledge of the purpose and nature, the consequences, and the risks of the treatment and rehabilitation supplied in plain language and other accessible formats".
82: Some members of the Working Group considered that the subparagraph should spell out the rights.
83: Some members of the Working Group also considered that forced medical intervention and forced institutionalisation should be permitted in accordance with appropriate legal procedures and safeguards (see also draft Article 11).
84: Some members of the Working Group suggested that this sub-paragraph was redundant and should be deleted.
85: The involvement of persons with disabilities in formulating legislation and policy, as well as in the planning, delivery and evaluation of services, has wider applicability than this draft Article. Some members of the Working Group suggested that it should be covered under draft Article 4 on general obligations.