Article
26 - Habilitation and rehabilitation
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Working Group
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
Footnotes:
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.