NGO Comments on the draft text
Draft article 11 - FREEDOM FROM TORTURE OR CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT

World Network of Users and Survivors of Psychiatry
May 26, 2004

Article 11 obligates states to prevent torture and other ill treatment of people with disabilities, in particular, medical or scientific experimentation without the free and informed consent of the person concerned, and forced interventions or institutionalization to correct, improve or alleviate any actual or perceived impairment.

This is crucial for people with psychosocial disabilities. World Network of Users and Survivors of Psychiatry is familiar with situations all over the world where people are subjected to invasive and harmful psychiatric procedures as well as experimentation, without their consent. These procedures range from psychosurgery and electroshock without anesthesia, to forced and coerced administration of drugs that interfere with our mental functioning and distort our personalities.

Such interventions violate the international human rights norm prohibiting torture, under certain conditions. The definition of torture in the Inter-American Convention to Prevent and Punish torture includes:

the use of methods upon a person intended to obliterate the personality of the victim or to diminish his physical or mental capacities.

Inter-American Convention to Prevent and Punish Torture, Article 2

When psychiatric interventions are used against the will of any person to interfere with the person’s capacity to produce certain kinds of thoughts, destroy the person’s existing psychological makeup, or prevent the person from carrying out actions, this fits within the definition of torture in the Inter-American Convention. This concept is closely related to the freedom of thought enshrined in ICCPR article 18, which is not subject to any limitations or derogations.

ICCPR article 18, paragraph 2 reads:

No one shall be subject to coercion which would impair his freedom to have or to adopt a religion or belief of his choice.

Psychiatric interventions that invade the brain and interfere with its capacity to produce thoughts violate article 18. No procedures or legal standards are contemplated by the ICCPR to allow limitation of this freedom or the corresponding state obligation to refrain from any coercive interventions.

The definition of torture in the UN Convention Against Torture reads,

For the purposes of this Convention, the term "torture" means any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions.

Convention Against Torture, Article 1(1)

Psychiatric interventions such as psychosurgery, electroshock and drugging with neuroleptics (often considered a “chemical straitjacket”) are often done for coercive purposes to induce the individual to change his or her behavior. Under such circumstances, it is appropriate to speak of the intentional infliction of severe mental and physical pain and suffering for a coercive purpose. This happens, for example, when a psychiatrist orders the forcible administration of one neuroleptic drug which makes a person vomit and feel extremely unwell mentally and physically, for the purpose of inducing her to accept another neuroleptic drug that she has refused. Another example of medical technology being used as torture is the use of implants under the skin to deliver psychiatric drugs against the person’s will, and beyond the person’s capacity to resist. Such technology is currently under development in research trials.

Another factor to be noted in the definition of torture is the element of discrimination. All forced psychiatric interventions are based on the notion that people with psychosocial disabilities should be extremely distressed to be who they are, and that failure to accept disabling interventions shows poor judgment. This violates the principle of respect for human diversity and for impairment as an ordinary part of the human condition, as well as the principles of autonomy and equality.

Forced psychiatric interventions, even of the most ordinary kind, cause severe mental and physical pain and suffering. A quick survey in the United States drew several personal stories of the devastating short- and long-term effects of such interventions. We should not be in the business of creating additional or secondary disability such as post traumatic stress, tardive dyskinesia (a brain disorder causing painful movements that can also be life-threatening, which is caused by neuroleptic drugs), or obliteration of memory, learned skills and creativity (which can be caused by electroshock). Medical interventions must follow the principles outlined in the supported decision-making model discussed under article 9. No human being is without the inherent human capacity to make choices and any interventions to support or assist the person must approach the person with solidarity, as a human being whose choices must be respected, and not as an object to be made over to the specifications of medically-prescribed normality.