Summary

This report examines the challenges experienced by persons with disabilities in their interactions with health providers and services, and how those challenges hinder development at personal and societal levels. For socio-economic development to be sustainable, the right to health and other interrelated rights must be ensured. The report provides guidance to States on how to promote health-care services that are inclusive of, and accessible to persons with disabilities, with an eye on improving the lives of persons with disabilities and the development of the community as a whole.

Health is central to human well-being and happiness. It enables everyone to lead meaningful lives and reach full potential. When people do not have access to health care, their opportunities to participate in society are hindered. They may be unable to go to school, work, or take part in cultural, political or leisure activities that connect us with the rest of the community.

Having an impairment does not equate to being unhealthy, and persons with disabilities have about the same health needs as everybody else: health education, preventive care, diagnosis, treatment and rehabilitation. However, they face unique challenges to access health services, which are directly related to their disabilities, due to inaccessible facilities and insufficiently trained health specialists and practitioners. They are also often discriminated against in health care settings, and they are much more vulnerable to violence, coercion and other human rights abuses in their interactions with health care professionals and institutions.

Autistic persons, persons with intellectual and psychosocial disabilities are particularly at risk to being subject to procedures or treatment without their consent, including involuntary hospitalisation, forced treatment, forced sterilization, among others. The risk is even higher for those living in institutions. This is why the Convention on the Rights of Persons with Disabilities calls for the banning of all medical interventions on persons with disabilities without their free and informed consent. Under no circumstance should the opinion of a health professional, a family relative or guardian replace the will of the person.

Ensuring the right to health not only requires enabling access to services, but also looking at the prevalence of other underlying determinants of health, such as poverty, discrimination, violence and social exclusion. Without addressing them, it is impossible to fulfil this fundamental right. Around the world, persons with disabilities are poorer, more discriminated and subject to violence and abuse than non-disabled people. This is why fulfilling this right is inextricable from advancing other fundamental rights, such as living independently in the community, social protection, participation, non-discrimination, among others.

Recommendations include:

• Ensure the participation of persons with disabilities in all decision-making processes regarding health care planning and legislation;
• Mainstream the rights and needs of persons with disabilities in health services, including primary care, ensuring also that services for specific, disability-related needs are also available;
• Guarantee that health care services seek informed consent and are overall respectful of the rights of persons with disabilities;
• Invest in awareness raising initiatives to change health care professionals and practitioners’ perceptions of persons with disabilities

Expert consultation

In preparing this report on the right to health of persons with disabilities, the Special Rapporteur with the support of the Government of Finland, hosted an Expert Group Meeting on the right of persons with disabilities to the highest attainable standard of physical and mental health in Geneva, Switzerland on 15-16 May 2018. Approximately 25 experts from UN entities, organizations of persons with disabilities, civil society and academia, with a variety of expertise, perspectives, and regional representation participated in the meeting.
A background document was also prepared to provide an overview of the different topics related to the health of persons with disabilities.