C. The consequences of the charity and medical approaches to disability

By approaching persons with disabilities as “objects of pity” or “problems to be fixed”, the burden of disability falls on the individual and, as a result, social transformation is virtually impossible. Moreover, it can give rise to certain social norms which can make it even more difficult for persons with disabilities to participate in society and enjoy their rights.

Perception that persons with disabilities are “special”

The main difference between the medical/charity approach on the one hand and the social/human rights approach to disability on the other is reflected in the difference between “special” and “inclusive” treatment. The term “special” often arises in connection with persons with disabilities: children with special needs, special schools, special services, special institutions. Yet, “specialty” is exactly what the Convention distances itself from. Being special in the context of disability is not necessarily rewarding; it may lead to marginalization.

Take special schools for example: special schools enable persons with disabilities to interact only with other persons with disabilities or with certain “professionals”. This forces them to live a situation which is not realistic since it does not reflect the diversity of society. Whom does this benefit then? Persons with disabilities? Persons without disabilities? It is difficult to see the benefits of actions/decisions aimed at keeping human beings separate. Human beings are social beings, and children have the right to study and play together. Diversity and inclusion must be the norm.

A segregated school is not a genuine mirror of society. Diversity is very limited there. Problems discussed among “special” students and “specialized” teachers are influenced by a setting focused on disability. The confrontation of ideas and opinions lacks a more diverse audience, including persons without disabilities not challenged by physical or attitudinal barriers.

The right to education is an important right, interrelated with other human rights. At school, persons with and without disabilities learn what society's expectations and opportunities are. They learn theories, skills and discipline; they elaborate values they may have developed in their circle of family and friends; and they develop new values. The school itself is a community where children share the same timetables, venues and obligations. By interacting with teachers and others, pupils learn to live in a society independently and in constant interaction with other members. School represents an embryonic opportunity for independent living that later in life will include gainful employment, participation in political and public life, home and family, access to justice, as well as business opportunities. The diversity of the classroom offers a unique opportunity to discuss human rights and opinions.

Another example of how persons with disabilities have been perceived as “special” under the medical/charity approach concerns institutionalization. Persons with disabilities—in particular persons with psychosocial and intellectual disabilities—have often been committed by force to psychiatric institutions, away from the community and without freedom to choose their medical treatments.

Under the human rights approach, persons with disabilities have the right to liberty on an equal basis with others, and deprivation of liberty cannot be justified on the basis of disability. Forced institutionalization or hospitalization on the basis of disability is prohibited. No one should be institutionalized against his/her will unless the reasons for such institutionalization apply to others in the community without disabilities (for example, imprisonment as a result of committing a crime and being sentenced by a judge).

Persons with disabilities have the right to live in the community, and to choose where and with whom to live, on an equal basis with others. Independent living does not necessarily mean living alone. Many people live in constant contact with others, including in the same house. People live with other members of the same family, with friends and with colleagues. Such cohabitation is usually seen as independent living.

Once a person can make his/her own decisions—including where and with whom to live—and to be respected for these decisions, that person is living independently. The same goes for persons with disabilities. Support is still possible while living independently. Persons with disabilities have the right to receive support if they request it. Independent living constitutes a frame for the enjoyment of several human rights: the right to adequate housing, the right to participate in public and political affairs, the right to privacy, the right to free movement, the right to vote, etc.

Perception that persons with disabilities are dangerous

Historically, persons with mental and intellectual disabilities have been mistreated and neglected in most societies. They have been subjected to such atrocities as government-sponsored hallucinogenic drug experiments on unknowing individuals, forced treatment, electric as well as insulin shock therapies, and even attempted genocide during the Second World War.

Today, stigma and myths around mental illness persist and the result is often discrimination and exclusion. Stereotypes of persons with mental/intellectual disabilities make them appear unintelligent, “weird”, unable to work, with no chance of recovery, unpredictable and dangerous.

News reporting on violent acts/crimes committed by “mentally ill offenders” usually has a strong impact on readers; it reinforces the belief that persons with psychological disabilities are dangerous.

Such generalizations not only sustain a sense of risk, lack of safety and general discomfort in society/the community, they also affect the self-perception of persons with mental and intellectual disabilities. Lack of self-esteem often exacerbates stigma and myths. According to organizations such as the World Network of Users and Survivors of Psychiatry, “one of the greatest losses we experience is the loss of our sense of who we are in the context of our community. An experience of forced treatment causes us to abandon our lives, and we return to a community that sees us as dangerous, vulnerable, volatile and ‘ill’.”4

Discrimination against persons with mental and intellectual disabilities has created a class of people who have been systematically disempowered and impoverished. Because of the stigma surrounding mental illness, many persons with disabilities become homeless, unemployed, undereducated and socially isolated and lack adequate health care or they are kept secluded under strong medication.

Most persons with mental and intellectual disabilities are not violent, nor are they more likely to commit violent actions or crimes than those without mental disabilities. Persons with psychological disabilities are as intelligent as everyone else and are able to function like others in a wide variety of settings.

Saying that persons with mental disabilities are not more violent than people without such disabilities recognizes the existence of violence as a social problem, not as a mental/psychological one. It also acknowledges mental illness as being caused by environmental and social factors, and not merely by genetic and/or organic ones.

Perception that persons with disabilities are superhuman

The media often portray persons with disabilities as somehow superhuman. While ostensibly attempting to promote positive images of them (which is of course welcome), the result can be the same as with other myths, namely that persons with disabilities become one-dimensional. They are courageous, powerful and somehow able to overcome a great difficulty—namely, a disability. When analysed more closely, this potentially positive image also implies that the majority of persons with disabilities have difficult and miserable lives (with most having to rely on charity). Disability becomes an (almost) insurmountable difficulty. The hero is presented as the person who was able to overcome the plight of many.

The thing to bear in mind is that a person with a disability is a human being with strengths and weaknesses, just like anyone else. It is important that persons with disabilities are portrayed in a positive way in public, particularly through the media, and this is referred to in the Convention (art. 8, awareness-raising). This includes highlighting the lives of persons with disabilities that have achieved a significant level in politics, sport, literature or any other field of endeavour. However, overcoming a disability need not be this person's only achievement. Instead, the person has managed to overcome a whole range of barriers facing anyone seeking the spotlight, e.g., excellence in education, competition from colleagues, expectations from the community or family and so on.

Perception that persons with disabilities are a burden

In contrast to the myth of the superhuman, persons with disabilities are often portrayed as a burden—to society, to family, to friends. This is the flip side of the superhuman approach and, again, intrinsically related to the charity approach to disability. This perception persists particularly in the media. How many times have we seen an apparently sensitive documentary on television which concentrates on the parents of a child with a disability, the struggles those parents are going through, the difficulties they face due to the attitudes to their child, the way their lives have changed and so on. The focus on the parents' struggles is generally not intended to promote a negative myth about persons with disabilities, but the immediate effect is three-fold. First, in this case the child with a disability, her concerns, struggles, interests and dreams tend to melt into the background and become secondary. Second, as a result, the child appears one-dimensional and the cause of her parents' distress. Third, there seems to be little way out for the child. Consequently, negative myths and stereotypes emerge.

This can have negative implications for persons with disabilities. For example:

All of this can combine to prevent social change.

Key principles of a human rights approach to disability (general principles of article 3 of the Convention)

PRINCIPLE DISCUSSION
Respect for the inherent dignity and individual autonomy, including the freedom to make one's own choices, and the independence of persons

Inherent dignity refers to the worth of every person. When the dignity of persons with disabilities is respected, their experiences and opinions are valued and are formed without fear of physical, psychological or emotional harm.

Individual autonomy means to be in charge of one's own life and to have the freedom to make one's own choices. Respect for individual autonomy means that persons with disabilities have, on an equal basis with others, reasonable life choices, are subject to minimum interference with their private lives and can make their own decisions, with adequate support if required.

Non-discrimination Non-discrimination is a fundamental principle of all human rights treaties and the basis of the Convention on the Rights of Persons with Disabilities. It essentially prohibits discrimination against anyone on the basis of disability, given that discrimination prevents people enjoying their rights on an equal basis with others. However, today, non-discrimination is understood as a much broader principle which encompasses not only prohibiting discriminatory acts but also taking steps to protect against potential future discrimination and hidden discrimination and promoting equality.
Full and effective participation and inclusion in society The concepts of full and effective participation and of inclusion mean that society, both in its public and in its private dimensions, is organized so as to enable all people to take part fully. They mean that society and relevant actors value persons with disabilities and recognize them as equal participants' for example, in processes related to decisions that affect their lives or in the freedom to run for public office. Participation goes beyond consultation and includes meaningful involvement in activities and decision-making processes, the possibility to voice opinions, to influence and to complain when participation is denied. Inclusion requires an accessible, barrier-free physical and social environment. It is a two-way process that promotes the acceptance of persons with disabilities and their participation, and encourages society to open up and be accessible to persons with disabilities.
Respect for difference and acceptance of persons with disabilities as part of human diversity and humanity Respect for difference involves accepting others in a context of mutual understanding. Despite some visible and apparent differences between people, all have the same rights and dignity. In relation to disability, it involves accepting persons with disabilities for who they are, rather than pitying them or seeing them as a problem that needs to be fixed.
Equality of opportunity Equality of opportunity is closely linked with non-discrimination. It refers to a situation where society and the environment are made available to all, including persons with disabilities. Equality of opportunity does not always mean that the exact same opportunities are made available to all, as treating everyone the same might result in inequalities. Rather it recognizes difference between people and ensures that, despite this difference, everyone has the same opportunity to enjoy rights.
Accessibility Making accessibility (and equality) a reality means dismantling the barriers that hinder the effective enjoyment of human rights by persons with disabilities. Accessibility enables persons with disabilities to live independently and to participate fully in all aspects of life. Accessibility is important in all areas of life, but in particular in the physical environment, such as buildings, roads, housing and so on, transport, information and communications, and other facilities and services open to or provided to the public.
Equality between men and women The principle of equality between men and women indicates that the same rights should be expressly recognized for men and women on an equal footing, and suitable measures should be taken to ensure that women have the opportunity to exercise their rights. Despite the overlap with the principle of nondiscrimination, the reiteration of equality between men and women is expressly included in treaties, especially because there are still many prejudices preventing its full application.
Respect for the evolving capacities of children with disabilities and for their right to preserve their identities Respect for the evolving capacities of children is a principle set out in the Convention on the Rights of the Child. It should be seen as a positive and enabling process that supports the child's maturation, autonomy and self-expression. Through this process, children progressively acquire knowledge, competences and understanding, including about their rights. Their participation in decision-making processes that affect them, including their right to preserve their identities, should be expanded over time in step with this evolution.