Dear AdHoc Discussion List:

We enthusiastically invite your input into discussing the Article on Health.  After this short message, you will find three texts in case you wish to refer to them here:   the Chair’s present Health Article (Number 25) Draft, The Original Working Group (Article 21) Draft, and the IDC Draft.

I especially invite your preliminary attention to Chair’s Draft section (d) – see below.  As you may recall, in our International Disability Caucus discussions we have often noted at least three main topics respective to enjoyment of Rights by Persons with Disabilities equally with others.  These are, briefly: 

-  services,

-  information access (both to receive and create, in networks with others),

-  and education (emphasizing that ’providers’ have appropriate training, including by pwd). 

I am wondering if colleagues here feel that services, the first of the above topics, have pre-dominance here, overall, and there is a bit of bunching up attempted in (d) as an omnibus clause to cover other (vital) bases.  And whether here pwd are somewhat cast into recipient and not planning mode?  Perhaps yes, perhaps not...

Acknowledging all good intentions to draft a Chair's Text inclusive of participation by pwd (us) in all aspects and phases involved with Health and Healthcare RIghts, what do we feel we should make as a  proposal?  For instance, would you like to see Section (d) broken up into separate sections, and each more elaborated, for instance?  And what are some ideas for proposing the least number and types of changes, if changes there should be, in the spirit of 'the light touch' we have agreed to?

I will hold my particularized notes and comments for a bit, looking forward to discussion with the group.

P.S. If you would like to discuss this in a separate sub-group, just wave.

And sending very best wishes, LDMF.

Dr. Linda D. Misek-Falkoff

IDC CSOD PWD PWP NDP CCCUN

TEXTS follow.

- - - - - - Heading Number One:  The Chair’s October, 2005 Draft – Text for Discussion. (Please share if you should notice any data errors inadvertently copied into the following texts).

Article 25

HEALTH

States Parties recognise that persons with disabilities have the right to the enjoyment of the highest attainable standard of physical and mental health without discrimination on the basis of disability.  States Parties shall take all appropriate measures to ensure access for persons with disabilities to health services, including health-related rehabilitation.  In particular, States Parties shall:

 (a)   provide persons with disabilities with the same range and standard of affordable health services as provided other persons, [including sexual and reproductive health services] and population-based public health programmes;

(b)   provide those health services needed by persons with disabilities specifically because of their disabilities including early identification and intervention as appropriate, and services designed to minimise and prevent further disabilities including amongst children and the elderly;

(c)    provide these health services as close as possible to people's own communities, including in rural areas;

(d)   require health professionals to provide care of the same quality to persons with disabilities as to others and on the basis of free and informed consent by, where necessary, raising awareness of the human rights, dignity, autonomy and needs of persons with disabilities through training and the promulgation of ethical standards for public and private healthcare;

(e)     prohibit discrimination against persons with disabilities in the provision of health insurance, and life insurance where permitted by national law, which shall be provided in a fair and reasonable manner.

- - - - - Heading Number Two:  The Original Working Group Draft as discussed at the U.N. AdHoc Meetings – Text for IDC Discussion.

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

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

- - - - - - Heading Number Three:  The International Disability Caucus Draft, August 2005 Sixth Session at the U.N. -  Text for Discussion.

States Parties shall take effective legislative and other measures to ensure that persons with disabilities enjoy the right to the highest attainable standard of health and health care services without discrimination and can obtain physical, mental, and social well being.

1.    To that end State Parties shall ensure that:

a.     accessible and affordable health care is provided without discrimination;

b.    persons with disabilities have access to the same range and standards of health services, including sexual and reproductive health service, as are provided to other citizens; 

c.     health services are not rationed, limited, curtailed or withheld on the basis of disability; 

d.    unwanted medical and related interventions and corrective surgeries are not imposed on persons with disabilities;

e.    informed consent of persons with disabilities, is required prior to and during course of medicinal, surgical, therapeutic, or other interventions and modalities; informed consent requires disclosure of the experimental nature of any intervention and all other available information about the nature, adverse effects and benefits of the intervention;

f.       persons with disabilities have access to their unedited health and medical records, and are entitled to give or withhold consent to disclosure of this information to third parties;

g.    choices among different treatment options, are available for persons with disabilities, such as paramedic, alternative health services, second opinions, counselling, therapies, peer support, including health service provided by organizations of persons with disabilities; 

h.     all health facilities, goods and services provided to persons with disabilities respect medical ethics and confidentiality and each individual’s needs, and are appropriate, respectful of and sensitive to:

i)                   the culture of individuals, minorities, peoples and communities,

ii)                 gender, age  and life-cycle requirements,

iii)               improve the health status of those concerned;

i.        all medical equipment used for screening or other purposes is accessible and appropriate for the needs of persons with disabilities;

j.        ensure that the provisions of special female health services include women with disabilities, i.e. during pregnancy, childbirth, postpartum health care, child-care and that all health service provided to other women, also is accessible for women with disabilities across the entire life span;

k.     health services are provided for persons with disabilities as close as possible to local communities if so desired;

l.        public and private health insurance are available for persons with disabilities on an equal basis with others;

m.  all persons with disabilities can access the information and services as desired, to maximize their level of health;

n.     information of all health related provisions, is provided in a timely, meaningful and accessible formats, modes, means and language, including sign language;

c)    education, training and continuing development of health professionals, including staff with disabilities, incorporates instruction on the needs of persons with disabilities, including gender specific needs;