scholarly journals Supported Decision Making in South America: Analysis of Three Countries’ Experiences

2021 ◽  
Vol 18 (10) ◽  
pp. 5204
Author(s):  
Alberto Vásquez Encalada ◽  
Kimber Bialik ◽  
Kaitlin Stober
Keyword(s):  
Decision Making ◽  
South America ◽  
Community Involvement ◽  
Civil Society Organizations ◽  
Legal Capacity ◽  
Middle Income ◽  
Persons With Disabilities ◽  
Essential Form ◽  
Training Community ◽  
The Right

Background. Following the adoption of the UN Convention on the Rights of Persons with Disabilities, there has been increased interest in supported decision making (SDM) as a strategy to realize the right to legal capacity of persons with intellectual and psychosocial disabilities. Support for decision making has been delivered formally through SDM services as well as informally through interpersonal networks. Various SDM programs have made efforts to systematize informal support, showcasing a variety of SDM delivery models that could benefit SDM implementation in low- and middle-income countries. Methods. This article examines and discusses three SDM projects in South America (Colombia, Peru, and Argentina) that have been directly implemented by civil society organizations, including organizations of persons with disabilities and their families. Analyzed program components include person-centered planning, the nature of support relationships, the presence of supporter training, community involvement, and the utilization of quality assurance measures such as monitoring and program evaluation. Conclusions. The results and learning from these initiatives constitute a valuable source of information for legislators and policymakers for the future development of supported decision-making programs, which are an essential form of support and a mechanism for fulfilling the right to legal capacity in low resource settings.

Legislating personhood: realising the right to support in exercising legal capacity

2014 ◽  
Vol 10 (1) ◽  
pp. 81-104 ◽  
Author(s):  
Eilionoir Flynn ◽  
Anna Arstein-Kerslake
Keyword(s):  
Decision Making ◽  
Political Philosophy ◽  
United Nations ◽  
People With Disabilities ◽  
Decision Makers ◽  
Legal Capacity ◽  
Mental Disabilities ◽  
Persons With Disabilities ◽  
United Nations Convention ◽  
The Right

AbstractThis paper examines the regulation of ‘personhood’ through the granting or denying of legal capacity. It explores the development of the concept of personhood through the lens of moral and political philosophy. It highlights the problem of upholding cognition as a prerequisite for personhood or the granting of legal capacity because it results in the exclusion of people with cognitive disabilities (intellectual, psycho-social, mental disabilities, and others). The United Nations Convention on the Rights of Persons with Disabilities (CRPD) challenges this notion by guaranteeing respect for the right to legal capacity for people with disabilities on an equal basis with others and in all areas of life (Article 12). The paper uses the CRPD to argue for a conception of personhood that is divorced from cognition and a corresponding recognition of legal capacity as a universal attribute that all persons possess. Finally, a support model for the exercise of legal capacity is proposed as a possible alternative to the existing models of substituted decision-making that deny legal capacity and impose outside decision-makers.

scholarly journals Supported Decision-Making and Paradigm Shifts: Word Play or Real Change?

2021 ◽  
Vol 11 ◽  
Author(s):  
Jill Stavert
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Legal Capacity ◽  
Paradigm Shifts ◽  
Mental Disabilities ◽  
Ongoing Debate ◽  
Persons With Disabilities ◽  
Word Play ◽  
Real Change ◽  
The Right

Article 12(3) CRPD requires states parties to provide access by persons with disabilities to the support they may require in exercising their legal capacity. This is to ensure that the rights, will and preferences of persons with disabilities are enjoyed on an equal basis with others [Articles 12(1)(2) and (4) CRPD]. Moreover, the Committee on the Rights of Persons with Disabilities has made it clear that supported decision-making must replace substitute decision-making arrangements as these are discriminatory and deny equal enjoyment of the right to exercise of legal capacity for persons. At the same time, there is ongoing debate as to whether or not the absence of substitute decision-making regimes is essential for the non-discriminatory realization of an individual's rights, will and preferences to be achieved. To resolve this debate, however, specific attention needs to be paid to the CRPD message on what it actually means to give effect to the equal and non-discriminatory enjoyment of rights for all. In the context of persons with mental disabilities this requires looking beyond human rights simply in terms of limiting unwarranted interventions to the proactive removal of obstacles to full rights enjoyment and the creation of environments that respect and support such enjoyment. With this in mind this paper will therefore critically consider the use of supported decision-making within existing substitute decision-making regimes with particular reference to Scotland's mental health and capacity laws. It will consider the challenges this poses and whether it is indeed possible to adapt existing regimes to achieve CRPD compliance. In doing so, it is suggested that a full appreciation of the overarching CRPD message about equality and non-discrimination in the enjoyment of rights is required to bring about such compliance.

The right to legal agency: domination, disability and the protections of Article 12 of the Convention on the Rights of Persons with Disabilities

2017 ◽  
Vol 13 (1) ◽  
pp. 22-38 ◽  
Author(s):  
Anna Arstein-Kerslake ◽  
Eilionóir Flynn
Keyword(s):  
Decision Making ◽  
Lived Experience ◽  
Law Reform ◽  
Cognitive Disability ◽  
Legal Capacity ◽  
Persons With Disabilities ◽  
Definition Of ◽  
The Right ◽  
High Level ◽  
Republican Theory

AbstractArticle 12 of the Convention on the Rights of Persons with Disabilities has created a revolution in legal-capacity law reform. It protects the right to exercise legal agency for people with disabilities with more clarity than any prior human rights instrument. This paper explores what constitutes an exercise of legal agency and what exactly Article 12 protects. It proposes a definition of legal agency and applies it to the lived experience of cognitive disability. It also uses a republican theory of domination to argue that people with cognitive disabilities who are experiencing domination are forced to assert legal agency in even daily decision-making because of the high level of external regulation of their lives and the ever-present threat of others substituting their decision-making. It identifies Article 12 as a tool for protecting such exertions of legal agency and curtailing relationships of domination.

scholarly journals Legal Capacity and Supported Decision-Making: Lessons from Some Recent Legal Reforms

Laws ◽  
2019 ◽  
Vol 8 (1) ◽  
pp. 4 ◽  
Author(s):  
Antonio Martinez-Pujalte
Keyword(s):  
Decision Making ◽  
Best Interests ◽  
Legal Capacity ◽  
Persons With Disabilities ◽  
State Laws ◽  
Legal Reforms ◽  
Change Of Perspective ◽  
Legislative Reforms ◽  
Legislative Changes ◽  
The Right

Article 12 of the Convention on the Rights of Persons with Disabilities calls for a thorough review of State laws to recognise the right of persons with disabilities to enjoy legal capacity on an equal basis with others, thereby abolishing substitute decision-making regimes, and to receive the support they need for its exercise. With the aim of providing useful guidelines for legislative changes yet to be made, the present study examines and assesses, in the light of the Convention, some of the most recent and innovative legislative reforms in the area of legal capacity. The analysis shows that, although they appropriately reflect a change of perspective, shifting from the paradigm of the “best interests” of the person to the respect of their will and preferences, some of these reforms are not fully satisfactory, particularly because they still allow partial or total deprivation of legal capacity for persons with disabilities, and maintain institutions which perpetuate substitute decision-making. However, the recent modification of the Peruvian Civil Code and Civil Procedure Code deserves a highly positive evaluation as the first regulation of legal capacity and supported decision-making substantially compliant with the Convention.

scholarly journals Can the World Health Organisation’s ‘QualityRights’ initiative help reduce coercive practices in psychiatry in Ireland?

2020 ◽  
pp. 1-4
Author(s):  
R. M. Duffy ◽  
B. D. Kelly
Keyword(s):  
Decision Making ◽  
Paradigm Shift ◽  
Training Programme ◽  
World Health ◽  
Legal Capacity ◽  
Persons With Disabilities ◽  
Decision Making Capacity ◽  
The World ◽  
Advance Planning ◽  
The Right

The treatment of mental illness is undergoing a paradigm shift, moving away from involuntary treatments towards rights-based, patient-centred care. However, rates of seclusion and restraint in Ireland are on the rise. The World Health Organisation’s QualityRights initiative aims to remove coercion from the practice of mental health care, in order to concord with the Convention on the Rights of Persons with Disabilities. The QualityRights initiative has recently published a training programme, with eight modules designed to be delivered as workshops. Conducting these workshops may reduce coercive practices, and four of the modules may be of particular relevance for Ireland. The ‘Supported decision-making and advance planning’ and the ‘Legal capacity and the right to decide’ modules highlight the need to implement the Assisted Decision-Making (Capacity) Act, 2015, while the ‘Freedom from coercion, violence and abuse’ and ‘Strategies to end seclusion and restraint’ modules describe practical alternatives to some current involuntary treatments.

How Persons with Intellectual Disabilities Are Fighting for Decision-Making Rights

2022 ◽  
Vol 121 (831) ◽  
pp. 30-35
Author(s):  
Chester A. Finn ◽  
Matthew S. Smith ◽  
Michael Ashley Stein
Keyword(s):  
Decision Making ◽  
Intellectual Disability ◽  
United Nations ◽  
Intellectual Disabilities ◽  
Legal Capacity ◽  
Disability Rights ◽  
Persons With Disabilities ◽  
New Approach ◽  
The United Nations

Paternalistic attitudes about what is in the interests of a person with an intellectual disability have long led to abuses, and are embedded in the guardianship laws still in place in most countries. Self-advocates, who identify as people with intellectual or other disabilities and are committed to demanding their rights and educating others about them, are calling for a new approach. They have found support for reforms in the Convention on the Rights of Persons with Disabilities, adopted by the United Nations in 2006 and since acceded to by 182 countries. By supporting the fundamental right of those with disabilities to make decisions, it has enabled disability rights advocates to successfully challenge legal capacity restrictions and push for “supported decision-making.”

Art.15 Protection against Torture and Cruel or Inhuman or Degrading Treatment or Punishment

2018 ◽  
Author(s):  
Fennell Phil
Keyword(s):  
Health Care ◽  
Informed Consent ◽  
United Nations ◽  
Right To Health ◽  
Legal Capacity ◽  
Persons With Disabilities ◽  
Right To Health Care ◽  
United Nations Convention ◽  
Degrading Treatment ◽  
The Right

This chapter examines Article 15 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which prohibits torture and cruel, inhuman, or degrading treatment or punishment (CIDTP), irrespective of the circumstances and the victim’s behaviour. Article 15 rights overlap with rights under other CRPD articles, including the right to legal capacity on an equal basis with others under Article 12; the right to liberty and security under Article 14; the right to protection against violence, exploitation and abuse under Article 16; the right to physical and mental integrity under Article 17 and; the right to health care on an equal basis with others and based on informed consent under Article 25.

Supported Decision-Making and Personal Autonomy for Persons with Intellectual Disabilities: Article 12 of the UN Convention on the Rights of Persons with Disabilities

2013 ◽  
Vol 41 (4) ◽  
pp. 792-806 ◽  
Author(s):  
Nandini Devi
Keyword(s):  
Decision Making ◽  
Intellectual Disabilities ◽  
Personal Autonomy ◽  
Self Determination ◽  
Persons With Disabilities ◽  
Equal Recognition ◽  
Conceptual Skills ◽  
Adults With Intellectual Disabilities ◽  
The Right ◽  
Everyday Living

Making decisions is an important component of everyday living, and issues surrounding autonomy and self-determination are crucial for persons with intellectual disabilities. Adults with intellectual disabilities are characterized by the limitations in their intellectual functioning and in their adaptive behavior, which compromises three skill types (conceptual skills, social skills, and practical skills), and this starts before the age of 18. Though persons with intellectual disabilities are characterized by having these limitations, they are thought to face significant decisionmaking challenges due to their disability. Moving away from this generalization, Article 12 (Equal recognition before the law) of the United Nations (UN) Convention on the Rights of Persons with Disabilities (herewith called “the Convention”) addresses this issue of decision-making for persons with disabilities, recognizing the right to legal capacity.

scholarly journals Canada Should Retain Its Reservation on the United Nation’s Convention on the Rights of Persons with Disabilities

2018 ◽  
Vol 63 (12) ◽  
pp. 809-812
Author(s):  
Mathieu Dufour ◽  
Thomas Hastings ◽  
Richard O’Reilly
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Human Rights ◽  
United Nations ◽  
Psychotic Disorders ◽  
Persons With Disabilities ◽  
Not Criminally Responsible ◽  
The United Nations ◽  
The Right

The United Nations adopted the Convention on the Rights of Persons with Disabilities (CRPD) in 2006. When Canada ratified the CRPD, it reserved the right to continue using substitute decision making schemes even if the CRPD was ‘interpreted as requiring their elimination’. This was a prescient decision because the CRPD Committee, which is tasked with overseeing the interpretation and implementation of the CRPD, subsequently opined that all legislation supporting substitute decision making schemes contravene the CRPD and must be revoked. The CRPD Committee insists that every person can make decisions with sufficient support and that if a person lacks capacity to make a decision, we must rely on their ‘will and preferences’. Many international legal scholars have called this interpretation unrealistic. We agree and, in this article, describe how this unrealistic approach would result in extensive harm and suffering for people with severe cognitive or psychotic disorders. The reader should also be aware that the CRPD Committee also calls for the elimination of all mental health acts and the United Nations Commissioner for Human Rights for the abandonment of the not criminally responsible (NCR) defence.

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