Likestillings- og diskrimineringsombudet: Funksjonshemmedes menneskerettigheter brytes

Se opptak fra Likestillings- og diskrimineringsombudets presentasjon av den første rapporten til FNs komité for rettighetene til mennesker med nedsatt funksjonsevne (CRPD-komiteen). WSOs Mette Ellingsdalen deltar fra brukerutvalget.



Les også: Omtaler i Handikapnytt og Fontene

Europarådets Menneskerettighetskommisærs rapport fra Norges-besøket i januar

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Strasbourg, 18 May 2015 CommDH(2015)9

English only

REPORT

BY NILS MUIŽNIEKS

COMMISSIONER FOR HUMAN RIGHTS OF THE

COUNCIL OF EUROPE

FOLLOWING HIS VISIT TO NORWAY

FROM 19 TO 23 JANUARY 2015

(..)

However, the Commissioner points out that the implementation of the CRPD in Norway falls short of some of its key objectives in promoting the self-determination, legal capacity and effective equality of people with psycho-social and intellectual disabilities. The best interest considerations continue to prevail over the CRPD approach highlighting the person’s autonomy, will and preferences. The new Guardianship Act, which entered into force in 2013, still enables substituted decision-making and plenary guardianship with reference to psychosocial

and intellectual disabilities. This is not in line with CRPD Article 12. The Commissioner is also concerned that the guardianship model hinders the development of supported decision-making alternatives for those who simply want assistance in making decisions or communicating them to others.

The Commissioner urges the Norwegian authorities to develop new systems for supported decision-making, based on individual consent. Such systems should be developed together with people with disabilities and along with measures for universal design and reasonable accommodation. Plenary guardianship and full incapacitation regimes should be revoked as a matter of priority, and information should be made available on the scope of guardianships applied under the current system.

The Commissioner welcomes the Norwegian national strategy 2012-15 to reduce the use of coercion in mental health care but stresses that a more comprehensive approach, including legislative reforms, will be required to bring about fundamental changes. There is a clear European trend towards reinforcing the rights and selfdetermination of patients and their participation in decisions about care, and people with psycho-social disabilities should not be excluded from this development. All people with disabilities have the right to enjoy the highest attainable standard of health without discrimination and the care provided to them should be

based on free and informed consent in line with Article 25 of the CRPD.

The Commissioner calls on Norway to reform legislation on involuntary placements in a way that it applies objective and non-discriminatory criteria which are not specifically aimed at people with psycho-social disabilities. Precise data on the use of involuntary medical treatment and restraints in Norway should be made available with a view to drastically reducing the recourse to such practices. Medical treatment should be based on free and fully informed consent with the exception of life-threatening emergencies when there is no disagreement about the absence of legal capacity. The Commissioner is not convinced that the documented involuntary use of ECT in Norway is in line with human rights standards.

NTRODUTION

1 HUMAN RIGHTS OF PEOPLE WITH DISABILITIES2

1.5 CONCLUSIONS AND RECOMMENDATIONS

36. While the Commissioner commends Norway for ratifying the CRPD, he points out that the

implementation of the Convention in Norway falls short of some of its key objectives in promoting the self-determination, autonomy, legal capacity and effective equality of people with psycho-social and intellectual disabilities. The best interest considerations and substituted decision-making continue to prevail over the CRPD approach highlighting the person’s autonomy, will and preferences. The

Commissioner urges the government to adopt a more pro-active stance in implementing its obligations under the CRPD in close cooperation with people with disabilities and organisations representing them.

37. In the Commissioner’s opinion, the withdrawal of Norway’s interpretative declarations concerning the CRPD would signal a new approach. The Commissioner also encourages Norway to sign and ratify the Optional Protocol to the CRPD on an individual complaints mechanism which would improve the access of people with disabilities to external review of their concerns.

38. The Commissioner acknowledges that the Norwegian authorities have attempted to develop some

elements of supported decision-making in the context of the new Guardianship Act and that the number of people put under guardianship with a loss of legal capacity is relatively small. However, he points out that the new guardianship system continues to enable substituted decision-making and plenary guardianship and hinders the full development of supported decision-making alternatives for those who simply want assistance in making decisions or communicating them to others.

39. In order to fully comply with the requirements of Article 12 of the CRPD, the Commissioner urges the Norwegian authorities to develop new systems for supported decision-making alternatives, based on individual consent. Such systems should be developed in coordination with measures for universal design and reasonable accommodation, and together with people with psycho-social and intellectual disabilities. Robust safeguards are needed to ensure that any support provided respects the will and preferences of the person requesting it and is free of conflict of interests. Plenary guardianship and full incapacitation regimes should be revoked as a matter of priority and information should be made available on the scope and specific conditions of guardianships applied under the current system.

40. The Commissioner welcomes the Norwegian national strategy to reduce the use of coercion in mental health care but stresses that a more comprehensive approach, including legislative reforms, will be required to bring about fundamental changes. There is a clear European trend towards reinforcing the rights and self-determination of patients and their participation in decisions about care, and people with psycho-social disabilities should not be excluded from this development. All people with disabilities have the right to enjoy the highest attainable standard of health without discrimination and the care provided to them should be based on free and informed consent in line with Article 25 of the CRPD.

41. Having regard to Article 14 of the CRPD (Liberty and security of the person), the Commissioner urges the Norwegian authorities to reform legislation on involuntary placements in a way that it applies objective and non-discriminatory criteria which are not specifically aimed at people with psycho-social disabilities, while ensuring adequate safeguards against abuse for the individuals concerned.

42. The Commissioner points out that precise data on the use of involuntary medical treatment and

restraints in Norway, including the length of their application, should be made available with a view to drastically reducing and progressively eliminating the recourse to such coercive practices. The

availability of supported decision-making alternatives and reasonable accommodation measures can

contribute significantly towards the development of alternatives to coercion. The Commissioner stresses that medical treatment should be based on free and fully informed consent with the exception of lifethreatening emergencies when there is no disagreement regarding absence of legal capacity. The Norwegian Patient and User Rights Act (Chapter 4A) also highlights this principle.

43. It is essential that the use of highly intrusive treatments such as ECT is subject to robust safeguards. The Commissioner is not convinced that the documented involuntary use of ECT in Norway with reference to the “principle of necessity” in the Penal Code (Article 47) is in line with human rights standards, including the provisions of the CRPD. The Commissioner points out that particular care should be taken to ensure that information given by health professionals about ECT is correct and complete, including information on secondary effects and related risks, so that patients are able to express their free and fully informed consent to the procedure. It is also necessary to collect precise data on the use of ECT and make this available to the public. During the visit, the Norwegian authorities informed the Commissioner of their intention to issue national guidelines on the use of ECT and the Commissioner welcomes this development.

44. In the Commissioner’s opinion, a comprehensive approach towards reducing coercive measures on

people with psycho-social and intellectual disabilities needs to cover a range of different settings in

addition to specialised psychiatric institutions. The intention of the Norwegian authorities to include

municipal care staff in the scope of their future national guidelines on reducing coercion is

commendable. Cooperation between local and specialised care providers will be useful in this context.

The Commissioner points out that the use of coercion in nursing homes and in educational settings should also be addressed.

Workshop om krenkelser i behandling og kurs om CRPD

Arrangement 1
Senter for medisinsk etikk i Oslo inviterer til workshop for mennesker som har opplevd tvang eller krenkelser i behandling innen psykisk helsevern.

Forskeren som leder workshopen stiller blant annet spørsmålet: Når kan man karakterisere en opplevelse med tvang som uforenelig med menneskerettighetene, og hvorfor?

Les saken hos Erfaringskompetanse.

Arrangement 2
Unge Funksjonshemmede inviterer til kurs om FN-konvensjonen for funksjonshemmedes rettigheter (CRPD) 5. desember. Gratis, men man må melde seg på. Les mer

Til deg som ikke har lest Hege Orefellens dissens

Jeg vil i de nærmeste ukene framover legge ut Hege Orefellens dissensuttalelse Selvbestemmelse og frihet på lik linje med andre i bloggen min, slik at flere får lest den.

For at det ikke skal bli for mye å lese på én gang, legger jeg ut i etapper, på lørdager og tirsdager. Følg med på bloggen eller via RSS. 

Hvor blir det av paradigmeskiftet i Norge?

Innlegg av Norsk Forening for Psykisk Helsearbeid.

Norge svarer for MR-praksis i FN: Universell periodisk undersøkelse

Utenriksminister Børge Brende: 00:07:59
Italia: 00:31:06
New Zealand: 00:47:49
Sveits: 01:41:33
Utenriksminister Børge Brende: 03:16:18

Kritisk til norske tolkningserklæringer

Førsteamanuensis Vibeke Blaker Strand ved Senter for menneskerettigheter har skrevet en artikkel om CRPD kalt "Norway's Ratification of the UN Convention on the Rights of Persons with Disabilities: Highlighting Current Discourses in the Field of Human Rights in Norway". Utdrag:

Norway has never before issued such relatively broad declarations that relate to treaty interpretation in the field of human rights. There are a few examples of Norway issuing reservations/declarations to human rights treaties but all of these have been narrowly formulated and are related to concrete provisions in domestic legislation. Most of these reservations/declarations have been withdrawn and those remaining are not controversial. In fact, Norway's policy on reservations and declarations has previously been not to submit these legal caveats upon signature. Rather, Norway's policy has been characterised by objecting to other states’ reservations and declarations, particularly those the Norwegian government considers to be incompatible with the object and purpose of the conventions.

Artikkelen kan leses i fulltekst her.

Mer om menneskerettigheter: FN ber Norge om å slutte med tvangsinngrep (wso.no)

Psykiaterne protesterer mot FNs spesialrapportør om tortur

FNs spesialrapportør om tortur vil ha forbud mot bruk av tvang mot personer med funksjonsnedsettelser.
Nå kommer det reaksjoner fra psykiaterne.

Spesialrapportør Juan Méndez
Skjermdump fra YouTube

Opptak fra tirsdagens CRPD-konferanse

Først i denne videoen snakker representanter fra Likestillings- og diskrimineringsombudet.
Psykisk helse starter 27:10. På slutten snakker Hege Orefellen fra WSO (fra 37:30).
Klikk på Meny for å se alle foredragene.

- Internasjonal menneskerettighetslov begynner å støtte oss

I går var det FN-dagen til støtte for torturofre. I den anledning skrev jurist og menneskerettighetsaktivist Tina Minkowitz et innlegg hos Mad in America om psykiatrisk tvang som tortur. Internasjonal menneskerettighetslov begynner å støtte oss, sier hun. Utdrag:

Foto: FN/Flickr

"Juan E. Méndez, the current Special Rapporteur on Torture, acknowledges that nonconsensual medical interventions against persons with disabilities – including restraint or solitary confinement for any period of time, as well as nonconsensual administration of electroshock, psychosurgery or mind-altering drugs such as neuroleptics – always amount to at least inhuman and degrading treatment, arguably meet the criteria for torture, and are always prohibited by international law. He calls for an absolute ban on forced psychiatric interventions, saying it is an immediate obligation that cannot be postponed due to scarce financial resources. In a statement to the Human Rights Council, Méndez said that detention on mental health grounds is never justified and in particular that it is not justified based on a motivation to protect the safety of the person or others."

Kritikk av regjeringens tilleggserklæring

Hvor mye tvang skal man tillate å bruke i psykiatrien? Norge ratifiserer i juni FNs konvensjon om rettighetene til mennesker med nedsatt funksjonsevne, men vil reservere seg på to viktige punkter.

WSOs leder er blant dem som kritiserer tolkningserklæringene til CRPD i siste nummer av Advokatbladet.

WSOs leder har kronikk i Fontene: Regjeringen vil diskriminere

Fontene 3.2013

Høringssvar om ratifisering av FN-konvensjonen om funksjonshemmede (CRPD)

Høringsnotat CRPD WSO 9-10

Regjeringen vil ikke helt ratifisere FN-konvensjon om funksjonshemmede

ICJ-Norge skriver om regjeringens forhold til konvensjonen om funksjonshemmedes rettigheter, CRPD: 

"Regjeringens forslag innebærer ... at Norge skal ta forbehold på vesentlige punkter overfor FN, slik at kjernen i konvensjonen i realiteten ikke ratifiseres med hensyn til rettighetene til personer med psyko-sosiale funksjonshemninger."

- På tide å tenke på nytt om lovverk om tvangsbehandling

Last year, the United Nations Committee on the Rights of Persons with Disabilities called for the repeal of legislative provisions that allow for the deprivation of liberty on the basis of disability, “including a psychosocial or intellectual disability”. After all, we don’t have diabetes or epilepsy laws compelling people to take medication, so why do we have mental health laws?

Les Time to rethink mental health laws for treatment without consent på det australske nettstedet The Conversation.

Ratifisering som legitimerer diskriminering

Norge skal ratifisere CRPD http://nb-no.facebook.com/permalink.php?story_fbid=177410049051198&id=114519735266130

Men folk med psykiske lidelser vil Norge fortsette med å diskriminere http://www.regjeringen.no/nb/dep/ud/dok/regpubl/prop/2011-2012/prop-106-s-20112012/11.html?id=681317

Mot et paradigmeskifte?

"Towards a Paradigmatic Shift in Mental Health Care?" av Ragnfrid E. Kogstad (fulltekst)

Tilegnet Hege Orefellen for banebrytende arbeid om menneskerettigheter for pasienter i psykisk helsevern.
http://t.co/U5UM9KQc

Fra Europarådets kommissionær for menneskerettigheter

WHO GETS TO DECIDE? Right to legal capacity for persons with intellectual and psychosocial disabilities

CommDH/IssuePaper(2012)2

Issue Papers are commissioned and published by the Commissioner for Human Rights, to contribute to debate and reflection on important current human rights issues. Many of them also include Recommendations by the Commissioner for addressing the concerns identified. At the same time, all opinions in these expert papers do not necessarily reflect the Commissioner’s position.

Acknowledgements

This Issue Paper was prepared by Anna Nilsson, doctoral student at the faculty of Law at Lund University and international expert on human rights and persons with disabilities.

https://wcd.coe.int/ViewDoc.jsp?id=1908555

Via RSMH-Skåne ved Maths Jesperson

Bok om CRPD i pdf-utgave

United Nations Convention on the Rights of Persons with Disabilities – Multidisciplinary Perspectives

Redigert av Jukka Kumpuvuori og Martin Scheinin

We Speak For Overselves

Sabrina Johnson, Darby Penney, Amy Colesante on human rights, voice and trauma


Flere videoer:

Part 2 - Isaac Brown and Joe Woodward on choice, treatment and housing
Part 3 - Joe Woodward, Eva Dech on housing rights, getting out of adult homes, and legislative advocacy
Part 4 - Ryan on "assisted outpatient treatment" experience, torture and advocacy
Part 5 - Dally Sanchez and John Donnelly on our rights as parents and as children/youth

Part 6 - Tina Minkowitz, Llewellyn George, Daniel Hazen on UN standards, repealing inpatient and outpatient commitment, forced medication and human rights

Hentet herfra.