Disability Rights

In 2004, a young Seattle girl with significant disabilities known only by the pseudonym Ashley X, underwent a series of medical procedures without her consent. At the request of her parents, Ashley received a mastectomy, a hysterectomy and hormonal treatment, designed to arrest her development in a childlike state. In the eyes of her doctors, her family, and their lawyers, it was urgent that Ashley's body be aligned with her purported cognitive age. The temporal and ethical arguments used to justify her 'Treatment' turned Ashley's body into a site of international debate over disability and human rights, consent and medical science, eugenics and human engineering. Yet the similarities and differences between Ashley's non-consensual pubertal arrest versus that actively sought by trans youth are rarely mentioned. This paper uses the clinical and media discourses at work in both the 'Ashley Treatment' and the treatment sought by trans youth to think through this moment in which some bodies are treated to greater forms of autonomy while other bodies have none. I argue that the discourses used to secure transition for some trans youth ought to be weighed against the implications for others, in particular for trans youth with disabilities. While the availability of puberty suppression for trans youth can be narrated as a sign that things are getting better, the literatures of queer temporality and critical disability studies help to consider that it may also augur something else—a widening gap between those invested with the ability to stop time versus those who are stopped in time.

Abstract
Although the contours of the “disabled person” category are questioned by anti-ableist activists, they remain rigid regarding transabled people (who want to become disabled). For anti-ableist activists, transabled people do not count as disabled. They are perceived to: (1) be falsely disabled; (2) steal resources from disabled people; and (3) be disrespectful by denying, fetishizing, or appropriating marginalized realities. By combining critical discourse analysis, genealogy, and deconstruction, I examine these negative discourses to encourage alliances between anti-ableist activists and transabled people. Ideas developed in disability and trans studies reveal the limits of these discourses anchored in ableist and cisnormative* assumptions.

Keywords: transability; body integrity identity disorder (BIID); stigmatization; exclusion; disability studies and activism; social movements.

Link: http://www.tandfonline.com/eprint/Zx4a96HuAbW2XmSsirAh/full

The paper talks about how a person with disability becomes a Victim of his/ her disability due to circumstances that are beyond his/her. The author of the paper has used the example of a case she worked on while doing her field work in Latur, Maharashtra.

Key Words:

Disability. Victim. Child Rights. Neglect. Abandonment. Human Rights.

L'articolo ricostruisce nella prima parte la normativa relativa a disabilità e scuola, delineando sinteticamente le varie risposte del legislatore in materia fin qui attuate e mostrando, in filigrana, la visione antropologica di cui ciascuna di esse è in qualche modo portatrice.
Il contributo intende, poi, riflettere sul tema dell'effettività del diritto all'integrazione dei bambini e degli adolescenti, portatori di una disabilità, alla luce anche delle modalità concrete con cui la legislazione vigente è attuata, nei paradossi che emergono nella quotidiane vicende delle famiglie che si trovano a vivere la fatica di vedere concretizzato questo diritto, che rischia così di restare solo un "paper right".

L'articolo si inserisce in una pubblicazione più ampia: M. Cerato, F. Turlon (a cura di), Scuola famiglia e minori. Profili normativi e psicologici, Pisa, Pacini giuridica, 2018.

Il volume complessivo delinea, come indicato anche nel sito della casa editrice, "profili giuridici e psicologici del rapporto tra istituzione scolastica, famiglia e minori ed è destinato a quanti (magistrati, avvocati, insegnanti, psicologi, assistenti sociali, genitori, educatori, minori), per motivi professionali e/o familiari, vivono quotidianamente la realtà delle relazioni scuola-famiglia, in un contesto caratterizzato da pluralità di stili familiari (matrimonio, convivenze, unioni civili) e di modelli educativi.
Esso si caratterizza, nel panorama editoriale, per l’apporto interdisciplinare e pratico.
Gli Autori hanno analizzato, con una visione ampia e non settoriale e con un linguaggio chiaro, il complesso sistema scuola-famiglia con precisi riferimenti alla normativa vigente (civile, penale, internazionale), alle caratteristiche psicologiche delle relazioni e alle prassi più ricorrenti, specie nei casi di disagio familiare e irregolarità scolastiche del minore, offrendo anche proposte operative concrete.
Al termine di ogni paragrafo, inoltre, sono indicati i riferimenti essenziali per approfondire gli argomenti (bibliografia, normativa, siti internet)".

Ableism is a form of prejudice that is common in schools and society but is often unrecognized or overlooked in analyzing why students with disabilities have difficulties being included. In this article, the author provides suggestions for recognizing and acting against ableism in schools. The author offers suggestions in terms of ability awareness, disability content in curricula and school activities, teacher in-service, disability literature, the use of role models, and hiring teachers with disabilities.

From a queer, transactivist, intersectional perspective and adopting a critical genealogy methodology, I extend the concept of “crip time” used in disability studies to trans people and linguistic minorities. I suggest a neologism, “trans-crip-t time,” that captures a triple temporality experienced by 1) disabled people (“crip time”); 2) trans people (“trans-crip time”); 3) minority Francophones and non-Anglophones (“transcript/translation time”). The explanatory value of this combined concept, “trans-crip-t time”, is twofold. First, it offers a way to understand the temporal experiences of disabled, trans, and non-Anglophone people in ableist, cisnormative, Anglonormative contexts. Second, it is useful to consider multidirectional, interlocking connections between these dimensions of identity. This essay aims to stimulate dialogue between these marginalized groups and their associated social movements and fields of study. First, I define the varied uses of “crip time” in disability studies. Second, I extend “crip time” to theorize trans temporality using the concept of “trans-crip time”. Third, I apply “crip time” to minority Francophone temporality through the notion of “trans-crip-t time”. To conclude, I consider the porous boundaries between the “disabled”, “trans”, and “Francophone” categories and highlight potential contributions of this intersectional analysis for disability studies by uncovering some of its cisnormative and Anglonormative assumptions.

Link: http://online.liverpooluniversitypress.co.uk/doi/abs/10.3828/jlcds.2016.14

Educational professionals, clinicians, and medical personnel largely accept and condone compliance-based behavioral interventions as appropriate or necessary methods for correcting, treating, or ameliorating disability, including psychiatric, learning, developmental, and behavioral disabilities. Such compliance-based interventions are grounded in a philosophy of indistinguishability from non-disabled people that emphasizes purely cosmetic behavioral changes. Yet behavioral changes centered on compliance and control are frequently contrary or detrimental to natural forms of movement, communication, and behavior. Unlike person-centered support services or self-directed therapy and care, compliance-based interventions do not support the development of functional skills or coping mechanisms. Furthermore, compliance-based behavioral interventions, which include restraint, seclusion, and aversive procedures, constitute torture as defined in the Convention Against Torture due both to their inherently and systematically abusive nature as well as their actual applications and methodology. Additionally, they discriminatorily target disabled people for such torture and violation of rights in contravention to the non-discrimination and protections provisions of the Convention on the Rights of Persons with Disabilities. Nevertheless, the prevalence and scope of compliance-based interventions, as well as their inherently discriminatory and abusive nature, have received little attention outside the disability community. Reframing the discussion of compliance-based behavioral interventions through an international human rights lens would strengthen existing advocacy efforts in the disability community as well as bring the issues to the forefront of international human rights activism.

Institutional policies, such as involuntary withdrawals, were
considered to be reasonable responses to student mental health challenges; however, increasing knowledge about the needs and rights of
students with disabilities reveals the importance of altering such policies.
Efforts to revise the policies should include multiple stakeholders and
institutional leaders who carefully consider the mental health needs of
students as well as the duty to promote safety across campus. In this
article, we analyze involuntary leave policies and propose policy solutions
informed by disability laws, regulations, and recent court cases.

This chapter discusses the intersecting relationships of feminist phenomenologies, queer phenomenologies, and phenomenologies of disability and race, in three contemporary examples of moving image work centrally featuring individuals or characters with lived experiences of disability. While each of these phenomenological modes puts forward substantively different methodologies, their common ground is found through a critique of the normative boundaries of the body as constituted by the white, male, able-bodied subject of philosophical and political discourse. Broadly speaking, their aims are also to create alternative visions of what these non-normativised subjectivities might be.

Phenomenologies extend far beyond the field of philosophy: examples of phenomenological praxis are also found in cultural studies, visual cultures, anthropology, the medical humanities, and, of course, film. The epistemological claims of feminist phenomenologies are therefore necessarily interdisciplinary. Not only this: I argue that feminist phenomenologies 'inform' the study of film no more and no less than the study of film informs the development of feminist phenomenologies. No one single relationship, identity or definition can designate the ways in which feminist phenomenologies contribute to ongoing intellectual conversations about the place of bodies and embodied experience in the world; the means by which these experiences and bodies are performed and represented in the world, through film, constitutes a vital dynamic in the development of feminist phenomenologies.

e l'amministrazione di sostegno. -5. I trust interni. -5.a. (segue) la maggior efficienza del trust, quale misura negoziale di protezione, rispetto alle misure legali di protezione. -5.b. (segue) il trust quale misura negoziale funzionalmente complementare alle misure legali di protezione. -5.c. (segue) il trust quale misura negoziale funzionalmente alternativa alle misure legali di protezione. -5.d. (segue) il trust tra potere autodeterminativo dei privati e intervento eterodeterminativo del giudice. -6. I contratti di affidamento fiduciario. -7. L'atto di destinazione ex art. 2645 ter c.c. -8. Il fondo patrimoniale. -9. La fondazione di famiglia. -10. I comitati di beneficienza. -11. La sostituzione fedecommissaria. -12. Le donazioni. -13. Gli altri strumenti negoziali di cura e di protezione negoziale dei minori d'età. -14. Conclusione. 1

L’inclusione scolastica dei disabili è un diritto inviolabile preposto allo sviluppo della persona. Una scolarizzazione inidonea negherebbe dignità sociale ai portatori di handicap, legittimando distinzioni personali
non compatibili con l’essenza democratica dell’ordinamento. Il nucleo
indefettibile dell’inclusione – che risiede nei livelli essenziali delle prestazioni sociali – è diretta emanazione di quella dignità e tende alla ricomposizione delle diseguaglianze socio-economiche. Si erge pertanto a
diritto incomprimibile e non soggiace alle statuizioni di cui all’art. 81
Cost. La cogenza di questo minimum constitutional guarantee deve tradursi in politiche di bilancio che valorizzino il vòlto personalista della
disabilità e lo elevino a vincolo budgetario positivo. In altri termini, i livelli essenziali parafrasano lo stato di bisogno dei soggetti più vulnerabili
e non possono essere assoggettati ad alcun vaglio di sostenibilità finanziaria: il legislatore è obbligato a salvaguardarli e non può addurre la loro inattuazione all’indisponibilità di risorse, ratione fortiori se il bilancio
include spese evitabili e suntuarie.

Dominant militarist ideologies materially and discursively produce dis/ability. In this paper, I outline the field of Critical Disability Studies to unpack intersections of disability and gender. I theorize militarism, gender, and disability, and discuss pedagogies of possibility to counter ableism and sanism in educational systems and institutions. [Castrodale, M.A. (2015). A critical discussion on disabled subjects: Examining ableist and militarist discourses in education. In Learning Gendered Militarism. Nancy Taber (Ed.). Edmonton, Alberta, Canada: University of Alberta Press]

Greco makes the case that within the human rights framework there is a serious problem regarding accessibility, what he deems the ‘Accessibility as a Human Right Divide’ Problem (AHRD Problem). The AHRD Problem highlights the divide between accessibility as a human right per se versus accessibility as an instrument for the fulfilment of human rights. Greco critically rejects the former, skilfully arguing how accessibility is indeed a proactive principle, and access a necessary requirement for achieving human rights. As a case in point, Greco closes with an example from South Africa, showing how full acknowledgement of the AHRD Problem, and the interpretation of accessibility as a means, and not an end, has the ability to transform the field of media accessibility.

his book critically examines the planning, management, and operations of the world’s premier event for Para sport athletes. Noting a lack of research into how these games are planned and managed, the authors of this contributed volume discuss how the Paralympics are essentially different to the Olympics and what this means for their management. Managing the Paralympics explores how the organizers and connected stakeholders effectively organize and deliver the Paralympics, taking into account what has been learned from previous events. Including emergent models of best practice from event management, project management and sport management literature, the book gives an insight into the planning of one of the world’s biggest sporting events that encompasses ten impairment types and multiple sport classes within sports.
http://www.palgrave.com/de/book/9781137435200#aboutBook

The rates of social and economic inequality facing Australians with disability compared to their fellow citizens, are among the highest in the world (PricewaterhouseCoopers, 2011). The concept of 'social inclusion' therefore holds promise, at the level of policy and practice, for creating a more inclusive and equal society. This paper presents a systematic literature review concerning the 'social inclusion' of adults with disabilities in Australia. It focuses primarily on research in scholarly publications concerned with achieving social inclusion in policy and practice. Although we acknowledge that there is much on this topic published in the grey literature (that is, documents produced by government, advocates, business, and industry that are not published in research journals), this article will focus on the scholarly literature. In summary, the literature review revealed a surprisingly small amount of formal literature about creating social inclusion in policy and practice for people with disabilities (nine in total), and most of it concerned people with intellectual and cognitive disabilities. The concluding section will summarise key themes, and recommend several avenues for future research, policy development and practice initiatives. Abstract This article provides a systematic literature review investigating how the social inclusion of adults with disability is conceptualised in research concerned with policy and service provision in Australia. The review will summarise this literature, and clarify its relative strengths and weaknesses. The findings from the literature review are grouped into recurring themes, namely: deinstitutionalisation; the changing nature of paid support; different forms of 'community engagement'; and socially valued roles, particularly in the realms of employment, volunteering, and consumer transactions. The literature mostly concerns people with intellectual and cognitive disability, more so than persons with sensory, psychosocial (mental health) and physical disabilities. Several gaps emerge in the literature, such as the experiences of Indigenous people with disabilities, both in terms of exclusion they may face, and solutions being developed by Indigenous communities; ambiguous understandings of social inclusion; and a lack of acknowledgement of prominent critiques of social inclusion. The review builds on these findings to make recommendations for policy, practice, and further research.

Although the employment situation of disabled people has widely been identified as in need of improvement, progress in this area remains slow. While some progress has been made in including the physically or sensory disabled in the workplace, other types of disability have been largely neglected. This applies particularly to disabled workers in atypical employment, such as those whose workplace is the Digital Economy. In this article, we discuss the case of disabled app developers as a significant example of how the current regulatory framework fails to be inclusive in its attempts to protect the rights of disabled Digital Economy workers. We identify two problems that are at the heart of this: first, a continuing failure to collect relevant and comprehensive data on disability, and second, a lack of accountability towards disabled workers in atypical employment. Consequently, we call for better data collection and argue for urgent policy changes to close the existing accountability gap.

This chapter presents research and activist work advocating for the sexual rights of disabled people. The romantic and intimate lives of disabled people have been marked by a history of oppression, abuse and de-sexualisation. State-sanctioned sterilisations of people with disabilities and the numerous eugenic movements associated with practices serve as the most overt and inhumane examples of how negative attitudes become reified into social policy. The variety of the initiatives exemplifies the richness and diversity of disability- sexuality activism and illustrates some of the ways that disabled people are advocating for and claiming intimate citizenship and socio-sexual rights. Disability activists have done the critical work of subverting the taboo and stigma commonly associated with disability and sexuality; and they have turned the conversation towards desiring disability. The sexual lives of disabled people have the potential to challenge dominant cultural ideas of what constitutes sex.

Australia has long placed restrictions on the immigration of people with disabilities. While recent civil society mobilisation has forced some shift in policy, it is far from clear whether this will result in people with disabilities being accepted as immigrants. The issue is complicated further for people defined as ‘refugees’ and ‘asylum seekers’ who have encountered the migration restrictions on disability. As a result of this policy landscape, there is limited rigorous research that seeks to understand the social inclusion and participation of disabled refugees and asylum seekers within the resettlement process. An extensive review reveals that refugees and asylum seekers with disabilities remain largely absent from both resettlement literature and disability research. This paper summarises the limited available research in the area around the following themes: processes of offshore migration and the way that disability is assessed under Australia’s refugee legislation; the uncertainty of the prevalence of disability within refugee and asylum seeker communities; the provision of resettlement services, both mainstream and disability-specific, through the transitional period and beyond; and the invisibility of asylum seekers with disabilities in Australia’s immigration detention centres, community-based arrangements and offshore processing centres. To conclude, the paper outlines implications for further research, policy and practice in the Australian context

Background

Public health interventions that are effective in the general population are often assumed to apply to people with impairments. However, the evidence to support this is limited and hence there is a need for public health research to take a more explicit account of disability and the perspectives of people with impairments.
 
Objectives

(1) To examine the literature on theories and models of disability; (2) to assess whether or not, and how, intervention studies of effectiveness could incorporate more inclusive approaches that are consistent with these theories and models; and (3) to use the findings to draw out implications for improving evaluative study designs and evidence-based practice.
 
Review methods

The project is a scoping review of the literature. The first stage examines theories and models of disability and reflects on possible connections between theories of disability and public health paradigms. This discussion is used to develop an ethical–empirical decision aid/checklist, informed by a human rights approach to disability and ecological approaches to public health. We apply this decision aid in the second stage of the review to evaluate the extent to which the 30 generic public health reviews of interventions and the 30 disability-specific public health interventions include the diverse experiences of disability. Five deliberation panels were also organised to further refine the decision aid: one with health-care professionals and four with politically and socially active disabled people.
 
Results

The evidence from the review indicated that there has been limited public health engagement with theories and models of disability. Outcome measures were often insensitive to the experiences of disability. Even when disabled people were included, studies rarely engaged with their experiences in any meaningful way. More inclusive research should reflect how people live and ‘flourish’ with disability.
 
Limitations

The scoping review provides a broad appraisal of a particular field. It generates ideas for future practice rather than a definite framework for action.
 
Conclusions

Our ethical–empirical decision aid offers a critical framework with which to evaluate current research practice. It also offers a resource for promoting more ethical and evidence-based public health research that is methodologically robust while being sensitive to the experiences of disability.
 
Future work

Developing more inclusive research and interventions that avoid conceptualising disability as either a ‘burden’ or ‘problem’ is an important starting point. This includes exploring ways of refining and validating current common outcome measures to ensure that they capture a diverse range of disabling experiences, as well as generating evidence on meaningful ways of engaging a broad range of disabled children and adults in the research process.

This paper sheds lights into the laguna that exists in our domestic laws due to their failure to comply with the requisite international standards as provided for under the United Nations Convention on the Rights of Persons with Disabilities.

ABORIGINAL AND TORRES STRAIT ISLANDER ON THE RECURRENT AND INDEFINITE DETENTION OF PEOPLE WITH COGNITIVE AND PSYCHIATRIC IMPAIRMENT
A Submission to the Senate Inquiry on the Indefinite Detention of People with Cognitive and Psychiatric Impairment
Prepared by:
FIRST PEOPLES DISABILITY JUSTICE CONSORTIUM
An alliance of Aboriginal and Torres Strait Islander community organisations, disability, justice and legal researchers, Universities and Research Institutes.
An initiative of First Peoples Disability Network (Australia), its strategic partners and supports.
April 2016

This article examines Australia's post-conflict reconstruction and development initiatives in Iraq following the intervention of 2003. Overall, it finds that Australia privileged the neo-liberal model of post-conflict state building by investing in projects that would enhance the capacity of the new Iraqi state, its key institutions and the private sector towards the imposition of a liberal democracy and a free-market economy. To demonstrate, this article documents the failures of the Australian government's stated aims to " support agriculture " and " support vulnerable populations " via interviews conducted in Iraq with rural farmers and tribal members and those working in, or the beneficiaries of, Iraq's disability sector. It concludes by noting that such failures are not only indicative of the inadequacy of the neo-liberal state building model, but also that these failures point the way forward for future post-conflict reconstruction and development projects which ought to be premised on a genuine and sustained commitment to addressing the needs of those made most vulnerable by war and regime change.

The use of the concepts “diversity” and “inclusion” are analyzed with regard to deaf people, whom we call Sign Language Peoples (SLPs), specifically in policy discourses (as used by the World Federation of the Deaf and in the UN Convention on the Rights of Persons with Disabilities) and academic discourses (particularly the con- cept of Deaf Gain). Discussing such discourses, we evaluate the promises and perils of “diversity” and “inclusion” in policy positions and scholarly analysis. We argue that in order for these concepts to be useful for SLPs in the achievement of rights, we need to foreground a specific understanding of inclusion as societal inclusion, and diversity as needing a group rights-based foundation. As such, we explore different paradigms for understanding how SLPs are part of diversity and how they can be included. As such, we contribute to scholarship and debate on inclusion and diver- sity beyond the particular case of SLPs.

Background: The national policy on disability in Namibia is overdue for review having been in existence for over 20 years. In 2017 the government of Namibia expressed intentions to review the policy. Concerns that can be framed as occupational injustice were raised by persons with disabilities in Namibia. Aim: To gather evidence from persons with disabilities; disability policy decision makers and occupational therapists for contributing towards disability policy formulation using an occupational justice perspective. Method: In-depth interviews were conducted with 15 persons with disabilities and eight disability policy decision-makers. Two focus groups were conducted with a total of 17 occupational therapists working in Namibia. NVivo 11 Pro version was used for thematic data analysis to generate themes with critical disability theory as the theoretical framework. Findings: Occupational participation barriers identified in the study were: attitudinal, access, physical, expertise, and systemic. These barriers can be framed as occupational marginalization, occupational deprivation and occupational alienation. All participant groups suggested policy reforms to promote occupational participation among persons with disabilities. Conclusion/Significance: There is potential for applying the participatory occupational justice framework in disability policy formulation to promote participation in occupations that are meaningful, and culturally relevant to persons with disabilities in Namibia.

Australia has developed a National Disability Strategy and a National Plan of Action on Violence Against Women in response to its international human rights commitments. Neither the Strategy nor the Plan, however, appears to adequately address violence against women with disabilities. Violence disproportionately affects women with disabilities as they are uniquely vulnerable to forms of violence due to their specific living circumstances. By drawing upon feedback from the UN convention committees, this article looks at Australia’s progress in meeting its international human rights obligations — especially under the Convention on the Rights of Persons with Disabilities — and discusses the shortcomings in Australian domestic legislation and emerging policies in addressing issues of violence against women with disabilities.

Negli ultimi decenni, l’evolversi delle normative ha favorito l’inclusione sociale delle persone disabili, in particolare negli ambiti della scuola e del lavoro. Tuttavia queste persone si trovano ancora oggi in una condizione piuttosto critica: raggiungono livelli di istruzione inferiori rispetto alla popolazione normodotata e affrontano maggiori difficoltà nell’ottenere posizioni lavorative che, sovente, richiedono un basso profilo professionale e non prevedono sbocchi di carriera.
Quali sono le ragioni di tale disparità?
Questo volume, che nasce da una ricerca empirica, intende approfondire queste tematiche da un punto di vista sociologico.

“Cosa vogliono i disabili? Una vita, come la vogliono gli altri”

Indice:
Per una introduzione al tema della disabilità
La struttura del volume e la presentazione della ricerca
1. Disability is part of the human condition
2. Per una scuola verso il lavoro
3. Un lavoro per fortuna
4. Un lavoro per dovere
Qualche riflessione conclusiva
Nota metodologica
Bibliografia

Nota sull'Autore
Albertina Pretto
È ricercatrice in Sociologia presso l’Università di Trento dove insegna “Metodi Qualitativi” e il suo principale interesse di studio riguarda l’analisi e lo sviluppo di questi ultimi. Le sue ricerche si concentrano prevalentemente su il senso di appartenenza socio-territoriale, i valori e alcuni ambiti della sociologia della salute. Ha recentemente pubblicato: “Narratives, Values and Voters: a case study in Italy” (2016) in French Journal for Media Research; “The socio-territorial belonging in a cross-border area: a sociological approach” (2016) in Space & Polity; “A type of interview with photos: the bipolar photo elicitation” (2015) in L’Année Sociologique.

This thesis argues that the nature of disability is, currently, fundamentally misunderstood. Current approaches to disability are nounal and seek to determine the locus of disability with the intention of better understanding the phenomenon of disability. In contrast, this thesis offers an adverbial perspective on disability and shows how disability is experienced as an increased and personally irremediable impediment to daily-living tasks or broader goals. This impediment is not a function of either biological individuality or the Social, but of a specific relation between the individual and their environment. The thesis delineates the Picture Theory of Disability — a mechanism for the evaluation of the experience of disability and a heuristic device for the proper interpretation of disability. The theory is born of Humean sentimentalism and elements of Wittgenstein’s Picture Theory of Language, and shows when, where, and how disability is experienced.

Neoliberal reforms lead to deep changes in healthcare systems around the world, on account of their emphasis on free market rather than the right to health. People with disabilities can be particularly disadvantaged by such reforms, due to their increased healthcare needs and lower socioeconomic status. In this article, we analyse the impacts of neoliberal reforms on access to healthcare for disabled people. This article is based on a critical analytical review of the literature and on two case studies, Chile and Greece. Chile was among the first countries to introduce neoliberal reforms in the health sector, which led to health inequalities and stratification of healthcare services. Greece is one of the most recent examples of countries that have carried out extensive changes in healthcare, which have resulted in a deterioration of the quality of healthcare services. Through a review of the policies performed in these two countries, we propose that the pathways that affect access to healthcare for disabled people include: a) Policies directly or indirectly targeting healthcare, affecting the entire population, including disabled people; and b) Policies affecting socioeconomic determinants, directly or indirectly targeting disabled people, and indirectly impacting access to healthcare. The power differentials produced through neoliberal policies that focus on economic rather than human rights indicators, can lead to a category of disempowered people, whose health needs are subordinated to the markets. The effects of this range from catastrophic out-of-pocket payments to compromised access to healthcare. Neoliberal reforms can be seen as a form of structural violence, disproportionately affecting the most vulnerable parts of the population – such as people with disabilities – and curtailing access to basic rights, such as healthcare.

Countries where the number of people with mental health problems receiving long-term support in the community is greater than the number of people in long-stay hospitals or institutions Unknown Countries where the number of people with mental health problems receiving long-term support in the community is lower than the number of people in long-stay hospitals or institutions Countries where the number of people with mental health problems receiving long-term support in the community is greater than the number of people in long-stay hospitals or institutions Unknown Countries where the number of people with mental health problems receiving long-term support in the community is lower than the number of people in long-stay hospitals or institutions

Thomsen (2015) argues that people with disabilities should be granted an exception to a general prohibition on paying for sex. In this paper, I argue that Thomsen’s definition of disability is too vague to be useful in identifying who should be granted an exception to an overall ban, and that Thomsen’s case for a ban also fails to withstand scrutiny. A more reasonable argument, in my view, is that mature individuals should be allowed to decide for themselves (a) what kind of consensual sex they wish to engage in, and (b) in exchange for what.

Rahnuma Family Planning Association of Pakistan (R-FPAP) engaged the Institute of Social Sciences (ISS) to conduct a research study to identify different kinds of sources of SRH information available to PWDs (Persons With Disabilities), identify assistance required and services available to and attained by PWDs to fulfil their SRH needs, and document perceptions, practices and attitudes of service providers, parents or immediate care takers and PWDs themselves, which make them more vulnerable for access to SRH information and services. 

The study involved in-depth interviews and focus group discussions with a wide range of stakeholders involved with the rehabilitation and welfare of PWDs, including PWDs themselves, their parents, staff of institutions involved in the education and care of PWDs, SRH and public health experts, physicians, government officials, and disability experts and advocates, assessment of the existing attitudes of service providers regarding PWDs using an attitude scale, and semi-structured interviews of 104 PWDs. A Reference Group consisting of key stakeholders reviewed and made inputs into the research design and instruments, as well as the study report, and participated in the dissemination meeting of the report.  The key findings of the study are summarized below.

There is a huge gap between the needs of PWDs for SRH information, counselling and services and the availability of the same to PWDs, both in mainstream institutions like hospitals, as well as institutions dedicated to PWDs.  The study identified many myths, misconceptions and unscientific thinking regarding SRH, disability and PWDs (e.g. many PWDs attributed the infertility of a couple, the birth of a disabled child, the determination of the sex of a child, or a person becoming disabled due to God’s will), and most PWDs and their teachers declared masturbation sinful and harmful to health.  However, about one-fourth of PWDs, mostly young, provided scientific explanations for most of these SRH myths.

Many staff members of special education had stereotypes of PWDs (e.g. over-sexed, stubborn, argumentative; prefer to interact with/marry persons of their own disability, do not share SRH matters with families). One reason for these stereotypes may be a lack of intimacy between the staff and students of special education institutions.  This is also evident in the disciplinary approach adopted by many staff members towards PWDs (separate boys and girls, do not let them be alone, always keep an eye on them, keep them busy, punish them for misbehaviour, etc.), focusing not on the SRH problems faced by PWDs, but the problems faced by staff in dealing with the SRH issues of PWDs.

There was considerable sharing regarding SRH matters between students with disabilities and their family members, as well as their friends and acquaintances (though the latter is considered an unreliable source by many PWDs). The incorrect idea that PWDs do not share SRH matters with family members may be based on the fact that this is more likely to be true of non-disabled children, who are much more independent, and have far greater access to persons outside the family than PWDs.  Since most PWDs are greatly dependent on their families, it can be expected that they share SRH matters with them much more frequently than non-disabled persons.
The data clearly shows that sexual harassment takes place in institutions where PWDs live and/or study, that there is a definite increase in the reporting of harassment of PWDs in institutions during the last year, and most cases are dealt with by the staff of the concerned institutions without informing or involving high ups.  At the same time we find that most staff members tend to deny the presence of harassment in their own institutions.  There is limited awareness of the law regarding sexual harassment, and is limited to punishment for the harasser, without any knowledge for the need for a committee to deal with complaints.  There is also a tendency to focus on the victim of harassment but not the perpetrator. 

On the whole one finds the prevalence of an exclusive approach regarding PWDs.  Most service providers and staff talk about separate facilities for PWDs regarding SRH and other services.  There is considerable talk of fixing the impairments and disabilities of PWDs, but little talk of fixing the society which is responsible for impairments and disabilities turning into handicaps, mainstreaming PWDs, or focusing on their constitutional rights. 

What is heartening to see however, perhaps for the first time in Pakistan, is the growing voice of PWDs themselves, which is both challenging and influencing decision makers at the highest levels, and bringing the discussion on inclusiveness and rights at the centre stage of the debate.  This is of course timely, since a number of policies and bills regarding PWDs are in the process of being finalised.

Recommendations

It is obvious from the findings and conclusions of the study that improving the situation of SRHR of PWDs in Pakistan will require a massive, concerted and long-term effort of all key stakeholders.  The present study is only a small beginning, and highlights some of the key issues involved.  In order to move forward certain short, medium and long term measures are recommended.

To start with the findings and recommendations of this report should be disseminated to key stakeholders and decision makers.  Since the present study is limited to one city, it cannot be deemed to represent the situation of SRH in Pakistan.  In order to use the study findings for advocacy and lobbying, a larger, national level study will have to be conducted, including the formation of a National Reference Group, on the lines of the Reference Group formed for this study.  The findings of such a national study should be used to develop key messages for policy makers, which can sensitize them to the need to develop a national policy and strategy for improving SRHR of PWDs.  Organisations of PWDs, which have become quite active in Pakistan, and which have contributed significantly to this study, can play a prominent role in leading the advocacy effort.

Another important strategy to get useful information on SRHR and PWDs is to lobby the government/Ministry of Health/Statistical Bureau so that future surveys on reproductive health in Pakistan include PWDs in their sample and report findings separately for people without disabilities and people with disabilities. This has been done successfully in other countries and would provide very useful information on similarities and differences in the knowledge, attitude and practice and help target services better.

Since there is easy access to special education and health care institutions at the Lahore level, a pilot programme for developing the SRH knowledge and skills of special education staff, health care staff dealing with PWDs, parents of PWDs, and PWDs themselves should be initiated.  It could include the following: development and distribution of easy to read pamphlets (including graphics, braille) on SRH for PWDs and their parents; development and conduct of a training programme for staff on CRPD, SRH, interpersonal skills, scientific and religious views regarding SRH; orientation of parents on SRH at Parent Teacher Meetings by trainers/staff; formation of anti-sexual harassment committees at each institution as per the law, followed by preventive actions at institutional level; establishment of peer counselling centres in institutions for PWDs, with SRH trained PWDs as mentors and trainers; development of culturally sensitive audio and video clips on SRH of PWDs for dissemination through electronic media, and simple articles for dissemination through print media.
Besides the training of staff mentioned above, other measures (e.g. involvement of former students as volunteers/interns, tutorial system, diary writing by PWDs) may also be considered for improving interaction between staff and students.  These initiatives could be coordinated by a lead agency (e.g. provincial directorates of special education) with external technical support.

Based on the outcomes of the pilot test mentioned in the foregoing, the programme may be expanded to other settings (e.g. hospitals, clinics).  Some possible measures include the introduction of SRH needs of PWDs in public health programmes so that health care providers are sensitized and equipped to deal with these needs in an appropriate manner, and the demonstration of a model of health care in public and private health care settings addressing the SRH needs of PWDs (e.g. easy access to health providers, providers trained to handle SRH needs of PWDs, sign language facilities).  Long term measures could include the review of draft bills and policies on SRH from the perspective of PWDs, and the inclusion of SRH needs in policies and bills on PWDs.  Civil society and research organisations focusing on health, human rights, special education, inclusive development, need to be actively involved in advocacy for the provision of services and awareness-raising for de-stigmatizing barriers. The sample may be widened to include transgender persons with disabilities, and persons from diverse religious communities and ethnic backgrounds in Pakistan.

The rights of disabled people are defined as medical care, employment opportunity, transportation equality and access to government-funded broadcasting. 6 This distinction, between "rights" and "needs" was informed by feminist scholarship, primarily Peggy McIntosh, in the Curriculum Studies Reader, 2009 by Eds. Flinders and Thornton. 7 The needs of disabled people include, but not limited to educational, cultural, linguistic, physical, emotional, civic needs. 8 A more extended discussion is in the Theoretical Framework section.

"Legal capacity is presumed for individuals who are not labeled as disabled, while capacity mustbe negotiated by those with intellectual, significant psychosocial, and communication disabilities. These individuals are presumed to lack legal and decision-making capacity and consequently must negotiate their capacity to access justice, select appropriate support and care, and choose treatment or care protocols. Determining incapacity based only on a person’s status as a disabled person, or on functional incapacity based on impairment, shifts the burden of proof to individuals to show they have the capacity to exercise their right to autonomy.
This chapter explores international treaties and guarantees of rights that affect the exercise of legal capacity. It addresses a number of critical areas at the intersection of legal capacity and individuals with multiple and complex needs. In particular, it focuses on domestic law in Colombia and Canada in order to assess how each of those countries have recently addressed issues of competence and incompetence in complex decision-making cases and the limitations on the exercise of legal capacity. Colombia and Canada have been selected because they represent two distinct legal systems, common law (with the exception of Quebec in Canada) and civil law, and because both have progressive courts that have made advances in human rights. This chapter will examine how Colombia and Canada justify limitations on the rights of persons with complex and multiple needs, including reliance on the rationales of protecting the public (including harm to self and others), entitlement to services, and protection of individual rights. After exploring the current Colombian and Canadian laws, the chapter will outline and assess the potential that supported decision-making presents for recognizing fundamental rights.
"

Si la historia de la rehabilitación en la Argentina ya fue objeto de exposiciones rápidas (CIBEIRA : 1997), nos proponemos estudiar en este artículo cómo se construyó progresivamente, en este país, el derecho a la rehabilitación integral para las personas con discapacidad; con el fin de entender las modificaciones importantes que se llevaron a cabo desde 1946 hasta 1974. Historiar 2 un asunto supone que se reflexione con mucho más cuidado sobre la construcción del objeto de estudio, que no se puede considerar como un objeto fijo. Conviene, entonces, poner atención en «que la identidad nominal de los conceptos y de las técnicas disimula la transformación profunda de los desafíos y de la confrontación de poderes y por lo tanto de los usos sociales» (CHRISTIN, 2001 : 5). Si bien el término ''rehabilitación integral'' se ha mantenido desde los años 50 del siglo pasado, su contenido, sus fronteras y sus desafíos han cambiado según las épocas. En realidad, en este estudio, tenemos que tomar en cuenta la variabilidad histórica de tres elementos, el perímetro de la ''rehabilitación integral'', el contenido del "derecho" a la ''rehabilitación integral'', así como las categorías de personas con discapacidad que tuvieran la posibilidad de verse rehabilitadas.