Report on the State of Human Rights in Institutions for Persons with Disabilities
tion with the aforementioned, it is important to revise the doctrine of “medical necessity” established by the European
Court of Human Rights, which the court discussed in the case of Herczegfalvy v. Austria102. Accordingly, regardless of
what type of “intent” (that of help, treatment, etc.) medical staff uses as an argument, it is important to appropriately
document all circumstances when assessing ill treatment towards persons with disabilities and accurately describe the
harm sustained by the person. The staff of residential institutions for persons with disabilities also has a habit of saying
that persons with mental health problems do not feel pain [in the case of ill-treatment] due to mental disorder. This is a
classic stereotypical opinion which must be immediately eradicated by human rights organizations.
The Working Group on Violence against and Ill-treatment as well as Abuse of People with Disabilities103 of the Council of Europe has actively deliberated on the difficulty of identifying violence inflicted on people of the aforementioned group; to prevent the aforementioned, a publication issued by the Working Group of the Council of Europe
included concrete forms and definitions of violence and ill-treatment towards people with disabilities104:
physical violence, including corporal punishment, incarceration – including being locked in one’s home or
not allowed out, over-or misuse of medication, medical experimentation or involvement in invasive research
without consent;
sexual abuse and exploitation, including rape, sexual aggression, indecent assault, indecent exposure, forced
involvement in pornography and prostitution;
psychological threats and harm, usually consisting of verbal abuse, harassment, humiliation or threats of
punishment or abandonment, emotional blackmail, arbitrariness, denial of adult status and infantilizing
disabled persons (treating them as children);
interventions which violate the integrity of the person, including certain educational, therapeutic and behavioral programs;
financial abuse, including fraud and theft of personal belongings, money or property;
neglect, abandonment and deprivation, neglect of health care needs or other daily necessities, etc.
The aforementioned publication of the Council of Europe distinguishes between active and passive forms of violence,
or between carrying out violence, on the one hand, and restriction of protection from violence, on the other hand.
The publication pays particular attention to facts of abuse and neglect of persons with disabilities in the field of healthcare, including:
rationing of interventions on account of disability rather than clinical need;
a perceived readiness to accept euthanasia or non-intervention in cases of life threatening illness because
of an individual’s impairment;
over, or inappropriate, use of sterilization and other intrusive or irreversible methods of contraception;
neglect of personal hygiene to the extent that it presents real health hazards;
102 Herczegfalvy v Austria. With the aforementioned decision of the European Court of Human Rights No. 10533/83 of
September 24, 1992, the Court upheld the use of long-term physical restraints where such practice is determined to constitute
“medical necessity”.
103 The Working Group was set up by the Committee of Rehabilitation and Integration of People with Disabilities of the Council
of Europe in 1998, which was caused by an increase in the number of cases of abuse and ill-treatment of persons with
disabilities in the member states of the Council of Europe. The group worked in the years 1999-2001, and the results of the
group’s work were reflected in the Resolution No. 2005 (1) on Safeguarding Adults and Children with Disabilities against Abuse
of February 2, 2005, https://wcd.coe. int/ViewDoc.jsp?id=817413&Site=CM
104 Hilary Brown (2003), Safeguarding Adults and Children with Disabilities from Abuse, Council of Europe Publishing, ISBN
92-871-4918-6
NPM Report
2012
discriminatory access to routine and preventative health care;
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