A/63/175 (d) Violence against persons with disabilities, including sexual violence 66. Inside institutions, persons with disabilities may be exposed to violence by other patients or inmates, as well as by the staff of the institution. 39 In Ximenes Lopes v. Brasil, the Inter-American Court of Human Rights held that the context of violence against the patients admitted to the psychiatric hospital, combined with regular beatings and restraints imposed on the victim and the poor conditions of detention (i.e. poor health care, sanitation conditions and food storage), violated the right to physical and mental integrity and the prohibition of torture and ill-treatment under article 5, paragraphs 1 and 2, of the American Convention on Human Rights. 40 67. The Special Rapporteur reiterates that custodial rape constitutes torture if carried out by or at the instigation of or with the consent or acquiescence of public officials, including officials working in hospitals, care institutions and the like. 41 68. In the private sphere, persons with disabilities, men and women alike, are up to three times more likely to be victims of physical and sexual abuse and rape, 42 both at the hands of family members and by their caregivers. Women and girls experience high rates of violence, including intimate partner violence, as a result of double discrimination on the basis of gender and disability. 43 In Z. and Others v. the United Kingdom and in A. v. the United Kingdom, the European Court of Human Rights recognized the obligation of States to take measures to protect individuals and, in particular, children and other vulnerable persons from ill-treatment, as well as to take reasonable steps to prevent ill-treatment of which the authorities had or ought to have had knowledge. 44 69. As stated in article 16 of CRPD, States have an obligation to take all appropriate measures to prevent and protect persons with disabilities from all forms of violence, abuse and exploitation, within and outside the home, including their gender-based aspects, and to investigate and prosecute those responsible. The Special Rapporteur notes that State acquiescence with regard to violence against persons with disabilities may take many forms, including discriminatory legislative frameworks and practices such as laws depriving them of their legal capacity or failing to ensure equal access to justice of persons with disabilities, resulting in impunity for such acts of violence. __________________ 39 40 41 42 43 44 08-44075 See MDRI and Center for Legal and Social Studies (CELS), Ruined Lives, Segregation from Society in Argentina’s Psychiatric Asylums, 2007, pp. 23-25; MDRI, Not on the Agenda: Human Rights of People with Mental Disabilities in Kosovo, 2002, pp. 10 and 11; MDRI, Behind Closed Doors: Human Rights Abuses in the Psychiatric Facilities, Orphanages and Rehabilitation Centers of Turkey, 2005, pp. 12, 23, 24. See also Human Rights Watch, Ill-equipped, op. cit., pp. 56-59 and 92. K. L. Raye, Women’s Rights Advocacy Initiative: Violence, Women and Mental Disability, MDRI, 1999. See Lopes v. Brasil, op. cit., paras. 120-122 and 150. See CAT/C/GC/2, paras. 17 and 18. World Bank/Yale University, HIV/AIDS & Disability: Capturing Hidden Voices. Report of the Global Survey on HIV/AIDS and Disability (Washington, D.C.: World Bank, 2004), p. 11. See Human Rights Watch, Women and Girls with Disabilities, available at http://www.hrw.org/ women/disabled.html and P. E. Erwin, Intimate and Caregiver Violence Against Women with Disabilities, Battered Women’s Justice Project-Criminal Justice Office, 2000. See Z. and Others v. the United Kingdom, application No. 29392/95, judgement of 10 May 2001, paras. 73 and 74 and A. v. the United Kingdom, application No. 25599/94, judgement of 23 September 1998, para. 22. 17