Skempes Dimitrios, Stucki Gerold, Bickenbach Jerome
Disability Policy Group, Human Functioning Unit, Swiss Paraplegic Research (SPF), Nottwil, Switzerland; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne; and SPF, Nottwil, Switzerland.
Disability Policy Group, Human Functioning Unit, Swiss Paraplegic Research (SPF), Nottwil, Switzerland; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne; and SPF, Nottwil, Switzerland.
Arch Phys Med Rehabil. 2015 Jan;96(1):163-73. doi: 10.1016/j.apmr.2014.07.410. Epub 2014 Aug 15.
Globally, disability represents a major challenge for health systems and contributes to the rising demand for rehabilitation care. An extensive body of evidence testifies to the barriers that people with disabilities confront in accessing rehabilitation services and to the enormous impact this has on their lives. The international legal dimension of rehabilitation is underexplored, although access to rehabilitation is a human right enshrined in numerous legal documents, specifically the Convention on the Rights of Persons with Disabilities. However, to date, no study has analyzed the implications of the Convention for Rehabilitation Policy and Organization. This article clarifies states' obligations with respect to health-related rehabilitation for persons with disabilities under the Convention. These obligations relate to the provision of rehabilitation but extend across several key human right commitment areas such as equality and nondiscrimination; progressive realization; international cooperation; participation in policymaking processes; the accessibility, availability, acceptability, and quality of rehabilitation services; privacy and confidentiality; and informed decision making and accountability. To support effective implementation of the Convention, governments need to focus their efforts on all these areas and devise appropriate measures to monitor compliance with human rights principles and standards in rehabilitation policy, service delivery, and organization. This article lays the foundations for a rights-based approach to rehabilitation and offers a framework that may assist in the evaluation of national rehabilitation strategies and the identification of gaps in the implementation of the Convention.
在全球范围内,残疾对卫生系统构成重大挑战,并导致康复护理需求不断增加。大量证据证明了残疾人在获得康复服务方面面临的障碍以及这对他们生活产生的巨大影响。尽管获得康复是众多法律文件(特别是《残疾人权利公约》)所规定的一项人权,但康复的国际法律层面尚未得到充分探讨。然而,迄今为止,尚无研究分析该《公约》对康复政策与组织的影响。本文阐明了各国根据《公约》对残疾人与健康相关的康复所承担的义务。这些义务涉及康复服务的提供,但延伸至几个关键的人权承诺领域,如平等与非歧视;逐步实现;国际合作;参与决策过程;康复服务的可及性、可得性、可接受性和质量;隐私与保密;以及知情决策和问责制。为支持有效实施《公约》,各国政府需要在所有这些领域集中努力,并制定适当措施,以监测康复政策、服务提供和组织中对人权原则和标准的遵守情况。本文为基于权利的康复方法奠定了基础,并提供了一个框架,可协助评估国家康复战略以及确定《公约》实施中的差距。