Fallon-Kund Marie, Coenen Michaela, Bickenbach Jerome E
Department of Health Sciences and Health Policy, Faculty of Humanities and Social Sciences, University of Lucerne, Lucerne, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland.
Department of Medical Informatics, Biometry and Epidemiology - IBE, Ludwig-Maximilians-Universität (LMU) München, Munich, Germany.
Int J Law Psychiatry. 2017 Jul-Aug;53:69-76. doi: 10.1016/j.ijlp.2017.06.002. Epub 2017 Jun 24.
Respect for individual autonomy is at the core of the Convention on the Rights of Persons with Disabilities (CRPD). However, the need to protect persons with disabilities, especially those with cognitive impairments and psychosocial conditions, from outright exploitation, violence and abuse is explicitly provided for in article 16. Legal authorities still decide on a daily basis upon the institution of measures, which aim to protect vulnerable persons and unavoidably impact on the autonomy of persons concerned, known as guardianship, curatorship or administration. Observations of court hearings, interviews with judges and analysis of written materials from the cantons of Geneva and Vaud in Switzerland as well as from Belgium - which all have differently composed authorities - were carried out in order to identify what influences authorities in decision-making processes regarding protective measures, and to explore how autonomy and protection can be balanced. We suggest pragmatic considerations that should not be ignored when trying to reach a balance between autonomy and protection from abuse, in line with the CRPD.
