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      Who controls your future: The convention on the rights of persons with disabilities from a service user focused perspective

      1 , 2
      Australian & New Zealand Journal of Psychiatry
      SAGE Publications

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          Abstract

          Although notions of personal autonomy are increasingly enshrined as the primary principle of ethical medical practice, psychiatry appears to have real difficulty in applying this. Notions such as compulsory treatment and mental health legislation serve to reinforce paternalism. This may not be in the interests of either the patient or the doctor. The Convention on the Rights of Persons with Disabilities (CRPD), although providing no new rights to mental health patients, has led to guidance as to what existing rights entail and how they should be applied. While service users were involved in the drafting of the Convention on the Rights of Persons with Disabilities, what is lacking is service user focused perspectives in the critique and debate that has ensued in response to the Convention on the Rights of Persons with Disabilities committee’s informed guidance as to the correct interpretation of the rights. Furthermore, consideration of how to translate the rights into practice is also lacking. This co-produced viewpoint aims to contribute to this debate and provides a brief overview of a novel educational approach to translating the Convention on the Rights of Persons with Disabilities committee’s guidance into clinical practice.

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          Reversing hard won victories in the name of human rights: a critique of the General Comment on Article 12 of the UN Convention on the Rights of Persons with Disabilities.

          The UN Convention on the Rights of Persons with Disabilities (CRPD) is a major milestone in safeguarding the rights of persons with disabilities. However, the General Comment on Article 12 of the CRPD threatens to undermine critical rights for persons with mental disabilities, including the enjoyment of the highest attainable standard of health, access to justice, the right to liberty, and the right to life. Stigma and discrimination might also increase. Much hinges on the Committee on the Rights of Persons with Disabilities' view that all persons have legal capacity at all times irrespective of mental status, and hence involuntary admission and treatment, substitute decision-making, and diversion from the criminal justice system are deemed indefensible. The General Comment requires urgent consideration with the full participation of practitioners and a broad range of user and family groups.
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            Interventions to Reduce Compulsory Psychiatric Admissions: A Systematic Review and Meta-analysis.

            Compulsory admissions, defined as admissions against the will of the patient (according to local judicial procedures), have a strong effect on psychiatric patients. In several Western countries, the rate of such admissions is tending to rise. Its reduction is urgently needed.
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              “Capacity”, “best interests”, “will and preferences” and the UN Convention on the Rights of Persons with Disabilities

              The United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) is the most up-to-date international legal instrument concerning the rights of persons with disabilities. Such persons are taken to include those with serious mental disorders. According to an authoritative interpretation of a crucial Article (Article 12 - Equal recognition before the law) by the UN CRPD Committee, involuntary detention and treatment of people with mental health disabilities are prohibited under the Convention. Both conventional mental health law and "capacity-based" law are deemed to violate the Convention. However, some other UN bodies are not in full agreement (for example, the UN Human Rights Committee and the Subcommittee on Prevention of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment), while others are less explicitly absolutist (for example, the Human Rights Council). Furthermore, strong criticisms of the position of the CRPD Committee have been mounted from a number of academic quarters. These criticisms center on whether the role of a person's ability to make a decision can be ignored, no matter the circumstances. Much of the above debate turns on the concept of "legal capacity" and the now often-repeated precept that one must always respect the "will and preferences" of the person with a disability. However, "will and preferences" remains undefined. In this paper, I offer an analysis of "will and preferences" that can clarify interventions that may be acceptable or non-acceptable under the terms of the UN Convention.
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                Australian & New Zealand Journal of Psychiatry
                Aust N Z J Psychiatry
                SAGE Publications
                0004-8674
                1440-1614
                February 2020
                December 11 2019
                February 2020
                : 54
                : 2
                : 134-137
                Affiliations
                [1 ]Department of Psychological Medicine, University of Otago, Wellington, New Zealand
                [2 ]World of Difference Group, Department of Psychological Medicine, University of Otago, Wellington, New Zealand
                Article
                10.1177/0004867419893443
                940f3c8e-27a8-4a82-8217-7ddde3b1e76f
                © 2020

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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