A/HRC/22/53
weight given to the child‟s views117 in determining their best interests, or may be taken as
the basis of substitution of determination and decision-making by parents, guardians, carers
or public authorities.118 Women living with disabilities, with psychiatric labels in particular,
are at risk of multiple forms of discrimination and abuse in health-care settings. Forced
sterilization of girls and women with disabilities has been widely documented. 119 National
law in Spain, among other countries,120 allows for the sterilization of minors who are found
to have severe intellectual disabilities. The Egyptian Parliament failed to include a
provision banning the use of sterilization as a “treatment” for mental illness in its patient
protection law. In the United States, 15 states have laws that fail to protect women with
disabilities from involuntary sterilization. 121
V. Conclusions and recommendations
A.
Significance of categorizing abuses in health-care settings as torture
and ill-treatment
81.
The preceding examples of torture and ill-treatment in health-care settings
likely represent a small fraction of this global problem. Such interventions always
amount at least to inhuman and degrading treatment, often they arguably meet the
criteria for torture, and they are always prohibited by international law.
82.
The prohibition of torture is one of the few absolute and non-derogable human
rights,122 a matter of jus cogens,123 a peremptory norm of customary international law.
Examining abuses in health-care settings from a torture protection framework
provides the opportunity to solidify an understanding of these violations and to
highlight the positive obligations that States have to prevent, prosecute and redress
such violations.
83.
The right to an adequate standard of health care (“right to health”) determines
the States’ obligations towards persons suffering from illness. In turn, the absolute
and non-derogable nature of the right to protection from torture and ill-treatment
establishes objective restrictions on certain therapies. In the context of health-related
abuses, the focus on the prohibition of torture strengthens the call for accountability
and strikes a proper balance between individual freedom and dignity and public
health concerns. In that fashion, attention to the torture framework ensures that
system inadequacies, lack of resources or services will not justify ill-treatment.
Although resource constraints may justify only partial fulfilment of some aspects of
the right to health, a State cannot justify its non-compliance with core obligations,
such as the absolute prohibition of torture, under any circumstances. 124
84.
By reframing violence and abuses in health-care settings as prohibited illtreatment, victims and advocates are afforded stronger legal protection and redress
117
118
119
120
121
122
123
124
20
Committee on the Rights of the Child, general comment No. 12 (2009), para. 21.
See A/HRC/20/5, para. 53 (d); A/63/175, para. 59.
See Independent Expert for the Secretary-General‟s Study on Violence against Children, World
Report on Violence against Children (2009).
Open Society Foundations, Against Her Will (footnote 43 above), p. 6, A/64/272, para. 71.
Open Society Foundations, Against Her Will, p. 6.
Convention against Torture, art. 2, para. 2, International Covenant on Civil and Political Rights, art. 7 .
See International Criminal Tribunal for the Former Yugoslavia, Prosecutor v. Furundzija, case No.
IT-95- 17/1-T, judgement (1998).
See Committee on Economic, Social and Cultural Rights, general comment No. 14.
Select target paragraph3
Connect to a paragraph
Connect to an entity
Disable highlights
Add to table of contents