A/HRC/43/41 continue to dismiss the value of the lives of persons with disabilities has long remained confined to disability circles. 12. Contrary to common belief, persons with disabilities can experience a good quality of life. They consistently report a quality of life as good as, or sometimes even better than, that of persons without disabilities. 7 The earlier in life that the impairment is acquired, the higher the resulting quality of life reported. 8 Furthermore, evidence indicates that differences in quality of life perceptions of persons with disabilities are largely associated with contextual factors such as social connectedness, employment opportunities, access to quality services and community inclusion. 9 No significant differences have been found between degrees of severity of impairment. What determines the quality of life of persons with disabilities is not the impairment, but the same things that determine the quality of life of persons without a disability. As for anyone else, persons with disabilities can have fulfilling and happy lives and will also be confronted with losses and adversity, particularly in the face of discrimination, oppression and barriers. 13. The contrasting assessments of the quality of lives of persons with disabilities reflect both ableist views of disability and a lack of understanding of the role of social and environmental barriers in the experience of disability. As research has shown, the lower estimation of the quality of life of persons with disabilities by external observers, including many bioethicists, are caused by unconscious biases towards persons with disabilities. 10 Fear, ignorance and prejudices permeate the understanding of the disability experience, a process that is constantly reinforced by dominant cultural representations of disability. Many persons have never had direct experience of persons with disabilities, owing to the long-standing practice of segregation and institutionalization. 14. Some persons with disabilities themselves hold negative and prejudiced attitudes towards disability. This internalized oppression is the result of the pervasive stigma and stereotypes of persons with disabilities that abound in society. Society systematically delivers degrading and dehumanizing messages about their appearance, behaviour and worth, which can distort the perceptions of persons with disabilities about themselves and their value. Internalized oppression can lead to disempowerment but also to harmful emotions, such as shame and self-loathing, which could increase the risk of isolation and self-harm. 15. Over the last 50 years, the disability rights movement has been challenging these deeply rooted negative perceptions, stating that the real problem is the failure of society to eliminate barriers, provide the required support and embrace the disability experience as part of human diversity. However, the claims of persons with disabilities to have their rights recognized are often dismissed and the underlying power imbalance invalidates their lived experiences. Their narratives are considered to be subjective and ill-suited to informing objective decision-making and thus are not given the space to be genuinely weighed or to challenge ableism. Access to the platforms on which discussions are taking place is limited, rendering the disability movement unable to share information on an equal basis with others. 7 8 9 10 4 See Tom Shakespeare, “Nasty, brutish, and short? On the predicament of disability and embodiment” in Disability and the Good Human Life, Jerome Bickenbach, Franziska Felder and Barbara Schmitz, eds. (New York, Cambridge University Press, 2013). See Sharanjit Uppal, “Impact of the timing, type and severity of disability on the subjective wellbeing of individuals with disabilities”, Social Science & Medicine, vol. 63, No. 2 (July 2006). See Ron Amundson, “Quality of life, disability, and hedonic psychology”, Journal for the Theory of Social Behaviour, vol. 40, No. 4 (November 2010); Bernd Fellinghauer and others, “Explaining the disability paradox: a cross-sectional analysis of the Swiss general population”, BMC Public Health, vol. 12 (August 2012); and Carli Friedman and Laura VanPuymbrouck, “The impact of people with disabilities choosing their services on quality of life outcomes”, Disability and Health Journal, vol. 12, No. 2 (April 2019). See Ron Amundson, “Quality of life, disability, and hedonic psychology”.