A/HRC/43/41 with a newly acquired impairment may opt for assisted dying based on prejudices, fears and low expectations of living with a disability, before even having the chance of coming to terms with and adapting to their new disability status. Second, persons with disabilities may decide to end their lives because of social factors, including loneliness, social isolation and lack of access to quality support services. A third problem is that persons with disabilities, particularly older persons with disabilities, may be vulnerable to explicit or implicit pressures arising from their context, including expectations from family members, financial pressures, cultural messages and even coercion. 38. Generally, when life-ending interventions are normalized outside the end stage of terminal illness, persons with disabilities and older people may increasingly feel the need to end their lives. For example, the available data from two countries show an increase in the demand for euthanasia among people who are not terminally ill, particularly persons with psychosocial disabilities and dementia. 35 Nevertheless, many disability rights advocates also oppose assisted dying in terminally ill contexts, as they fear it will put at risk persons with new or progressive disabilities or diseases, who may be mistakenly diagnosed as terminally ill but who have many years of life ahead of them. 36 VI. Embracing disability as part of human diversity 39. The Convention on the Rights of Persons with Disabilities, adopted in 2006, provides the most appropriate framework from which to approach the issues arising at the intersection of bioethics and disability. The Convention embodies a shift of paradigm in the way persons with disabilities are perceived, which entails a move from the medical model to the human rights model of disability. While the former reduces disability to a medical phenomenon of impairment, the latter recognizes disability as a social construct. In doing so, the Convention locates the “problem” of disability outside the person and within society by recognizing that social barriers are the main obstacles for the enjoyment of human rights by persons with disabilities. Persons with disabilities are considered as subjects of rights rather than objects of charity, protection or care. That entails recognizing their equal value and ensuring that all persons with disabilities enjoy all human rights and fundamental freedoms without discrimination. 40. The Convention embraces differences between human beings and underlines the importance of taking the diversity of the human experience into account. Society has traditionally ignored or discounted the difference of disability and thus societal structures have not considered the rights of persons with disabilities. The Convention restores the importance of the human being in the human rights discourse by emphasizing the individual and social aspects of the human experience. In that way, the Convention challenges traditional approaches to disability and has the potential to redress the legacy of disempowerment, paternalism and ableism. 37 A. General principles of the Convention on the Rights of Persons with Disabilities 41. The general principles of the Convention on the Rights of Persons with Disabilities are fundamental for ensuring a human rights approach to disability while medical and scientific practice concerning persons with disabilities are under discussion. The principle of respect for inherent dignity, individual autonomy, including the freedom to make one’s own choices, and independence of persons (art. 3 (a)) must, in particular, be of primary consideration. The term dignity appears in the Convention more often than in any other 35 36 37 10 Ibid. See Marilyn Golden, “Why assisted suicide must not be legalized”, Disability Rights Education & Defense Fund, available from https://dredf.org/public-policy/assisted-suicide/why-assisted-suicidemust-not-be-legalized-2. See Gerard Quinn and Anna Arstein-Kerslake, “Restoring the ‘human’ in ‘human rights’: personhood and doctrinal innovation in the UN disability convention” in The Cambridge Companion to Human Rights Law, Conor Gearty and Costas Douzinas, eds. (Cambridge, Cambridge University Press, 2012).

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