A/HRC/43/41 the rights, will and preferences of individuals in the provision of support and protect them from conflicts of interest, undue influence and abuse (see A/HRC/37/56). Respect for autonomy and self-determination, including in situations which may not align with clinical best interests, is central to protecting the integrity of persons with disabilities on an equal basis with others. 66. States must immediately repeal all laws, regulations, customs and practices that allow sterilization or other surgical invasive, painful and/or irreversible procedures on girls, boys and young persons with disabilities without their free and informed consent, and/or when decided by a third party. The interpretation of a child’s best interests cannot be used to justify such practices, which conflict with the child’s human dignity, identity and right to physical integrity.56 Furthermore, the child’s best interests must be determined on a caseby-case basis and any assessment must include hearing the views of the child. States should consider adopting protocols to regulate and request the free and informed consent of children and adolescents with disabilities with regard to all medical and scientific procedures. 67. States must take all effective legislative, administrative, judicial or other measures to prevent persons with disabilities from being subjected to torture and ill-treatment. In addition, they have an obligation to criminalize acts of torture and ill-treatment, prosecute perpetrators, impose penalties and provide redress to victims. The right to redress includes restitution, compensation, rehabilitation, satisfaction, guarantees of non-repetition and the right to truth.57 D. Protecting the right to life 68. States must protect the rights of persons with disabilities on an equal basis with others. They must adopt legislation to expressly prohibit discrimination on the basis of disability in decisions to withhold or withdraw life-sustaining treatment. Those decisions must respect the rights, will and preferences of individuals, including advance directives. 58 States must also consider adopting legislation banning discrimination on the basis of disability in organ transplantation. Persons with disabilities must receive equal priority for organ transplants. Expedited complaint procedures and robust remedies are needed to protect the right to life of persons with disabilities adequately in both situations. 69. States considering legalizing any form of assisted dying should conduct extensive discussions with the active participation of organizations representing persons with disabilities. In such debates, States should pay particular attention to the social factors that may affect the decisions of persons with disabilities in relation to assisted dying, including ableism, social stigma and discrimination, societal views on the quality of life of persons with disabilities and the availability of community support and services, social protection programmes and palliative care. Assisted dying must not be seen as a cost-effective alternative to providing personal assistance and disability services for persons with disabilities, in particular those with high support needs. 70. If assisted dying is to be permitted, it must be accompanied by strong measures to protect the right to life of persons with disabilities. 59 First, access to assisted dying should be restricted to those who are at the end of life; having an impairment should never be a reason for assisted dying to be permitted. Second, the free and informed consent of persons with disabilities must be secured on all matters relating to assisted dying and all forms of pressure and undue influence prevented. Third, access to appropriate palliative care, rightsbased support (see A/HRC/34/58), home care and other social measures must be guaranteed; decisions about assisted death should not be made because life has been made unbearable through lack of choices and control. Fourth, accurate information about the prognosis and availability of peer-support counselling must be provided. Fifth, accountability regulations 56 57 58 59 16 Committee on the Rights of the Child, general comment No. 13 (2011) on the right of the child to freedom from all forms of violence, para. 61. Committee against Torture, general comment No. 3 (2012) on the implementation of article 14 of the Convention. See A/HRC/37/56, para. 44. Tom Shakespeare, Disability Rights and Wrongs (Abingdon, Oxon, Routledge, 2006), p. 169.