A/HRC/18/37 problems further frustrate efforts to obtain informed consent, such as the amount of time available to doctors and health-care workers to consult with patients. Older persons may require additional attention and assistance to fully understand the implications of the healthrelated information with which they are presented and which may render them particularly affected by scarcity of available consultation time. In general, each person should receive an individualized treatment, and his/her state of health should be regularly reviewed, including his/her medication. 66. Persistent denial of the right to informed consent could constitute a form of physical and psychological abuse of older persons, who are much more prone to treatment and care without consent. This is compounded by discrimination directed against older persons, who in some cases may have a diminished capacity to consent to treatment. The Special Rapporteur previously pointed out that older persons are taken advantage of due to perceived ignorance and helplessness, as well as actual physical or mental frailty such as that caused by degenerative diseases resulting in decreased ability to provide informed consent (A/64/272, para. 51). They face more frequently situations in which informed consent is necessary, and the possibility of infringement and abuse is therefore greater. 67. Domestic jurisdictions often fail to enact legislation or design policies in order to address and resolve problems particular to informed consent and older persons. The problem of legislation on older persons and the right to health is particularly acute in developing countries, which often lack an adequate legal framework concerning guardianship or consent. In some countries, the legal requirement for informed consent is circumvented by guardianship proceedings even in partial incapacitation, replacing patient’s consent with that of the guardian. The right to health requires that States respect, protect, and fulfil the right to health, and it is incumbent upon States to develop policies and frameworks through which the right to health of older persons can be addressed to meet these requirements. It is important to establish safeguards to ensure the informed consent of older persons in the context of guardianship and build the capacity of older persons to fully understand and make use of health information.38 68. The Special Rapporteur believes that the issue of informed consent of older persons is increasingly important given global ageing and the consequent societal challenges. He further believes that international guidelines and national systems should be developed to regulate practices and ensure that older people are supported in making informed health-care decisions. It is also desirable to establish peer groups who would provide older persons with information before their visit to a doctor or other care provider for treatment, which might help overcome immediate problems such as lack of training. 69. The Special Rapporteur points to the importance of increasing awareness and empowering of older persons in order to strengthen their participation in health policymaking and build networks of older persons through which health information can be more easily accessed. It is also important that older persons are in a position to fully understand health information and make voluntary and informed decisions based on that information. It is the duty of the State to find and implement new and innovative ways to reach out to older persons, identify age-friendly means to disseminate health-related information and encourage their participation. 38 Convention on the Rights of Persons with Disabilities, arts. 12(3) and (4). 17

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