A/HRC/43/41 disabilities; commissioned a study on access to justice for persons with disabilities; and contributed to the United Nations global study on children deprived of liberty. 7. The Special Rapporteur continued to collaborate closely with the special procedures system, the treaty bodies and other United Nations experts and entities, including the Office of the United Nations High Commissioner for Human Rights (OHCHR), the Office for the Coordination of Humanitarian Affairs, the United Nations Development Programme, the United Nations Children’s Fund, the World Health Organization and the United Nations Partnership to Promote the Rights of Persons with Disabilities. She also engaged with regional organizations, national human rights institutions, organizations of persons with disabilities, other non-governmental organizations, universities and the diplomatic community. C. Communications 8. Summaries of communications sent and replies received during the period covered by the present report are available in the communications reports of the special procedures (A/HRC/40/79, A/HRC/41/56 and A/HRC/42/65) and in the public communications database of OHCHR. III. Lives not worth living 9. Despite the significant advances in the recognition of the rights of persons with disabilities at international and national levels, the deeply rooted negative perceptions about the value of their lives continue to be a prevalent obstacle in all societies. Those perceptions are engrained in what is known as ableism; a value system that considers certain typical characteristics of body and mind as essential for living a life of value. Based on strict standards of appearance, functioning and behaviour, ableist ways of thinking consider the disability experience as a misfortune that leads to suffering and disadvantage and invariably devalues human life. As a result, it is generally assumed that the quality of life of persons with disabilities is very low, that they have no future to look forward to and that they will never live happy and fulfilling lives. 4 10. Ableism leads to social prejudice, discrimination against and oppression of persons with disabilities, as it informs legislation, policies and practices. Ableist assumptions lie at the root of discriminatory practices, such as the sterilization of girls and women with disabilities (see A/72/133), the segregation, institutionalization and deprivation of liberty of persons with disabilities in disability-specific facilities and the use of coercion on the basis of “need of treatment” or “risk to self or to others” (A/HRC/40/54), the denial of legal capacity on the basis of mental capacity (A/HRC/37/56), the denial of treatment on the basis of disability (A/73/161), or the failure to consider the extra costs of living with a disability (A/70/297). 11. The eugenics movement was born out of, and grew on, the basis of ableist premises during the late nineteenth and early twentieth centuries. Under this widely accepted approach, thousands of persons with disabilities, including children, were prevented from reproducing through forced sterilization programmes in North America and Europe. 5 In Germany, Nazi eugenic practice was responsible for the murder of approximately 300,000 persons with disabilities who were considered to have “lives unworthy of life”.6 Unlike the widespread moral revulsion and outrage against comparable atrocities of the twentieth century, the significance of the eugenics movement and its impact on how societies 4 5 6 See Ron Amundson, “Disability, ideology, and quality of life: a bias in biomedical ethics”, in Quality of Life and Human Difference, David Wasserman, Jerome Bickenbach and Robert Wachbroit, eds., (New York, Cambridge University Press, May 2005). See David Pfeiffer, “Eugenics and disability discrimination”, Disability & Society, vol. 9, No. 4 (1994); Daniel J. Kevles, “Eugenics and human rights”, BMJ, vol. 319 (7207) (August 1999); and Ayça Alemdaroğlu, “Eugenics, modernity and nationalism” in Social Histories of Disability and Deformity, David M. Turner and Kevin Stagg, eds. (Abingdon, Oxon, Routledge, 2006). See Michael Robertson, Astrid Ley and Edwina Light, The First into the Dark: the Nazi Persecution of the Disabled (London, Ubiquity Press (UTS ePress), 2019). 3