A Human Rights update from Mary Radnofsky

DAI member Mary Radnofsky reports from her time at the United Nations in New York. Mary has also provided a gallery of images she took whilst attending the meeting representing us. Thank you from all of us Mary.

Dear Fellow Members of Dementia Alliance International (DAI),

I was recently in New York to represent DAI at the annual United Nations Conference of States Parties (COSP) to the Convention on the Rights of Persons with Disabilities (CRPD) June 13-17, 2016.

DAI’s Human Rights Adviser, Professor Peter Mittler, had to be in Brussels for another important event and has contributed background information for this report.

DAI is the global organisation OF people with dementia. We work in close but autonomous partnership with Alzheimer’s Disease International: the global organisation FOR people with dementia. In April 2016, the Council of ADI adopted a human rights-based policy, which includes full access for people living with dementia to the CRPD.

The United Nations has two basic roles: Peacekeeping and Economic and Social Development.

The UN commitment to human rights was reflected in the original Universal Declaration of Human Rights in 1948. This was followed by legally binding Conventions on Economic, Social and Cultural Rights; Civil and Cultural Rights and by a series of Conventions designed to benefit sections of the world’s populations who were not benefiting from the 1948 Declaration: women, children, people exposed to racial discrimination and torture, migrant workers. The CRPD is the most recent of these treaties, and preliminary discussions are now taking place on a Convention on the Rights of Older Persons.

The UN Convention on the Rights of Persons with Disabilities (CRPD)

The CRPD is an international treaty whose purpose is to ensure that governments safeguard the human rights of persons with disabilities. Because it was adopted by the UN General Assembly in December 2006, we are celebrating the 10th anniversary of a landmark international agreement that holds governments both to a moral standard and to a commitment in international law to promote and protect the rights of people with disabilities.

ISSUES RAISED BY DEMENTIA ALLIANCE INTERNATIONAL

Although people living with dementia are included in the broad definition of disability in Article 1 of the CRPD, they are being excluded from its implementation by their governments (except in Scotland).

In addition, new regional and national dementia strategies launched in the last few years by governments who have ratified the CRPD have not used CRPD Principles and Articles to underpin these strategies.

This may reflect the fact that organisations for people with dementia were not present when Disabled Persons’ Organisations first proposed such a Convention to the UN in the 1980s, while it was being co-drafted by government representatives and Disabled Persons’ Organisations or in its subsequent development and monitoring.

Under the Convention, DAI already has the right to raise its concerns with the United Nations, the European Commission and the World Health Organisation because the exclusion of people with dementia from an international treaty to which they are legally entitled is tantamount to discrimination, even though this may not be the intention.

Participants at the Conference of States Parties (COSP)

Delegates from the 165 countries that have ratified the CRPD assemble yearly for the COSP to discuss what has, and has not been achieved in meeting the requirements of the treaty.

Non-Governmental Organisations and Disabled Persons Organisations can also send representatives, as can all recognised Civil Society Organisations. The unique character of the CRPD Committee, 17 of whose 18 members have a disability, makes the CRPD the first UN treaty to be created and monitored by the people it is designed to benefit. Accordingly, it takes full account of the views of organisations of persons with disabilities.

Full information on the COSP, CRPD, a list of ratifying countries as well as the UN Enable Newsletters can be found on www.un.org/disabilities in English and other languages.

The United States Congress has still not ratified the CRPD, though it participated in its drafting and President Obama’s signature commits the USA to its General Principles. These are:

  1. Respect for the inherent dignity, individual autonomy, including the freedom to make one’s own choices, and independence of persons
  2. Non-discrimination
  3. Full and effective participation and inclusion in society
  4. Respect for difference and acceptance of persons with disabilities as part of human diversity and humanity
  5. Equality of opportunity
  6. Accessibility
  7. Equality between men and women
  8. Respect for the evolving capacities of children with disabilities and respect for the rights of children with disabilities to preserve their identities.

The UN 2030 Sustainable Development Goals (SDGs)

The main theme of this COSP meeting was “Implementing the 2030 Development Agenda for all Persons with Disabilities: Leaving No One Behind.”

The 17 Goals are: No Poverty; Zero Hunger; Good Health and Well-Being; Quality Education; Gender Equality; Clean Water and Sanitation; Affordable and Clean Energy; Industry, Innovation and Infrastructure; Reduced Inequalities; Sustainable Cities and Communities; Climate Action; Life Below Water; Life on Land; Peace and Justice: Strong Institutions; Partnerships for the Goals.

Because people with disabilities had not been mentioned in the original 2000-2015 Millennium Development Goals, Disabled Persons’ Organisations such as our friends at Inclusion International (www.inclusion-international.org) have worked hard and successfully to ensure that persons with disabilities were explicitly included in the indicators that have since been developed to check its progress.

DAI is applying to join the International Disability Alliance to make it clear that its advocacy includes us.

DAI has expressed its concern that people with dementia, especially in Low- and Middle-Income Countries, are at greatest risk of being Left Behind because they have not been involved in the drafting of policies to protect them. DAI will be raising this issue with the UN High Commission on Human Rights which monitors all human rights.

The four sub-themes for the COSP were:
  1. Eliminating poverty and inequalities for all persons with disabilities
  2. Protecting the rights of persons with mental and intellectual disabilities
  3. Enhancing accessibility to information, technology and inclusive development
  4. Celebrating the 10th Anniversary of the CRPD.

MY CONTRIBUTIONS, CONTACTS AND IMPRESSIONS

My name is Mary Radnofsky. I’m American. Although I was diagnosed many years ago, I’ve only ‘come out’ two months ago. I’m here to represent Dementia Alliance International. We ARE the voice of dementia: We speak for ourselves. 

Since DAI was founded by Kate Swaffer and six others in 2014, we have gained some 2000 members from across the world with a wide range of cognitive impairments and medical diagnoses of dementia, the most common being Alzheimer’s Disease. There are some 50 million people living with dementia across the world, and our numbers are set to double every twenty years because people are living longer.

Whatever our diagnoses, we are, like all of you, unique individuals. But all too often, we are stripped of that individuality at the point of diagnosis. We then become subject to the stigma, fear and ignorance that surrounds the complex and little-understood effects of this group of diseases on our day-to-day lives, in our homes, on our families and friends – effects which can lead to social isolation and the denial of our individuality.

My question was: “How can the CRPD help to eliminate culturally-systemic discrimination against people with disabilities, especially those of us who have felt that we’ve had to hide our condition rather than deal with our society’s stigma?”

As I was leaving the UN on my last day, a young man who works in the office of the UN Special Rapporteur on Disability told me that my comment regarding stigma associated with the disability of dementia was important, and the first time he had heard this issue raised. He assured me it would be included in his UN report.

Legal Capacity and Our Rights

Regarding “legal capacity” of individuals diagnosed with mental or intellectual disabilities, advocates stated that ‘substitute decision-making mechanisms’ must be replaced by ‘supported decision-making’ but these practices are on a continuum, and legal experts are split on where to draw the line.

The CRPD calls for laws which systematically allow – and often encourage – someone other than the person with the disability to make decisions on his or her behalf should be abolished. DAI maintains that decisions about competence should be based on impartial, independent assessments, such as yearly driving tests.

Klaus Lachwitz, President of Inclusion International and a lawyer, said that no country has thus far successfully implemented an assistive decision-making program that meets CRPD requirements. Several have tried but have merely substituted one decision making body for another. One complication is that people with dementia and mental and intellectual disabilities may want and need assistance. How and when to provide that assistance is difficult.

Teresa di Fiandra, from the Italian Ministry of Health explained that her country created a Support Authority to help people with decision-making – not to reduce their choices but to help them maintain autonomy as long as possible.

The Civil Society Forum

I sat in on a high-level political forum on the participation of people with disabilities, and a discussion of practical steps for implementation. When the floor opened for comments, I introduced myself as a person living with dementia and representing Dementia Alliance International, with the question,

How can people with dementia begin to participate in decision-making processes as well as in the implementation of these strategies, and become active participants or members of committees?”

Alistair de Gaetano, an expert in disability law and human rights from Dublin suggested joining advocacy groups and linking to larger networks to work on major projects together. The self-advocacy movement was a dominant theme at the conference: that is why we were there.

Several countries and organizations are highly supportive of DAI, contributing not only to our collective strength, but also to our individual mental and physical health. For example, Mohammed Ali Loutfy of Lebanon said that, despite many countries’ steps to recognize the CRPD, all governments must involve people with disabilities, because we are the experts on the conditions of our lives.

I spoke with several Italians and people from the tiny Republic of San Marino in central Italy. One of the delegates explained that when a child has a disability, there is respect for the child. The problem is that they are no longer respected when they become adults. Social attitudes must be changed.

Another Italian, Sebastiano Cardi, Vice President of the COSP, said that Italy had just adopted a new law to help people with disabilities in what he calls the “after” time, i.e., when parents or other caregivers die or leave. In other words, the state will help, but people with disabilities whose adult children care for them need back-up plans.

Speaking about the rights of women with disabilities, Judith E. Heumann, of the American Women with Disabilities Forum in Washington, DC, and advisor to Presidents Clinton and Obama, said that empowerment of disabled women is critical. In general, women with disabilities need to participate more in the electoral process, and run for political offices at all levels.

In all countries, including the US, people with disabilities are twice as likely to be un- and under-employed than non-disabled people. Yet research shows that across the board, people with disabilities boost a company’s productivity, engaging non-disabled colleagues in more creative work.

Several self-advocates with an intellectual disability from Inclusion International pointed out that many barriers to inclusion are often not due to their disabilities but rather to society’s attitudes; people with disabilities often don’t have enough choices and don’t get the needed support because other people simply don’t know or understand what those of us with disabilities find important. So it’s our responsibility to make our voices heard. Self-advocacy is key.

When Klaus Lachwitz, President of Inclusion International was asked what was missing from the dialogue on people with disabilities, he unflinchingly stated

 “What’s missing is the big group of people with dementia. We’re a generation of people getting older. We all know people with dementia… So all of these things have to be discussed, interpreted and described”.

GENERAL OBSERVATIONS

Prince Hussein of Jordan, who reported on advances in his country, commended the UN on refurbishing the General Assembly Hall but added that the high podium should be accessible. This was, after all, a Conference on the Convention on the Rights of Persons with Disabilities. The panel of officials had to sit behind a fold-up table at ground level, squeezed in front of the first row of delegates because there are a dozen stairs to get to the high podium!

Equally ironic and unfortunate were the elections for membership of the CRPD committee by Member States resulting in seventeen men and only one woman. This happened despite clear guidance from the UN that the Committee should be balanced for gender, ethnicity and location.

On a positive note, one of the men elected was Robert Martin, proposed by the New Zealand government, a self-advocate, and the first person with an intellectual disability to sit on the committee. He helped draft the CRPD and has been active in its implementation ever since.

It took ten years for a person with an intellectual disability to be elected. How long will it take for a person with dementia to join him? 

IMPLICATIONS FOR DEMENTIA ALLIANCE INTERNATIONAL

At DAI, we are uniquely situated to provide the expertise needed for these discussions. There is a role for all of us to play as we advocate for our rights and simply show how we can live well with dementia for many years.

So start to think about what YOU can do to improve the lives of people with dementia – including your own. You might want to print and mail out flyers, make phone calls, write or edit letters, do fundraising, put an ad in the paper or online for group events, record stories from people living well with dementia, speak to classrooms or clubs, assemble articles about brain research, post notices of drug trials and non-pharmaceutical treatments, attend support groups, share recipes, describe successful dietary and exercise ideas – above all, recruit new members to DAI!

I need DAI so I can maintain the quality of life that I’ve found through support groups and advocacy. DAI needs you because you can make a difference in the world for everyone whose lives you touch. Through letters, social media, phone, email, and in person, you can still reach a lot of people that need DAI too.

Let’s continue to help each other enjoy our lives, starting with our human right to medical care, living in our communities, and choosing how we want to be treated.

Thanks.

Mary L. Radnofsky, Ph.D.
June 28, 2016