IX. Health Services Situations
Article 13 of the Constitution, identifies the Department of Health (DOH) as the Lead agency in servicing the sector of persons with disabilities. In compliance with this provision, in the structure of the National Anti Poverty Commission of Republic Act 842559, is called the Champion of the Sectoral Council of Persons with Disabilities. This may be a result of the old and rejected medical views of disabilities, which considers persons with disabilities as incessantly sick and diseased citizens.
The progressive dominance of the social model and the rights-based approach does not in any manner diminished the entitlements of persons with disabilities to adequate and quality health services. There is no question on the expertise of medical and other health professionals relative to the individuals’ and public health programs. The CRPD however is explicit in the principle of informed consent prior to any interventions that would be done to patients including patients with disabilities. Furthermore, while certain impairments may need maintenance treatments either to arrest or delay the progress of further disabilities, the same degree of respect for informed consent prior to any interventions must be strictly and consistently observed.
Relating in particular to persons with psycho social disabilities, during lucid intervals, an agreement or prior consent must be forged on how he or she would be dealt with if a professional or group of professionals should comply with the letter and spirit of Article 12 of CRPD The inherent legal capacity is extended to actual performance of one's inherent and autonomous right on decision making. In the provision in Article 12, it states that States Parties shall recognize that persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life; and Subject to the provisions of this article, States Parties shall take all appropriate and effective measures to ensure the equal right of persons with disabilities to own or inherit property, to control their own financial affairs and to have equal access to bank loans, mortgages and other forms of financial credit, and shall ensure that persons with disabilities are not arbitrarily deprived of their property.
On the issue of full inclusion, since the 1990s, DOH had intensified its program on the prevention of diseases and conditions that may cause disabilities. Immunization drives against measles, polio, and other diseases identified as causing blindness and orthopedic impairments must be equally serviced to those with congenital blindness and mobility impairments. Access to all types of medical, health and interventions must be granted to persons with disabilities on an equal basis with the rest of the population. This includes the provision of accessibility features in hospital and clinic buildings and the adequate training of professionals and health staffs in dealing with patients with disabilities. Staff with a basic understanding of sign language must be readily available when deaf and hard of hearing patients visit for consultations.
RA 7277 as well as Batas Pambansa 34460 explicitly declare the imperative of integrating the concerns of persons with disabilities in all types of public services, including health and medical. But, the blatant disregard of these mandates have caused the marginalization and even the deprivation of the sector of these basic rights based services.
A survey in 2002 revealed that a large percentage of citizens residing in non urban areas do not experience any medical care at all,61 thus, the need to strengthen barangay or community health centers has been on the priority list in health care advocacy.In study of 2006 revealed that the sector also looks on the realization of these goals as imperative due to the fact that that over 70 percent of persons with disabilities reside in rural communities
.62 Instead of bringing persons with disabilities to the urban centers, health and medical care services should rather be brought to them. Availability and affordability of needed medicines and curative cares are recently being acted on through the recently enacted Cheaper Medicine Law or RA 950263. The Generics Law or RA No. 667564 was enacted in 2000 with the intent of making available indigenous herbal based medicines to the populations. In response to the dwindling supply of medical practitioners, Philippine Association of Human Rights Advocate (PAHRA) medical workers have been recognized through legislative actions.
On the issue of participation in activities directly affecting the sector, from the start of the formulation of the National Health Plan of Actions for Persons with Disabilities, has consistently involved representatives of the identified seven (7) disability groups -ortho/moving disabilities, communication deficits, visual/seeing disabilities, learning (cognitive or intellectual) disabilities, chronic illnesses with disability, mental disabilities, and psychosocial and behavioral. It is the understanding of the Sectoral Council of Persons with Disabilities that the sector’s representatives should be also consulted and allowed to participate and benefit in various consultations and formulations of programs and projects of general application. For example, the aggressive campaigns on proper nutrition like the Vitamin - A campaign and the delivery of primary nutrition and health care services using the community-based rehabilitation or CBR approach should also practice participation of members of the sector. The project of on early detection and intervention against signs of visual impairments, which is being conducted in schools, in coordination with the Department of Education, must also benefit pupils with low vision and other types of impairments. In the Munting Doktor
(Little Doctors) program, where children are taught to teach their elders how to examine their vision, pupils with disabilities should also participate. Parents of children with disabilities in schools have reported that their children are often left out of these activities.
Unlike other tribes, the sector of persons with disabilities would not like their tribe to increase. Organizations of the blind and visually impaired persons are fully supportive of the Visions 2020 which is an aggressive campaign on cataract surgery with the aim of eliminating avoidable blindness. The sector commends the government on the report of the Institute of Opthalmology that since 1995 to 2002, due to greater awareness of the citizenry, a 17 percent decrease in the incidence of blindness occurred as a result of the programs65. On the other hand, the blind and vision impaired sector laments the fact that there are other causes of blindness that are hardly remediable and are creeping up the ladder of the 10 common causes of blindness, The sector is willing to join all efforts to ensure that the remediable causes like cataract, corneal opacities and refractive errors are wiped out as a public health problem in the next 10 years, or even earlier. Organizations of blind people would like to be counted among the stakeholders of the projects under Vision 2020 Philippines. The principle of full participation mandates that persons with disabilities be among the supporters and implementers, on an equal basis as all other stakeholders.
- Note #65
- Excerpt from the Country Report of Capt. Oscar J. Taleon presented in Belgium 2007.
- Return
The Philippines with its pro-life and strict anti-abortion policies does not show any records of going counter to the right to life of persons with disabilities, though, it may violate the right of women including women with disabilities to autonomy in deciding to abort pregnancies at their will. To a certain extent, medical practitioners have allowed abortion when the health and safety of mothers are endangered. In the website of pro-life Philippines, it argued that, for the cases of ectopic pregnancies and cancerous uterus, even if it has been ascertained that either the mother or the fetus will die, the doctor should maintain the principle of saving both lives. One life may be lost in the process, but only per accident, that is, without intending it.
66
Forced detention in institutions providing psychiatric care to persons with psycho-social disabilities is still prevalent. The use of electric shock, in many reported cases against the will of the individual is still a part of psychiatric interventions. In spite of having been identified as a violation of the provisions of the United Nations Convention Against Torture67 it the period when such blatant violation of inherent dignity and autonomy of individuals be a thing of the past may be yet a subject of greater aggressive struggles. The current Mental Health proposed legislation pending in both House of Congress and Senate have explicit provisions fully contrary to the Article 12, 25 and other provisions of CRPD In the proposed Mental Health Act of 2008 (DOH Brochure) of Section 6: Fundamental Rights, provision started that:
G. The State shall ensure that informed consent is obtained freely, without threats or improper inducements, pertinent disclosure to the patient of adequate and understandable information in a form or language that is understood by the patient, except under the following conditions:
- When the patient, at the relevant time, is held as an involuntary patient;
- An independent authority designated by the court deems that the patients lacks the capacity to give or withhold informed consent.
- The independent authority is satisfied that the proposed plan of treatment is in the best interest of the patient's health needs.
H. A major medical or surgical procedure may be done on a person with mental illness only where it is considered that it would best serve the interest of the patient's health needs and where the patients gives informed consent, except that, when the patient is unable to give consent the procedure shall be authorized only after an independent review.
- Note #67
- Convention Against Torture
- Return