Monday 12 January 2015

Where To From Here? One Month On From Prime Time Investigates: Aras Attracta

Considering the major fall out from the Prime Time Investigation into Aras Attracta, about a month ago, we decided to take a look back at the implications to date and ask : "Where to from here? That's the question we all wish to answer!


Where do we go from a Prime Time investigation that highlights explicit and consistent abuse of people with intellectual disabilities in a care home such as Aras Attracta? Among the extensive examples of physical and emotional abuse, the culture of control and hatred was exemplified through lines such as "Even if you died, I wouldn't take you to the toilet... you should be dam glad you have a roof over your head."



Do we treat this as an unfortunate once off? Is it representative of Irish society's attitude towards our most vulnerable? Is the responsibility shared or is some single someone, somewhere responsible?

In a December episode of Prime Time, Minister Kathleen Lynch couldn't rule out the possibility that such findings were "just the tip of the iceberg".

That declaration from the Minister, combined with 700 abuse allegations, gathered over a two year period by HIQA, spells the great potential for even more Aras Attracta style revelations down the line.


Ever since December, the debate has been widespread throughout the airwaves, television channels and households of Ireland - and further afield. Some have highlighted the need for legislative change, cultural change, increased training, increased accountability, even CCTV cameras in these care homes.

But what's the real answer?

The situation is incredibly complex, and it would be naive to think that it could be fully solved within a 500 word document such as this one. Therefore, in answer to "where to from here?" we, at Capacity2Change seek to answer this question by drawing on the contribution legislative change can make to resolving the issues raised in the horrendous fall out from Aras Attracta.

We will do this by outlining the implications of current laws and the widespread calls for its reform - beyond those made by Capacity2Change. In an interview with Marian Fincuane, Colm O'Gorman, urged the government to prioritise ratification of two major UN Conventions that we signed almost 7 years ago ."The UN Convention On The Rights Of Persons With Disabilities". "The UN Convention Against Torture".  


Understanding of the current Lunacy Regulation Act (1871) can help us to contextualise these conventions. 




Due to the Lunacy Regulation Act (1871),(LRA) the victims of abuse will not be included as official witnesses entitled to give statements - and that will occur regardless of the severity of their disability of the competency they show as potential witnesses. 



The Prime Time investigation highlighted how one resident was non verbal in her expressive communication. However, she could "understand everything." Yet, the LRA deems her to "lack capacity" and thus, there is no legal obligation to hear her verison of events. Instead, legal professionals will have to rely on video evidence, as provided by Prime Time, or an eye witness who has capacity ie: doesn't have an intellectual disability. 



This law has been widely criticized as a prejudiced write off of potential witnesses, based on a diagnosis of intellectual disability. It is also completely artificial way of determining capacity - which fluctuates depending on the complexity of the decision to be made. 



These issues have been highlighted in a report published by UCC lecturers: that systematically reviews the issues how people with intellectual disabilities are included in the criminal justice system. 



"Access To Justice For People With Disabilities As Victims of Crime In Ireland."

Claire Edwards, Gillian Harold and Shane Kilcommons. 
Faculty of Law: University College Cork. 




The main findings of this report are as follows:


  • Crime against people with disabilities is significantly underreported and often fails to proceed to prosecution. 
  • Issues of capacity were seen as a key stumbling block for people with disabilities in the criminal justice system 
  • In conclusion: "People with disabilities experience numerous barriers in their encounters with the criminal justice system: from reporting to post trial experiences: some are legislative, procedural, structural, attitudinal. 
  • What is key is the need to make justice more accessible. 
  • "There is still a significant way to go in terms of people with disabilities being recognised as victims of crime with specific needs in Ireland, particularly in a context where current criminal law and capacity legislation remains outmoded and reinforces the vulnerability of people with disabilties.  

Considering both the findings of Prime Time Investigates and the above report, we can see just how relevant publication of the Capacity Bill (2013).  This is where  the objectives of Capacity2Change come in.

Here at Capacity2Change, we want the Capacity Bill (2013) to be passed into law, so that people with disabilities can be appropriately supported by the criminal justice system,That is not to say that the bill perfectly fulfills criteria for ratifying the UN conventions previously mentioned.
However, we deem it to be  a step in the right direction towards doing so.


Best Wishes,
Rachel.



Thursday 8 January 2015

The Irish Hospice Foundation and the "Think Ahead" Initiative

11th December 2014

I hope you all had a good Christmas! Our apologies for not posting for a while, but we've had exams and then Christmas mania and we're only now getting back to work! 

On Thursday the 11th of December, mid exam season, myself and
Rachel met with Angela Edghill of the Irish Hospice Foundation to discuss our campaign. The meeting was extremely productive and we left with our notebooks full of new ideas and contacts. The most interesting thing that we discussed was the Irish Hospice Foundation's initiative "Think Ahead" and how it is linked to the Capacity Bill.


Think Ahead is a campaign focusing on "living wills" or Advanced Healthcare Directives. An Advanced Healthcare Directive is a document in which a capable adult sets out what medical procedures and treatments they would not want should they lose capacity to make these decisions in the future - even if refusing these treatments leads to their death. They will also be able to indicate what treatments they would like - however this will not be legally binding, as ultimately it is the doctors decision as to which treatments are suitable. The Capacity Bill will include a provision, making the documents legally binding if they meet the following conditions: 


  1. You must be over 18 in order to make an Advanced Healthcare Directive
  2. The person must have capacity when writing the directive
  3. The directive must be in writing
  4. The person must state the specific treatments they are refusing, and the situations in which the refusal applies
  5. It must be witnessed - this is in order to prevent people from being forced to make decisions against their will
Currently in Ireland, anyone can make such a directive, however there are no laws outlining how they should be made and how doctors should treat these directives if there is a dispute about its validity. The new provision states what steps need to be followed in order to make these documents legally binding, provides a structure to manage disputes and will allow people to appoint a representative, should they need someone to make decisions for them. The document can be changed at any time, if the person has capacity. 

This provision will bring Ireland into line with international laws and conventions. It will help doctors treat patients who have lost capacity, and, most importantly, it will ensure that people do not have to undergo a treatment that they do not want. 

Any of us could lose our capacity to make decisions in the future - whether that be due to an illness such as dementia, traumatic brain injuries or falling into a coma. It is important that our right to make decisions regarding our health is acknowledged, and the best way to do so is by writing an Advanced Healthcare Directive. 

If anyone would like more information about the "Think Ahead" initiative, or Advanced Healthcare Directives there are some excellent resources available on the Think Ahead website. The Irish Hospice Foundation also has a page containing a series of video's explaining Advanced Healthcare Directives, with experts outlining different aspects of the legislation and how it will be implemented. Patricia Rickard Clarke, a former Justice Commisioner, has also written an excellent article on thejournal.ie about the importance of these directives. 

Talk to you again! 
Patricia :)