Page 14 - Reduction of coercive measures

Chapter 1
A collective acknowledgment of the special vulnerability of people with disabilities to infringement on the universal right of people on self-determination can be found in the UN Convention on the Rights of Persons with Disabilities. The convention explicitly prescribes signatory nations to respect self-determination and to take measures to support persons with disabilities to exercise their rights (United Nations, 2006). To implement the convention, nations have been reviewing and renewing their laws and regulations. In the Netherlands, this has led to the drafting of the Care and Coercion law, which sets requirements for more diligence by healthcare organizations in the use of coercive measures (Romijn & Frederiks, 2012). While it may appear from the lawmaking process in the Netherlands and elsewhere that there is wide consensus regarding the value of self-determination for the quality of life of people with disabilities and the undesirability of measures that can restrict freedom, these coercive measures are still regularly applied and reduction takes place arbitrarily and inconsistently (Schreiner, Crafton, & Sevin, 2004; Williams, 2010; Williams & Grosset, 2011). Empirical research on the use of coercive measures in practice and the effect of methods to reduce their application may contribute to increasing the impact of newly formulated principles and laws.
Criticism on the use of coercive measures and hence the need to adapt legislation and regulations have been reinforced by incidents in the Netherlands and elsewhere that involved very far-reaching and disproportionate coercive measures. At the end of the 1980s, Dutch society was shocked by the images of a young woman with intellectual disability who was tied to a wall without wearing any clothes. The societal and political debate that followed increased awareness of the rights of people with intellectual disabilities (Denktank Complexe Zorg, 2012). However, more recent examples showed that practice around coercive measures is still fraught with dilemmas. In 2011, the media showed footage of an 18-year-old man with an intellectual disability who had been trained to tie himself to a wall upon signal from the care staff. He spent his time almost exclusively indoors. For several years, the care organization had tried unsuccessfully to develop a care plan that would both ensure the physical safety of
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