By Gretchen Ward, MS, OTR/L, MPower Me Clinical Director
The presumption of competence is the most basic right upon which all others are founded.
In 1946, the World Health Organization identified “the highest attainable standard of health as a right to every human being.” But what does that mean for people with disabilities?
Often individuals with disabilities, especially those with cognitive limitations, are left out of the conversation regarding their own health, happiness, and right to work and live as they choose. It has only been within the last 30 years that organizations have begun to review and develop policies surrounding the rights for people with disabilities. Within the disability rights community, the movement is solidified with the phrase, “Nothing about us, without us.”
Simplified, this means each person is entitled to their own “Voice and Choice” about their care, living conditions, finances, and health. Every person, regardless of disability or need is entitled to be an active agent in their own life. How can we support this movement in our own lives with the individuals we live and work with?
One of the main ways we discuss people with disabilities is in terms of access and accessibility. If we can provide equal access to opportunities, we will achieve true inclusivity. Though accommodations for physical and sensory-neural differences (e.g. hearing and vision) such as ramps, closed captioning, and braille have become mainstream since the passing of the Americans with Disabilities Act (ADA), individuals with cognitive differences, such as focus, comprehension, time management, organization and/or emotional regulation, continue to be marginalized. They often face higher rates of poor health and are frequently left out of conversations regarding their own lives.
We must do better. The first step will be to acknowledge the inherent competence of individuals regardless of presentation.
One of the reasons people with disabilities were institutionalized and left out of human rights considerations for so long was because as a result of their disability, they were deemed incapable of basic competence and in need of “care and protection.” However, in an effort to protect these individuals, we have unintentionally silenced them. Research has shown this increases their vulnerability to undiagnosed health issues, exploitation, and abuse.
To prevent these inequities and potentially deadly outcomes, we must presume competence and honor every attempt at communication. MyGuide users call it having their own voice and choice. This is the most basic human right upon which all others are founded.