Belgium under the UN’s microscope regarding the rights of people with disabilities: between inclusion and the extinction of Down's syndrome

The CRPD, made up of independent experts, periodically assesses the progress, challenges and shortcomings of States parties to the Convention on the Rights of Persons with Disabilities to ensure they meet the commitments made. Adopted in 2006, the Convention was ratified in 2009 by Belgium, which is one of the countries to be examined at the CRPD's next working session (from 12 August to 6 September).

A number of civil society organisations, as well as Unia (an independent public institution with particular expertise in the field), have already been able to submit written contributions in advance of this session, in order to share their observations regarding respect for the rights of people with disabilities in Belgium in recent years.

What kind of inclusion for people with disabilities?

Among the issues to be taken into account in the CRPD review are those relating to the participation and consultation of people with mental and/or physical disabilities in the political and civic sphere (particularly as regards the right to vote in elections). The inclusion of people with disabilities in the workplace is also an important issue.

In addition, the 2024 review will be an opportunity for the Committee to return to the difficulties encountered by people with disabilities during the Covid-19 health crisis, some of whom (living in accommodation centres) were faced with complete isolation during periods of confinement.

The accessibility of the healthcare that their situation requires will also certainly be closely examined (particularly in terms of social security coverage of certain consultations such as speech therapy).

From generalised screening to the gradual extinction of people with Down's syndrome

In terms of bioethics, it remains to be seen whether the CRPD will examine the social and ethical implications of widespread prenatal screening for Down's syndrome in Belgium, using the NIP-test. This non-invasive blood test is routinely offered to pregnant women, and is fully reimbursed by the Belgian state. There is no official campaign to encourage women and couples to keep the child or, conversely, to have an abortion if a trisomy is detected (particularly for Down’s syndrome, the most common). Although carers are supposed to leave the choice to couples faced with this announcement, over 95% of pregnancies are nevertheless aborted in the event of a diagnosis of Down’s syndrome in Belgium (see IEB 25/02/2021).

This trend, which is also present in other countries such as the Netherlands and Sweden, has already prompted the UN committee to question its societal implications.

Link between screening and rejection of people with disabilities

The increasingly positive reception given by our societies to people with Down's syndrome contrasts fundamentally with the assessment of the undesirable nature of the birth of these same people. There is a risk that, because their disability can been detected and their birth can be avoided, the parents of these children will be perceived or presented as all the more responsible for their care, or even their situation.

Last March, in its comments on Sweden, the CRPD expressed its ‘concern’ about ‘Negative attitudes against persons with disabilities, in particular against persons with intellectual and/or psychosocial disabilities, permeating processes and decisions on prenatal testing and abortion, geared towards the extinction of certain types of intellectual impairments’. The Committee recommended that the Swedish authorities ‘ensure that medical and social advice on prenatal testing and abortion rendered by professional staff does not convey negative attitudes against persons with intellectual and/or psychosocial disabilities and is not aimed at extinguishing certain types of impairments’.

The massive recourse to screening and abortion also contrasts with the continuous improvement in the living conditions of people with Down's syndrome, both in terms of their health and their social and professional integration.