Assessment of individuals with disabilities in Latin America: a comparative study of the legislation

Abstract

Objective: The aim of the present study was to analyze the legislation relating to individuals with disabilities in Latin America, focusing on the definition of individuals with disabilities and how they are certified as such. 
 Method: In this investigation, the legal provisions in force in Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Dominican Republic, Uruguay and Venezuela were retrieved via the internet. It was then sought to identify the following: the specificity of guarantees of human rights and fundamental freedoms for individuals with disabilities, in line with the United Nations Convention on the Rights of Persons with Disabilities; the definition of disability and individuals with disability; what criteria are applied, i.e. whether a specific table, the International Classification of Functioning (ICF) or the International Classification of Diseases (ICD) is used; and whether the disability is assessed in a biomedical or biopsychosocial manner, i.e. whether this is done solely by a doctor or is a multiprofessional assessment, and whether, if done by a doctor, there is any support through psychological or social worker evaluation when necessary.
 Results: With the exception of Cuba, for which no specific legislation was found, the legislation dealing with individuals with disabilities in the other Latin American countries investigated in this study has been constructed in line with the main provisions of the United Nations Convention on the Rights of Persons with Disabilities. In Bolivia, Chile, Colombia, Ecuador, El Salvador, Guatemala, Honduras, Panama, Dominican Republic, Uruguay and Venezuela, disabilities are assessed and certified through tables or the ICD or ICF. Biopsychosocial assessments are made by doctors in Bolivia, El Salvador, Guatemala, Honduras, Uruguay and Venezuela. In Brazil, Chile and Ecuador, social assessments are made by other professionals to support evaluations made by doctors. In Argentina, Colombia, Costa Rica, Haiti and Panama, the assessment is biomedical. In relation to the other countries, it was not possible to understand, from the legislation, how disabilities are assessed.
 Conclusion: This study demonstrated that the laws in the countries examined here all have the purpose of guaranteeing fundamental rights and freedoms for individual with disabilities through public policies. Their aim is to enable equality of opportunity in the fields of healthcare, rehabilitation, education, work, leisure, culture and justice, in accordance with the principles recommended in the United Nations Convention on the Rights of Persons with Disabilities. Out of all the countries investigated, social assessments by professionals of other specialties to support medical evaluations are only required in three of them; tables or the ICD or ICF are used in assessing and certifying disabilities in eleven of them; the biopsychosocial assessment is made by doctors in six of them; and the assessment is biomedical in another five countries. In the remainder, the assessment criteria were not made clear through the legislation examined. 

Brazilian law of inclusion: an applied analysis of the correlation of bioethical principles

“…Disability is an evolving concept resulting from the interaction between the disabled person and the barriers erected by attitudes and the environment that prevent that person's full and effective participation in society with equal opportunities (3). When assessing the disabled person, it is essential to understand that person within their social context without overlooking the functional deficit linked to their disability.…”