Selvstendig liv og smittevern – rettigheter i krysspress under covid-19-restriksjoner for personer med utviklingshemming

Abstract

I artikkelen retter vi søkelyset mot helse-og omsorgstjenester for personer med utviklingshemming, og vi diskuterer hvordan tjenesteytere erfarte ulike krysspress mellom smittevern og selvstendig hverdagsliv under den første koronanedstengningen. Artikkelen bygger på en kvalitativ intervjustudie som ble gjennomført i juni 2020, hvor 19 tjenesteytere ved kommunale botilbud i ulike deler av landet deltok. Gjennom vår analyse av datamaterialet fremkom det at sikring av den enkeltes rett til smittevern kan stå i krysspress med retten til respekt for eget hjem, til et selvstendig liv og til en aktiv og meningsfylt tilvaerelse. Vi finner videre at smittevernspraksisen kan medføre nye former for «institusjonalisering».

Staffs' experiences and strategies to maintain care for individuals with intellectual disabilities living in supported living facilities during the Covid‐19 pandemic

“…Municipalities were given the responsibility for implementing measures to reduce the risk of infection for individuals receiving municipal health care and care services, including people with intellectual disabilities (Melbø et al, 2021). People with intellectual disabilities have a higher risk of severe illness from Covid‐19 due to a high prevalence of underlying health conditions such as diabetes, obesity, cardiovascular disease, hypertension, and more, all of which are associated with severe outcomes of Covid‐19 (Doody & Keenan, 2021; Lunsky et al, 2022; Melbø et al, 2021; Røstad‐Tollefsen et al, 2021). They are also vulnerable to infection due to cognitive challenges and often live in supported living facilities with frequent contact with multiple staff members (Doody & Keenan, 2021; Melbø et al, 2021).…”

“…People with intellectual disabilities have a higher risk of severe illness from Covid‐19 due to a high prevalence of underlying health conditions such as diabetes, obesity, cardiovascular disease, hypertension, and more, all of which are associated with severe outcomes of Covid‐19 (Doody & Keenan, 2021; Lunsky et al, 2022; Melbø et al, 2021; Røstad‐Tollefsen et al, 2021). They are also vulnerable to infection due to cognitive challenges and often live in supported living facilities with frequent contact with multiple staff members (Doody & Keenan, 2021; Melbø et al, 2021).…”

With the best intentions: Implications on self‐determination during Covid‐19 restrictions

“…Ervin and Hobson‐Garcia (2020) highlight practical issues which service providers must consider in the challenging balance between providing services to protect the health and safety of people with intellectual disabilities, whilst safeguarding their right to self‐determination. Melbøe et al (2021) and Kane and Melbøe (2022) discuss how the individual's right to infection control measures can represent unreasonable limitations considering the right to an independent, active and meaningful life, and may imply new forms of “institutionalisation.” Desroches et al (2022) stress how the right to self‐determination regarding socialisation was restricted to a much greater extent for people with intellectual disabilities than for others. According to Liddell et al (2021, p. 14), a “blanket policy” on isolation rather than individually adapted restrictions “is likely to be unlawful,” and the authors highlight the importance of exhausting “soft” protection strategies before imposing “hard” ones.…”

“…On this basis, we have raised the importance of investigating these pressures also from a Norwegian perspective. This article represents the fourth research theme in our project regarding independent living and infection control during Covid‐19 (Gjærum et al 2021; Kane & Melbøe, 2022; Melbøe et al 2021).…”

“…Panocchia et al (2021) warns how this shift challenges the existing paradigm for service provision with person-centred services and decision support for people with disabilities, and under disguise of public health concerns causes a return to paternalism.Prior literature focusing on how the Covid-19 pandemic influenced people with intellectual disabilities' autonomy and selfdetermination is still limited. Ervin and Hobson-Garcia (2020) highlight practical issues which service providers must consider in the challenging balance between providing services to protect the health and safety of people with intellectual disabilities, whilst safeguarding their right to self-determination Melbøe et al (2021). andKane and Melbøe (2022) discuss how the individual's right to infection control measures can represent unreasonable limitations considering the right to an independent, active and meaningful life, and may imply new forms of "institutionalisation.…”