I’m currently participating in a series of workshops run by the British Institute of Human Rights for my NHS trust. These workshops have given me a chance to reflect on the connection between human rights and occupational therapy. Human rights are fundamental in ensuring that people are treated with dignity, respect, and fairness. In healthcare, these principles should form the foundation of everything we do.
Having been a patient myself, I’ve had time to reflect on how well my rights were upheld, and how these experiences now influence my work as an occupational therapist.
What Are Human Rights?
Human rights are the basic rights and freedoms to which every individual is entitled. In the UK, they are protected by the Human Rights Act 1998, which incorporates the European Convention on Human Rights (ECHR) into domestic law. These rights ensure that people are protected from harm, have access to justice, and are treated fairly across all aspects of life, including healthcare.
Here are some of the key articles from the Human Rights Act:
- Right to life (Article 2)
- Prohibition of torture and inhuman or degrading treatment (Article 3)
- Right to liberty and security (Article 5)
- Right to respect for private and family life (Article 8)
- Prohibition of discrimination (Article 14)
For healthcare professionals, understanding these rights is essential, but how often do we, as occupational therapists reflect on whether we are truly upholding them in our practice?
Reflecting on My Own Experience
During a lengthy hospital stay at the height of the pandemic, I experienced both the strengths and limitations of how human rights were applied in practice. I was placed in a room at the end of a ward and couldn’t leave without assistance. The isolation, combined with the inability to engage in meaningful activities, had a significant impact on my well-being. Reflecting on this, I can see how my right to liberty and security (Article 5) and my right to respect for private and family life (Article 8) were affected.
Upon being discharged home, things didn’t improve as much as I had hoped. I had to rely on carers to come at set times to help with essential activities like getting into bed often at times that didn’t suit my needs. This lack of control over my daily routine further impacted my autonomy and well-being, contributing to what occupational therapists refer to as occupational deprivation, the inability to engage in meaningful activities due to external barriers.
Human Rights in Occupational Therapy Practice
As occupational therapists, we have a unique role in promoting and protecting human rights. Our work is centred on enabling individuals to participate in meaningful activities, which are essential for well-being and self-fulfilment. In this context, we must consider our duty to uphold human rights, particularly the right to liberty (Article 5), the right to respect for private life (Article 8), and freedom from inhuman or degrading treatment (Article 3).
When human rights are compromised, people can experience occupational deprivation or alienation. These conditions arise when individuals are unable to engage in meaningful occupations, either because of restrictive practices, institutional barriers, or societal constraints. This not only impacts their mental health but also their overall physical and emotional well-being.
For instance, when patients are subject to restrictive practices like seclusion or restraint, they may be deprived of the ability to participate in meaningful activities, leading to occupational alienation. It’s our responsibility as occupational therapists to ensure that any such restrictions are necessary, proportionate, and respectful of the person’s dignity.
My Experience with Occupational Deprivation
During my hospital stay, being left alone in a room without the ability to engage in meaningful activities highlighted the severe impact of occupational deprivation. The lack of visitors further compounded the sense of isolation. After returning home, relying on carers who couldn’t accommodate my personal schedule for essential tasks like going to bed was another clear example of occupational alienation. My right to respect for private life (Article 8) was compromised as I had no control over basic aspects of my life.
Additionally, delays in receiving occupational therapy interventions and home modifications, which would have allowed me to move around freely, resulted in further occupational deprivation. This reflected a breach of my right to liberty(Article 5) and right to private life (Article 8), even though the pandemic placed additional strain on services.
When I returned to work, the absence of reasonable adjustments that would allow me to perform my job to the best of my ability was another challenge. This situation reflected a lack of compliance with Article 14, the prohibition of discrimination. Without these adjustments, I was unable to fully participate in meaningful work, which led to a sense of occupational alienation.
Reflection and Call to Action
I recognise that many of the delays and challenges I faced were due to the extraordinary pressures brought on by the pandemic. However, this doesn’t negate the personal impact. These experiences underline the importance of balancing individual human rights with broader systemic challenges. I encourage all healthcare practitioners to reflect on the decisions they make and consider their impact on the people they work with.
Are the people you support able to engage in meaningful occupations?
Are you giving them the opportunity to make decisions about their care, or are you unintentionally contributing to their occupational deprivation or alienation? Even when faced with larger systemic issues, it’s crucial that we strive to empower, respect, and support individuals in living the way they want to live.
The Importance of Legal Duties
During the Human Rights Practice Leads Programme, we discussed how healthcare staff have a legal duty to respect, protect, and fulfil human rights. This means that any restrictive practices must comply with the three-part test for non-absolute rights: they must be lawful, serve a legitimate aim, and be proportionate.
The course also highlighted the cumulative impact of restrictive practices. If human rights are not upheld from the start, a build-up of restrictions can lead to bigger incidents and greater distress. Baroness Hollins’ November 2023 report, “My Heart Breaks”, emphasised how solitary confinement and seclusion can harm individuals with learning disabilities or autism, showing the need for continuous reflection on whether our interventions are truly rights-respecting.
Lessons Learned and Moving Forward
Reflecting on my own experiences and the lessons from the programme, I’ve learned that human rights aren’t just legal obligations—they’re practical, day-to-day considerations that must guide our actions. As healthcare professionals, it’s our duty to protect people’s safety while also upholding their autonomy, dignity, and freedom to engage in the occupations that give their lives meaning.
Occupational therapy is about promoting health and well-being through meaningful activities. By embedding human rights into our practice, we can ensure that individuals have the freedom to live fulfilling, independent lives without unnecessary restrictions.
Conclusion
Human rights are the foundation of occupational therapy practice. My own experiences have shown me how easily these rights can be overlooked in healthcare settings, but they’ve also given me the insight and drive to advocate for change. As occupational therapists, we must remain vigilant in upholding human rights, ensuring that restrictive practices are only used when absolutely necessary and that individuals have the freedom to engage in meaningful activities.
Together, we can create a more rights-respecting healthcare system that recognises the importance of dignity, autonomy, and meaningful engagement for all.
References:
- Human Rights Act 1998. Available from: https://www.legislation.gov.uk/ukpga/1998/42/contents
- Baroness Hollins’ Report “My Heart Breaks” (November 2023). Available from: https://www.gov.uk/research
- British Institute of Human Rights. TEWV Human Rights Practice Leads Programme.
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