Quality of life, participation and occupational rights: A capabilities perspective

BACKGROUND: Research suggests that perceptions of diminished quality of life among people with a severe physical impairment might be a consequence of environmental barriers and inequity of opportunity rather than the impairment itself. However, occupational therapists remain preoccupied with assessing and addressing individual dysfunctions and have directed little attention to assessing and challenging inequitable environmental constraints on people's occupational opportunities. PURPOSE: To highlight briefly what is known about environmental impacts on quality of life among people with impairments; to outline the relationship between occupational rights and human rights; to explore the concept of 'participation' and thereafter to outline the relevance of the Capabilities Approach for occupational therapists who seek to address inequalities of occupational opportunity and inequities in participation. MAIN FINDINGS: Sen's Capabilities Approach focuses on equality of the opportunity to 'do', and is relevant to occupational therapy in the context of the World Health Organisation's construct of 'participation', the United Nations' Convention on the Rights of Persons with Disabilities, and the World Federation of Occupational Therapists' (WFOT) Position Statement on Human Rights. PRINCIPAL CONCLUSIONS: Adoption of Sen's Capabilities Approach might facilitate critical occupational therapy practices focussed on equality of occupational opportunities and on the fulfilment of occupational rights, in accordance with the standards of rights-based practices advocated by disability scholars, WFOT and the UN.