12 3. Expert report by expert witness proposed by the Commission: a) Eric Rosenthal, international expert in human rights of people with mental illness People with mental illness are subject to bias and strong stigmata, thus constituting a vulnerable group for human rights violations at a global level. Four United Nations Rapporteurs verified that people with mental illness suffer the most perverse forms of discrimination, as well as difficult life conditions, compared with any other vulnerable group of society. These practices, which violate the rights of people with mental illness, follow similar patterns throughout the world. Such people are arbitrarily and unnecessarily segregated from society in psychiatric institutions, where they are subject to cruel, degrading treatment or torture. It has been proved that most people with mental illness can receive treatment in a safe and respectable manner within their community, and responsibly decide on their own treatment. On many occasions, protectionist rules may cause them great harm by denying the opportunity to make important decisions for their lives. The lack of a specific language regarding to the people with mental illness in human rights international instruments makes it difficult to apply the rules to such people. As a result of such discriminating practices, people with mental illness do not have the resources or recognition necessary to create organizations to defend their rights at the national and international level. The Inter-American Convention on the Elimination of All Forms of Discrimination Against Persons with Disabilities is the first human rights international instrument that specifically addresses the issue of people with disabilities and represents a priceless commitment by Latin American States to secure that they will enjoy the same rights the rest of the community is endowed with. The United Nations Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care are the broadest human rights rules concerning mental health treatment and assistance. Such principles are particularly useful as guidelines for the interpretation of the rights established in human rights treaties. International human rights law acknowledges that individuals with mental illness, who are admitted in psychiatric institutions, as was Ximenes-Lopes’s case, have the right to informed consent and, consequently, the right to refuse treatment. Exceptionally, involuntary treatment may be justified in emergency cases, when a doctor deems it necessary in order to prevent an imminent risk for the individual or third parties. In non-emergency cases, involuntary treatment is only justified by the approval of an independent doctor. In Ximenes-Lopes’s case, there was no imminent or immediate risk, and there was no information as to a decision issued by an independent doctor. Due to the inexistence of these conditions, Damião XimenesLopes had the right to refuse treatment, and any attempt to apply involuntary treatment would result in a violation of the human rights protected under international law. Given the potentially dangerous and painful nature of the adverse effects of psychotropic substances, the unjustified and constrained use of such drugs in violation of international standards must be considered a form of cruel and degrading treatment and an infringement of Article 5(2) of the American Convention on Human Rights.