What the duty to provide humane and dignified treatment involves and how to evaluate whether there has been a violation?
Everyone has the right to humane and dignified treatment. This means that agents of the State must not only avoid treating you in an inhumane or degrading way, or torturing you, but must also actively protect and investigate any cases where such treatment has been done by someone else.
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Certain conditions at a mental health care institution (such as the conditions in your room, a lack of light or the number of people) or the actions of medical personnel or state officials (such as the use of restrictive measures or the choice of medical treatment) may cause physical pain or the feeling that you have been degraded or humiliated if not provided or carried out properly. Human rights prohibit state officials or medical personnel from causing such suffering to you at any time and in any situation. It is called the prohibition on inhumane or degrading treatment, or in the most serious cases – torture.
Certain restrictions of your rights will not cause immediate suffering.
example Although you are entitled to a shower as part of regular hygienic activities, missing a day will not ordinarily cause you major inconvenience. However, a long period without an opportunity to shower may seriously damage your emotional well-being and potentially cause physical health problems.
To establish that someone has been treated inhumanely, in a degrading manner or even tortured, there has to be a certain minimum level of suffering caused to a person. Mere inconvenience, even if it lasts for a certain period, will not be considered a violation of the prohibition against inhumane or degrading treatment. Therefore, an evaluation must always be made of whether there was a restriction on your rights and whether the effect of that particular situation was so severe on you personally that it violated your rights.
Situations in which conditions or treatment may amount to inhumane or degrading treatment may differ from one person to another. A situation, which is quite adequate for one, may be humiliating to another. Therefore, a separate evaluation of each individual situation is important, taking into account the characteristics of the treatment and the particular person involved, such as:
- the age, sex and state of health of the person etc.
example Being placed in a cold room for a certain period may cause minor inconvenience to a healthy adult; however, a longer period of cold temperature may cause serious suffering and damage to the health of an elderly person in a poor state of health. Providing meat to a person with no special dietary needs will not cause humiliation either. However, forcing meat on a person whose religious beliefs prohibit him/her from eating it, will most likely violate their freedom of religion, and also cause humiliation and moral suffering.
- the conditions and effects of the treatment etc.
example The use of restraining straps, even in situations where this is justified, will always leave certain negative mental effects. If you are kept restrained a little longer than necessary, it is more than likely that this will not add much more to the negative effects that you have already felt. However, if you have been left restrained for much longer than necessary, this will probably result in much worse mental and even physical effects than normally expected. It may be considered to be inhumane or degrading.
- the duration and frequency of the treatment etc.
example If two persons share a small room with only two beds in it, but they have access to a larger common room for most of the day, very likely, it will not violate the prohibition of inhumane treatment. However, if these persons are forced to spend 23 hours a day for an extended period in a room which has no space for sitting down or for taking a few steps, it will probably cause severe mental and physical suffering.
There are strict conditions for any use of force or restrictive measures. Most importantly, the use of force or restrictive measures must always be strictly necessary to prevent danger or ensure order. Read more about the use of restrictive measures.
Generally, any use of force or restrictive measures, which are not strictly necessary, will be considered to be a violation of the prohibition of inhumane treatment or even torture. Even use of light physical force can violate human rights if it infringes upon a person’s human dignity.
In addition to the general criteria above, to evaluate whether a patient’s rights were violated by the use of force or restrictive measures, it is important to also look at the nature of the patient’s conduct, the level of danger the conduct posed and whether the measures used were excessive or not in ending that conduct.
example If the police handle a patient who is not showing any aggression or resistance while being escorted to a mental health care institution, roughly or strike him/her, this will violate the prohibition of inhumane treatment. However, if medical personnel apply restraining straps to a patient who exhibited a sudden worsening in their mental state and is trying to harm him/herself, this will most likely not be a violation of the prohibition of inhumane treatment.
Read more about the right to life, if the use of restrictive measures by medical personnel or the police has resulted in a patient’s death.
The administration at the mental health care institution, the police and other relevant authorities in charge of your involuntary placement, are also under an obligation to prevent and properly investigate any cases where you may have been treated inhumanely, degraded or even tortured.
Although the State itself may not even be directly responsible for the treatment in these situations, it must investigate your complaints about ill-treatment or inhumane conditions properly and prevent them from happening again in the future. If the State fails to fulfill that duty, it will be considered to have violated the prohibition of torture, or inhumane or degrading treatment.