Access to medical care

While you are in prison, you should have the opportunity to see a doctor whenever there is such need. The prison administration must ensure that you can consult a qualified doctor without unjustified delay.
Case summary

Tymoshenko v. Ukraine


European Court of Human Rights
30 April 2013

Facts
The applicant, Ms. Tymoshenko, was detained because of criminal suspicion. She complained to the domestic court that her health has deteriorated and asked to be seen by her doctor. The claim was refused. Instead she was offered a medical examination by doctors assigned by the Ministry of Public Health. She refused the offer. Although Ms. Tymoshenko complained about several health issues she also refused to undergo any other medical examinations in the detention centre and  several other suggested civil hospitals. 

Complaint
Ms. Tymoshenko complained, under Article 3 of the Convention, of a lack of appropriate medical treatment during her detention.

Court’s ruling
The Court noted that the “adequacy” of medical assistance remains the most difficult element to determine. On the whole, the Court retained sufficient flexibility in defining the required standard of health care, deciding it on a case-by-case basis. That standard should be “compatible with the human dignity” of a detainee, but should also take into account “the practical demands of imprisonment”.
The mere fact that a detainee is seen by a doctor and prescribed a certain form of treatment cannot automatically lead to the conclusion that the medical assistance had been adequate. Medical treatment can be considered adequate if:

  1. a comprehensive record is kept concerning the detainee’s state of health and his or her treatment while in detention
  2. diagnosis and care are prompt and accurate
  3. where necessitated by the nature of a medical condition, supervision is regular and systematic and involves a comprehensive therapeutic strategy aimed at curing the detainee’s diseases or preventing their aggravation, rather than addressing them on a symptomatic basis and
  4. the necessary conditions have been created for the prescribed treatment to be actually followed through.

However, the Court also emphasized that although the state is obliged to provide adequate medical treatment for the detainees Article 3 cannot be interpreted as requiring a prisoner’s every wish and preference regarding medical treatment to be accommodated. This means that the State cannot be held responsible for delays caused by the applicant’s own refusal to undergo medical examinations or accept treatment.
In the particular case the Court found that Ms. Tymoshenko’s health received considerable attention from the domestic authorities, which invested resources and efforts far beyond the normal health-care arrangements available for any ordinary detainee in Ukraine.  Finding that Ms. Tymoshenko herself refused from the medical treatment that was offered, the Court rejected her application as being manifestly ill-founded. 

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