JEAN-JACQUES GAUTIER NPM SYMPOSIUM 2016 This treatment without consent should, however, have safeguards, including the possibility of appeal to an independent authority, which is often not available in practice. The CPT and SPT nevertheless consider that alternatives to involuntary placement must be put in place in accordance with article 19 of the CRPD, to minimise longterm institutionalisation and promote health-care services in the community. As noted above, the CRPD proposes a paradigm shift, which prohibits deprivation of liberty based on disability. The Committee therefore believes that any placement based on disability constitutes a form of arbitrary detention and also calls for a total prohibition on medical procedures without the individual’s free and informed consent. Some participants expressed their concerns that this new paradigm embodied in the CRPD does not have sufficient support among states. Given the high number of ratifications of this treaty, they therefore recognised that it should become a key reference, including for torture prevention bodies. The participants in the Symposium, and in particular the NPMs, discussed at length these different international standards and interpretations and the difficulties this inconsistency presents to the work of monitoring bodies. The last Paraguay: Criteria on involuntary placement and treatment The NPM requires four cumulative conditions to limit cases of involuntary deprivation of liberty: 1. As provided for the Paraguayan Health Code, the risk the person presents must be proven in written after evaluation by a panel of independent experts (minimum two health professionals) who have no interest in institutionalising the person. 2. This proven risk must involve a danger to the life or personal integrity of a third person or of the person herself/himself. 3. The absence of an emergency treatment in case of crisis will lead to irreversible harm. chapter of this report will revisit this point. 16