JEAN-JACQUES GAUTIER NPM SYMPOSIUM 2016 “What is the alternative that allows us to continue saving lives, without establishing forced treatment and deprivation of legal capacity as a general rule? There lies the challenge. (...) It seems to me that focusing public policies on the exceptional situations basically ends up being a discussion that is not about public policies. We should think of systems that can cover 99.99% of cases, instead of concentrating on the minimum number of cases.” Facundo Chávez, UN Office of the High Commissioner for Human Rights In addition to the ethical arguments and the danger of administering involuntary psychiatric treatments, the participants also discussed the counter-productive nature of these treatments, as illustrated in a study published by the European Union Agency for Fundamental Rights in 2012.10 This study highlights the fact that the persons’ involvement in their treatment, and their support for the choice of treatment has a positive impact on their hospitalisation. Conversely, if the treatment is administered without consent and the person does not understand its implications, this causes suffering and has far greater long-term harmful consequences for the person’s health. The testimony of a victim of forced treatment also allowed to illustrate the negative effect of some treatments and the need to recognise the harm caused as an initial form of reparation and a necessary first step towards a change in practice. The principle of “medical necessity” of certain treatments was thus challenged as a vague notion that is not backed by clear scientific evidence, as stated by the UN Special Rapporteur on the Right to Health and the UN Special Rapporteur on the Rights of Persons with Disabilities: “The concept of “medical necessity” behind non-consensual placement and treatment falls short of scientific evidence and sound criteria. The legacy of the use of force in psychiatry contravenes the “primum non nocere” (first do no harm) principle and should no longer be 10 20 European Union Agency for Fundamental Rights, Involuntary placement and involuntary treatment of persons with mental health problems, 2012: http://fra. europa.eu/en/publication/2012/involuntary-placement-and-involuntary-treatmentpersons-mental-health-problems