Hospitals and psychiatric institutions Furthermore, the traceability of the measures taken is an important aspect for the protection of the patients in the same way as it is for investigations in cases of alleged human rights violations. XX  Intensive personal care with very frequent verbal contact and sufficient staffing must be provided in order to avoid or reduce the use of coercive measures. XX  A designated single room must be set up for applying restraints. XX  Measures that restrict freedom must be applied as gently as possible. This also includes holding follow-up meetings with the patients after the end of the measure. XX  The application of measures that restrict freedom must be fully documented in a comprehensible way. 2.2.4 Doctor‘s prescription mandatory Measures that restrict freedom prescribed in advance The right to freedom is protected by the Constitution as one of the highest legally protected rights through Federal Constitutional Law on the Protection of Personal Freedom and through Article 5 ECHR. Section 33 of the Hospitalisation of Mentally Ill Persons Act (Unterbringungsgesetz) also regulates the procedure for restriction of the freedom of movement in detail. Restrictions of the freedom of movement depending on type, extent and duration are only permissible insofar as they are absolutely vital to avert danger pursuant to Section 3 (1) of the Hospitalisation Act (danger to patients themselves or to others) as well as to perform medical treatment or care on a case-by-case basis, and are not out of proportion to their purpose. Every restriction of the freedom of movement to one room or inside a room must be prescribed specifically by a doctor, documented in the medical history including the reason and reported to the representative of the affected person without delay. During a visit to the gerontopsychiatric ward of Rankweil Regional Hospital, Commission 1 observed, however, that in practice, restrictions of freedom were applied using prescriptions that were written by doctors in advance on a weekly basis and held ”on stock”. This is incompatible with the legal requirements and results in the illegal infringement of the right to freedom guaranteed under constitutional law. This practice means in particular that it is not the doctor who prescribes the measures but that the authority to carry out the measure by using the prescription is delegated to the nursing staff, who can decide on the “if” and “how long” directly before the measure is applied. This is even more the case, when several measures are prescribed as an alternative and/or cumulatively, because the nursing staff then also decide which of the possible measures is to be applied. 50

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