hyperextended position)”. In this case the delegation saw such hooks in the police establishment which was referred to in the allegation concerned.184 Germany In its 2014 visit, the CPT recorded that at Tegel Prison, inmates were subjected to Fixierung, pending their transfer to the prison hospital, by being shackled with broad metal handcuffs to metal rings on a platform covered with a mattress and their legs being immobilised with leather belts. The CPT noted that the prison doctor expressed concern about the potentially harmful effects of such restraint devices. The delegation was informed by the management that the prison administration of Berlin had very recently decided to stop the use of handcuffs for the purpose of Fixierung and to replace them with soft cloth straps.185 In its 2015 visit, the CPT delegation highlighted its concerns that “persons were still being subjected to Fixierung in police establishments in several … Länder, despite the specific recommendation repeatedly made by the Committee to put an end to the resort to Fixierung in police establishments throughout Germany.”186 It further noted with concern that, “at Munich Police Headquarters, persons who were highly agitated or presented a risk of self-harm were on occasion shackled by metal cuffs on their left wrist or ankle to an iron ring fixed to the wall inside a security cell; in some cases, a body belt was applied to the person, the back of which was then attached with handcuffs to that ring.”187 Russian Federation In its 2013 report, the CPT highlighted the use of “handcuffs fixed to the wall” at the Temporary Detention Isolator (IVS) No. 1 of the Kazan Internal Affairs Directorate, in the Republic of Tartarstan. The CPT stated that whilst the “use of handcuffs may be justified when a person in custody was acting in a highly agitated or violent manner…the person concerned should not be shackled to a wall or fixed objects but rather be kept under close supervision in an appropriate setting.” The CPT consequently recommended that “the Russian authorities take measures to ensure that this apparatus is removed from the IVS No. 1 in Kazan, as well as from any other establishments in which similar devices have been installed”.188 The CPT delegation also recorded the practice in the same institution of handcuffing life sentenced prisoners, to a ring fixed to the wall during medical examinations and while being provided with dental care. The CPT considered such a practice to infringe upon the dignity of the prisoners concerned, prohibited the development of a proper doctorpatient relationship, was possibly detrimental to the establishment of an objective medical finding; and consequently should be halted.189 While it is unclear exactly what equipment is employed in some of these countries (i.e. a specially designed wall cuff or a pair of conventional handcuffs), the practice of cuffing to walls or other fixed objects should be prohibited regardless of the type of cuffs used. 184 CPT (29 January 2015) op.cit., paragraph 13. CPT (24 July 2014) op.cit., paragraph 43. 186 CPT (1 June 2017) op.cit., paragraph 33. 187 CPT (1 June 2017) op.cit., paragraph 34. 188 CPT (17 December 2013) op.cit., paragraph 52. 189 CPT (17 December 2013) op.cit., paragraph 112. 185 38