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50.
Every instance of the physical restraint of a patient (manual control, use of instruments
of physical restraint, seclusion) should be recorded in a specific register established for this
purpose (as well as in the patient's file). The entry should include the times at which the measure
began and ended, the circumstances of the case, the reasons for resorting to the measure, the
name of the doctor who ordered or approved it, and an account of any injuries sustained by
patients or staff.
This will greatly facilitate both the management of such incidents and the oversight of
the extent of their occurrence.
F.
Safeguards in the context of involuntary placement
51.
On account of their vulnerability, the mentally ill and mentally handicapped warrant
much attention in order to prevent any form of conduct - or avoid any omission - contrary to
their well-being. It follows that involuntary placement in a psychiatric establishment should
always be surrounded by appropriate safeguards. One of the most important of those safeguards
- free and informed consent to treatment - has already been highlighted (cf. paragraph 41).
the initial placement decision
52.
The procedure by which involuntary placement is decided should offer guarantees of
independence and impartiality as well as of objective medical expertise.
As regards, more particularly, involuntary placement of a civil nature, in many
countries the decision regarding placement must be taken by a judicial authority (or confirmed
by such an authority within a short time-limit), in the light of psychiatric opinions. However, the
automatic involvement of a judicial authority in the initial decision on placement is not foreseen
in all countries. Committee of Ministers Recommendation N° R (83) 2 on the legal protection of
persons suffering from mental disorder placed as involuntary patients allows for both approaches
(albeit setting out special safeguards in the event of the placement decision being entrusted to a
non-judicial authority). The Parliamentary Assembly has nevertheless reopened the debate on
this subject via its Recommendation 1235 (1994) on psychiatry and human rights, calling for
decisions regarding involuntary placement to be taken by a judge.
In any event, a person who is involuntarily placed in a psychiatric establishment by a
non-judicial authority must have the right to bring proceedings by which the lawfulness of his
detention shall be decided speedily by a court.
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