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(d) As regards prisoners placed in solitary confinement for protection
purposes, there is a balance to be struck between on the one hand the need to avoid
making this kind of solitary confinement too attractive to prisoners and on the other
hand minimising the restrictions put on persons to whom the measure is applied.
Certainly, at the outset of such a period of solitary confinement, steps should be
taken to reintegrate the person as soon as possible; if it becomes clear that there is a
need for long-term protection, and no other response is possible, regime
enhancement should be pursued. Special efforts should be made to identify other
prisoners with whom the prisoner concerned could safely associate and situations
where it would be possible to bring the person out of cell.
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62. Medical practitioners in prisons act as the personal doctors of prisoners and
ensuring that there is a positive doctor-patient relationship between them is a major
factor in safeguarding the health and well-being of prisoners. The practice of prison
doctors certifying whether a prisoner is fit to undergo solitary confinement as a
punishment (or any other type of solitary confinement imposed against the
prisoner’s wishes) is scarcely likely to promote that relationship. This point was
recognised in the Committee of Ministers’ Recommendation Rec (2006) 2 on the
Revised Prison Rules; indeed, the rule in the previous version of the Rules obliging
prison doctors to certify that prisoners are fit to undergo punishment has now been
removed. The CPT considers that medical personnel should never participate in any
part of the decision-making process resulting in any type of solitary confinement,
except where the measure is applied for medical reasons.
63. On the other hand, health-care staff should be very attentive to the situation of
all prisoners placed under solitary confinement. The health-care staff should be
informed of every such placement and should visit the prisoner immediately after
placement and thereafter, on a regular basis, at least once per day, and provide them
with prompt medical assistance and treatment as required. They should report to the
prison director whenever a prisoner’s health is being put seriously at risk by being
held in solitary confinement.
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