“death row cells” in America.
The commission proposed to the medical director of the facility and his
deputy that the walls of the room be painted in a calming colour. In
addition, it suggested placing a cover with a pleasing colour over the
bed, which hides the straps and can be easily removed, if necessary.
Immediate measures
The proposal was accepted and the walls of the room were painted
green – to remind the patient of nature, have a calming effect and give
a sense of safety. The bedspread that covers the straps is also green.
The commission was promised that the check list for authorising
restraints and isolation will be revised in the near future and those
points that the CPT considered mandatory will be added. Under the
CPT standards (Item 43 et seq.), this includes the continuous presence
of a trained employee during the period of restraint to provide
therapeutic assistance. The technical video monitoring, which is
provided, should also be mentioned on the check list. This should
contain standards on how to watch the video monitor. Rules should be
added with respect to the duration of the restraint and when the
restraint order must be renewed by the physician. The check list
should be supplemented to include provisions on employee training,
the policy for filing complaints and the debriefing session. Moreover,
the patient should be provided an opportunity to add his or her own
comments. Finally, it should be guaranteed that a copy of this form
sheet is provided to the patient.
Process organisation
must be changed
The NPM points out that, under the case law of the European Court of
Human Rights, any strapping of an inmate to a hospital bed may only
last as long as absolutely necessary under the circumstances (ECHR
27 October 2003, Hénaf/France, Appl 65.436/01 No. 52).
Strict case law
The NPM recommended that a form be prepared with respect to
“restrictions on the freedom of movement”. The form should instruct
the ordering physician to describe the milder measures available in
the individual case in detail and to list which milder measures had
been tried without success in order to avoid this additional restriction
of freedom. Here too, reference is made to the CPT standards, under
which patients may only be restrained as a “last resort”.
Restraint as a last resort
The form should also require documentation of any injuries to patients
or staff so that they will be verifiable.
Alternatives must be
documented
In this regard, the medical facilities authority stated that the Intranet
form entitled “Restrictions on freedom of movement” is currently being
revised by the Tyrolean hospital operating company TILAK with respect
to the electronic medical history. This form will, of course, also be used
at Station A6. The form is supposed to mention milder measures.
Form is being revised
Strapping a patient to a hospital bed is only permitted when it is absolutely necessary due
to the progression of the disease.
108
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