Since then, the place allotted to the person has grown continuously and the most
important official texts have been published concerning the rights of persons suffering from
illness.
Act no. 2002-303 of 4th March 2002 concerning patients’ rights and the
quality of the health system is aimed at the establishment of a truly
democratic approach to health. It transformed the rights of persons
suffering from illness into patients’ rights and is for the most part concerned
with the assertion of the right to be informed, making provision for patients
to be able to enlist the help of a trusted person appointed as legal
representative. It bears witness to a major sociological change in doctorpatient relations.
This Act is non-specialised in nature, and does not make any provisions specific to
psychiatry, apart from the restrictions of liberty made necessary during treatment and the
conditions of hospitalisation without consent. It does not deal with the question of autonomy
and of making patients aware of their responsibilities in psychiatric institutions with a view to
their social readjustment.
For its part, Act no. 2011-803 of 5th July 2011 amends the provisions of the Public Health
Code concerning the rights of patients in psychiatric hospitalisation and the rules governing
hospitalisation without consent resulting from the Act of 27th June 1990. 103
In search of balance between the exercise of the patient’s fundamental freedoms and the
constraints involved in psychiatric treatment without consent, it aims to reinforce the rights and
guarantees granted to these persons and completely changes the conditions under which they are
dealt with, in particular through the establishment of systematic control of committals by the
liberty and custody judge (JLD). Furthermore, it asserts patients’ rights in relation to these rules,
both in terms of communication with the authorities and with departmental committees for
psychiatric treatment (CDSP), as well as with the CGLPL. It also recalls that patients have voting
rights, the right to correspondence and the right to engage in religious and philosophical activity.
Finally, certain provisions of the Act of 5th July 2011 were improved by Act no. 2013-869
of 27 September 2013. Article L. 3211-3 of the amended Public Health Code expressly states
the objective of the patient’s reintegration and specifies that “any restriction upon the exercise of
their individual liberties shall be adapted, necessary and proportioned to their mental state and to
the implementation of the required treatment. In all circumstances, the dignity of the person shall
be respected and their rehabilitation sought.”
th
Today psychiatry is thus no longer based upon the asylum model and
authoritarian paternalism, but incorporates the demand of autonomy for
persons in western societies. 104
Within psychiatric institutions, although autonomy is often radically impaired, the
objective of reintegration, fixed by the Act of 27th September 2013, consists of restoring patients’
capacity for initiative and making them actors in their own lives.
Within the framework of a study concerning psychiatric hospitalisation, the author
emphasises that restoration of autonomy is promoted by the existence of reference points in the
progress of the treatment, freedom of movement and provision of information concerning
103
CGLPL Annual Report 2013 - The Rights of the Sick and those Suffering from Mental Health Problems. Dalloz,
Paris, p. 215.
104
Summary Report (Rapport d’information) on mental health and the future of psychiatry presented by Mr Denys
ROBILIARD, deputy, French National Assembly, 18th December 2013.
121
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