Section 3
Autonomy and Places of Deprivation of Liberty
In the spring of 2014, while visiting a specially-equipped hospitalisation unit (UHSA), that is to
say a psychiatric treatment unit for prisoners, the inspectors were present during a scene which
took place in the dining room: the patients had sat down at the table; one of them was balancing
on the two back legs of a chair, with his feet on the ground. Three members of medical staff were
present for the meal, gathered together in a corner of the room and watching over and/or
supervising the patients. One of the members of medical staff then raised his voice from their
place in the room, in an unkind manner, in order to enjoin the person concerned to sit properly.
The man, who was about forty years old, immediately and silently obeyed.
What argument could be used to justify this man being thus publicly treated like a child?
His illness? His usual behaviour? Any possible risk?
A little later in the day, the inspectors had interviews with the medical staff. None of
them had attached any special importance to this scene. Nothing in the patient’s previous history
or personality appeared to have justified this admonition. General justifications of a security
nature were subsequently put forward: it was important to “control the situation”, “to avoid
things getting out of hand”, one could never tell what might happen. On the assumption that
action had been necessary, all were agreed that it would have been preferable to have done it in a
more discreet manner.
A scene of this kind is neither exceptional nor caricatured. It is no way
intended to stigmatise any individual medical workers, whose capacities for
dialogue were moreover noted by the inspectors. It simply illustrates how
far the combination of routine and tensions may lead to regrettable
behaviours, which are sometimes devoid of all sense. It is perhaps only a
reflection, or consequence at the individual level, of the concerns that guide
and limit the action of the administrations and departments: “security” and
“effectiveness”.
Security concerns are naturally understandable, with regard to institutions catering for
persons considered to be dangerous, particularly when the staff are few in number and
inadequately trained. They nevertheless cannot apply in a uniform manner and without
distinction to all patients hospitalised in psychiatric wards and all prisoners.
Effectiveness refers to the need to cater for what are sometimes large groups of persons,
often in difficult circumstances in view of the number of officers and the working conditions. It
is, of course, a legitimate concern.
However, it raises the question of determining how far and to what point the individual
becomes secondary in the face of these considerations. How far are demands for individual
liberty legitimate or, on the contrary, disqualified and prohibited? It is beyond doubt that the
same person would have been just as sharply snubbed, had they wanted to go to the toilet or eat
some cheese after their desert.
It is not a question of disputing the need for rules - which are a factor of organisation and
order and a frame of reference -, but of establishing what it is that they protect, what they allow
and what they prevent since, as Simone Weil wrote, “liberty is not greater or lesser according to
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