it, has been compounded by a lack of communication and concerted efforts on the part of the various medical stakeholders in the host hospital, child welfare social workers and judges. The dysfunctional communication between the different institutions led to a hospitalisation in a legal framework which significantly complicated the child's care, and lost sight of its protection and healthcare objective because of a primarily security purpose - the end result being the child was deprived, for nearly eight months, of direct access to fresh air, contact with other children of his age and schooling. Accordingly, there have been unjustified and disproportionate violations of the child's fundamental rights throughout the process: violation of the right to an education, by a lack of schooling; violation of the right to education, by an educational provision that is not comprehensive enough given the problems and situation of isolation and idleness experienced by the child; violation of the right to a social life and learning about living in society, by reduced contact with people from outside the hospital and with child welfare services and by a total lack of contact with children of the same age; violation of the right to leisure and recreational activities specific to his age; violation of the right to have a legal guardian capable of exercising the child's rights during administrative and legal procedures; violation of the right to access medical treatment, by a delay in the provision of psychiatric care when the first requests for treatment were made, by the refusal of the child psychiatry structures called on to receive the child and, finally, by the harm that keeping him at the hospital ended up having on his state of health, despite the consideration of the nursing staff; unequal treatment, insofar as children in a similar situation, but living in a health territory that has a better provision of child psychiatry structures, can have access to more suitable care in light of their needs and their state of health, which amounts to lost opportunities for the child; violation of the freedom to come and go, by longterm seclusion in a room, unjustified by the child's condition but on the grounds of his hospitalisation in an ill-suited structure; unjustified deprivation of liberty, since his sectioning was no longer justified by strictly medical reasons but was primarily due to the various institutional and structural difficulties mentioned in the on-site verification report. 4.1.5 The provision conditions for a prisoner on a hunger strike Two inspectors including one medical inspector travelled to the national public health institution at the remand prison of Fresnes (ESPNF), and then to a hospital following a referral on the provision conditions for a prisoner on a hunger strike for 69 days. The investigation particularly examined organisational and medical provision at ESPNF. The inspectors also observed difficulties in the organisation and delivery of the system whereby guards remain in place to keep watch at the hospital, which have endangered the prisoner's health. Lastly, the investigation bore on the conditions in which a doctor may or may not resort to force-feeding a prisoner where his condition is becoming life-threatening over the short-term, in relation to respect for fundamental rights. A study of the international and regional texts as well as national legislation and regulations – spread across the Public Health, Civil, Criminal and Criminal Procedure Codes –, of case law - not least that of the European Court of Human Rights - and the standpoints of such bodies as the National Order of Doctors (CNOM), National Ethics Advisory Council (CCNE), World Medical Association (WMA) and International Committee of the Red Cross (ICRC) reveals a diversity of significantly different approaches. Following the investigation, the Chief Inspector contacted the CNOM, the Interregional Directorate for Prison Services (DISP) and the prefectures concerned for their comments on the difficulties observed. 97

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