Selected topics from 2019 The Ombudsman was critical of the fact that ­inadequate research meant that it remained unclear whether ECT is necessary to save lives, or whether other measures could prove just as effective. In more general terms, the Ombudsman also called for the proposed draft legislation to clarify that any person deprived of their liberty still has fundamental rights. The Ombudsman also pointed out that the law is construed in a complex manner, making it difficult to understand both for the individual patient or user and for medical and care personnel. There is therefore a need to ensure that the ­legislation is written in a more accessible language. The Ombudsman expressed concern over the Committee’s proposal that measures are only to be considered coercive if the patient shows resistance. The background for this concern is that many patients do not show resistance due to trauma, or because an unequal balance of power makes resistance seem futile. The Ombudsman was furthermore critical of the Committee’s proposal to make a lack of decision-making competence a key requirement for the use of coercion. This is problematic for reasons such as it being unclear how such assessments should be done and which criteria it should be based on. The Committee also proposed rules on the use of force in emergency situations, including legally ­establishing health law rules for grounds of ­necessity and self-defence, and strengthening the rules on particularly intrusive measures to prevent injury in emergency situations. The Committee’s proposal to phase out mechanical restraints within three years will, in the Ombudsman’s view, help to reduce the risk of inhuman or degrading treatment. Even so, the Ombudsman recommended that immediate measures be considered to ensure that the use of mechanical constraints on children ceased as quickly as possible. 43 The Ombudsman also called for special legal safeguards to prevent long-term use of mechanical restraints. We also pointed out that it was doubtful whether the Committee's proposal to allow segregation to prevent injury (isolation) in order to prevent damage to property is in accordance with human rights standards. The Ombudsman was also critical of the Committee’s proposal to limit the list of particularly intrusive measures to include only the act of being held to the ground by force, and not other intrusive forms of manual coercion. With respect to segregation, we noted that several of the Committee’s proposals reflected findings from the Ombudsman’s visits. The Ombudsman noted that more stringent rules applied to the option of using segregation as a treatment measure, but that the proposal to lower the threshold for use of segregation out of consideration to others constituted a risk of more widespread use. Furthermore, the Ombudsman called for clearer guidelines on the practice of segregation, including setting limits for the use of force or for maintaining segregation. The Ombudsman also called for assessments of special legal safeguards to prevent prolonged segregation, including limiting the allowed duration of segregation decisions. The Ombudsman also made several other ­comments on topics such as, the proposal to ­introduce a duty to prevent the use of coercion, the right to limit visits and telephone use, use of house rules and procedural rules.

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