Implementation of Duties and Powers of the National Preventive Mechanism in 2010
In both hospitals, we thus established that the method of keeping data on notification did
not provide an integral overview of the observation of the statutory time limits defined in
hours by ZDZdr. Therefore, we proposed that they adhere strictly to the statutory time limits
specified for the notification of the hospital manager, the next of kin, the legal representative,
and the representative on admission without consent, and for the notification of the court,
which is arranged by the manager. We also suggested that the records and documents
on admissions without consent be kept with consistency and due care, as they constitute
evidence on the legality of the action.
We also found that the court competent for the area of the receiving psychiatric hospital
promptly responded to the notifications on admissions without consent.
During the visit, we were warned of frequent disagreements between the consulting
psychiatrist and the court’s decision regarding the urgency, admissibility and duration of
detention of persons against their will in the secure ward, and of the fact that the court only
rarely heard the consulting psychiatrist and preferred to consider the external expert’s opinion.
In the case of one secure ward in one hospital, we found that the patient’s medical record did
not include the court’s decision on detaining the person in the secure ward and contained
only a copy of the court’s decision instituting a procedure. According to the explanations by
the ward, the court does not send decisions on the detention of persons in the secure ward
to the hospital. However, we received another explanation at the other secure ward of the
same hospital, and when accessing the randomly chosen medical records, we were able
to locate the court’s decisions on detention. We pointed out that according to Article 66 of
ZDZdr, the court must submit decisions on detention (Article 65 of ZDZdr) to the hospital,
which has the right to appeal against such decisions, and so the above-mentioned practice
violates this right. If the hospital is not informed of the final decision, a patient could be
detained in a secure ward without a legal basis. We therefore proposed that in cases when
the hospital has the only court’s decision instituting a procedure and not the final decision of
the court, the hospital should warn the president of the court thereof and demand that the
court submit a final decision.
Special protection measures (PVU)
The hospitals maintain records of the order, execution, duration and termination of PVUs in
each secure ward, and also maintain a central record. A review of some randomly chosen
cases showed certain irregularities or inconsistencies in the maintenance of records on PVU,
which prompted us to suggest to the hospitals that they provide consistent completion of
data required for keeping records on PVU in accordance with the fifth paragraph of Article 29
of ZDZdr. In the case of one hospital, access to the record of restraints in one of the secure
wards showed that fixation in two cases had lasted considerably longer than permitted by
ZDZdr. We pointed out that in such cases, doctors should be particularly careful in writing
down the patient’s condition, and reasons for PVU prolongation, and should append their
signature. The DPM finds that ZDZdr prescribed a number of procedures and records, but
failed to provide an adequate and transparent method of monitoring the data. Although the
psychiatric hospitals were preparing together for ZDZdr implementation, they use different
forms. With the multitude of forms, it stands out that each of them requires the manual entry
of identification data, that submission of the completed forms to all addressees has to be
provided, and that they should be archived in a way that enables review. Completing the
forms takes up the staff’s time, which prior to the implementation of ZDZdr was used for
patient interviews. The DPM recommends that the Ministry of Health commission software
to enable faster, more consistent and more efficient monitoring of ZDZdr implementation.
National Preventive Mechanism in the Republic of Slovenia under the Optional Protocol to
the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment
53
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