that is not made necessary by a person’s condition as being “degrading”: it uses this term, in particular with regard to the needless use of chains during removal from prison to go to hospital. Fetters and handcuffs are not only used during transport and arrival at hospital. Very often, they continue to be used, with the continuous presence of the prison officers, during the whole of the stay in hospital, if the latter is for a clinical examination; and in certain circumstances, in cases of hospitalisation for medical treatment (surgical operations for example). Thus, when the patient has to be installed in a ward that does not have a “secure” room (with increased security for the accommodation of prisoners), the Contrôleur général notes in one inspection that “the admission of prisoners… always leads to their being handcuffed to the bed and the presence of two police officers in front of the door” 118. Prisoners are known to refuse medical treatment because of these procedures and the impact thereof, as the Contrôleur général mentioned in its annual report for 2008, in which it published a woman prisoner’s testimony 119. On this point, the Prisons Act of 24th November 2009 appears to fall short of the requirements of treatment in accordance with humanity. Article 52 of the Act provides that “any childbirth or gynaecological examination shall take place without fetters and without the presence of prison staff…” A provision120 of this kind contains two devastating contradictions: it means that although prisoners cannot be fettered, they may be handcuffed; above all, it means that f or all other examinations and surgical operations, handcuffs, fetters and the presence of prison officers are lawful, whereas article 45 of the same act specifies that “the prison administration complies with the right to medical secrecy… as well as secrecy of consultation”, which is certainly a bare minimum. It is recommended that other provisions should be made in order to replace the current article 52, stating that: “respect for secrecy under article 45 and of dignity stand in the way of the wearing of handcuffs and fetters and of the presence of prison staff during treatment of any kind administered to prisoners. The required security is ensured by other means”. The Contrôleur général also means that the use of handcuffs and fetters should be limited to scenarios in which they are absolutely necessary, that is to say that there is a need to return to the diversity provided for in the rules, since the inspectorate has ascertained that, since the beginning of its activity, the procedures in use have not changed in any way whatsoever as far as this point is concerned. To this end, it is naturally necessary to understand the point of view of the escort staff. Their position provides a simple illustration of the phenomena that lead staff and the administration to prefer uniformity (in this case harshness) to diversity. When interviewed by an inspector on the procedures used, which corresponded to those which have just been described, one officer involved replied: “Humanity is not recognised, but the slightest incident leads to penalisation”. In its brevity, this expression summarises the most important aspects. It situates methods of action (in this case removal from prison in order to go to hospital) within the framework of relations between escorting officers and their superiors in the prison service (and not within the framework of relations with prisoners). Within the framework thus defined, it separates attitudes which do not, if it is permissible to speak in this manner, produce any advantage, and of which it is unnecessary to make use – humanity – from those which give rise to trouble – the occurrence of incidents. If a choice has to be made between absence of recognition of humanity and absence of trouble, who could hesitate? All the 118 Inspection report for the remand prison of Nice, p. 40. Annual Report for 2008 of the Chief Inspector of places of deprivation of liberty, section 5, p. 109. 120 Justifiably inspired by the account of a parturient woman prisoner who gave birth while attached with chains and “in public”. 119 55