Moreover, the ECtHR ruled against France on three occasions in 2011 196, due to the absence of effective remedy against disciplinary measures. Two requirements appear to have been laid down through these rulings: on the one hand, the right to effective remedy against sanctions imposed by disciplinary authorities; on the other hand, guarantees with regard to conditions of detention within punishment wings. Although these rulings concern the conditions of exercise of disciplinary regulations in prisons, one can only note that no similar case law exists with regard patients hospitalised without their consent, children in young offenders’ institutions and foreigners in detention. Thus, in the absence of formal disciplinary regulations meeting the requirements of the European Convention for the Protection of Human Rights, the human imagination, which is very fertile in this respect, has invented a whole range of disguised, unlawful and clandestine sanctions within institutions where their presence is unexpected, in particular with regard to committal to hospitalisation and patients who are prison inmates. While the disciplinary regimes within other institutions, such as detention centres for illegal immigrants (CRA) and young offenders’ institutions (CEF), have poorly-defined contours and might be described as being “in their embryonic stages”. Provisions exist, however they remain very inadequate, allowing a non-negligible proportion of arbitrariness to remain. Prisons, on the other hand, unquestionably possess real disciplinary regulations subject to codified rules, though much room for improvement nevertheless remains. Indeed, the existence of sanctions that are indirect, or devoid of any legal and statutory basis, is a reality and certain practices, which resemble the absence of law, are similarly not exempt from arbitrariness. 1. Empirical Disciplinary Practices built upon Legal Uncertainties 1.1 Misuse of Therapeutic Practices for Disciplinary Purposes within Health Institutions Do practices which might resemble disciplinary management of patients exist within health institutions such as units for difficult psychiatric patients (UMD), public mental health institutions (établissements publics de santé mentale / EPSM), interregional secure hospital units (unités hospitalières sécurisées interrégionales / UHSI), specially equipped hospital units (UHSA) and secure hospital rooms? Can disciplinary regimes apply insofar as the notion of fault cannot exist within psychiatric institutions? How should certain practices, and physical restraint and placement in seclusion in particular, be interpreted? 1.1.1 Within Mental Health Institutions Disguised sanctions can affect very concrete aspects of patients’ daily lives. Officially, these involve “treatment measures taken in the patient’s own interest”. Indeed, the notion of a “framework of treatment” sometimes appears to serve the purposes of the organisation of departments and of discipline, rather than strictly therapeutic aims, including as far as the administration of neuroleptics - sometimes referred to as “chemical straightjackets” - is concerned. 196 ECtHR, 20th January 2011, no. 19606/08, Payet vs. France; ECtHR, 3 rd November 2011, no. 32010/07, Cocaing vs. th France; ECtHR, 10 November 2011, no. 483337/09, Plathey vs. France. 101