107 1 or to cruel, inhuman or degrading treatment or punishment under article 16 of the Convention against Torture, and to a breach of article 377 7 of the International Covenant on Civil and Political Rights. 281. According to the doctrine of the Committee for the Prevention of Torture of the Council of Europe, solitary confinement of pretrial detainees must be governed by the following standards: (a) it should only be resorted to in exceptional circumstances, be strictly limited to the requirements of the case, and be proportional to the needs of the investigation; (b) restrictions should be authorized by a court; (c) detainees should have an effective right of appeal to a court or another independent body; (d) detainees should have access to a doctor whose written report should be forwarded to the competent authorities; and (e) detainees should be offered purposeful 378 activities in addition to outside exercise and guaranteed appropriate human contact. 282. Additionally, “[t]he punishment of solitary confinement shall not affect the access to a lawyer and shall allow minimum contact with family outside. It should not affect the conditions of […] detention in respect of bedding, physical exercise, 379 hygiene, access to reading material and approved religious representatives.” 283. In fulfilling the different duties assigned to it under its mandate, the IACHR has observed over the past years that as a general rule solitary confinement is used mostly in the countries of the region that do not adhere to the norms and standards of international human rights law, and that it is generally applied to both convicted persons and pretrial detainees alike. 284. Thus, in the context of this report, the Commission received information that in the United States there are approximately 60,000 persons in pretrial detention each year under the federal jurisdiction and another 700,000 persons in pretrial detention at the state level. Based on these figures and on the fact that solitary confinement is consistently used in the United States, one could infer that there may be hundreds of thousands of individuals awaiting trial in solitary confinement each year in the country. Additionally, there have been documented instances of the practice of holding juveniles in conflict with the law in solitary confinement over the course of the entire proceedings as a protection measure when they are in custody in adult prisons, and of the frequent use of solitary confinement of juveniles as a disciplinary measure. As an example, the New York City Department of Prisons estimates that more than 14% of 377 UN, Special Rapporteur on Torture and other Cruel, Inhuman or Degrading Treatment or Punishment, Interim Report, A/66/268, published on August 5, 2011, para. 73. 378 2008, pag. 30. 379 Shalev, Sharon, A sourcebook on solitary confinement, Mannheim Centre for Criminology, LSE, Council of Europe/Committee of Ministers Recommendation Rec(2006)13 on the use of remand in custody, the conditions in which it takes place and the provision of safeguards against abuse, approved on September 27, 2006, para. 42.