personnel entered patients’ rooms without knocking and addressed patients by names.
Moreover, patients placed in the observation room of one of the wards stated that they
had limited access to use toilets (the same limitation was found in the Psychiatric
Clinic of the Independent Public Clinical Hospital No 1 of the Pomeranian Medical
Academy in Szczecin). According to patients, requests to be able to use the toilet
outside specified hours were reluctantly fulfilled by the personnel. Patients also
experience limitations concerning their free movement around the ward, although it is
not banned by regulations, and the use of mp3 and mp4 players is prohibited. The
National Preventive Mechanism recommended that the administration of the
establishment strove to improve the treatment of patients by the personnel and
eliminated inacceptable limitations of patients' rights and liberties in hospitals.
The visiting persons also saw the need to guarantee the right of patients to
privacy and intimacy. There are occasional cases of toilet doors only partly covering
persons using the toilet (Institute of Psychiatry and Neurology in Warsaw). The
Deputy Director of the Institute explained that it was due to security reasons. The
National Preventive Mechanism did not see these explanations as sufficient and
addressed the Director of the Department of Science and Higher Education of the
Ministry of Health with a request to undertake relevant actions in this regard. It results
from the explanations obtained, that patients of the Institute of Psychiatry and
Neurology suffer from neurological illnesses related with specific symptoms (e.g. loss
of consciousness). Therefore, it is necessary to have constant contact with them. Toilet
doors must allow the observation of patients. Given the above, the Director of the
Department of Science and Higher Education stated that disputes concerning the
relation between patient's intimacy and care for his life and health could become an
academic discussion. In the light of the Convention Against Torture and Other Cruel,
Inhuman or Degrading Treatment or Punishment, he stated that observing patients is
not reprehensible.
Representatives of the Mechanism on many occasions recommended the
lawful application of coercive measures. In one of the hospitals, among others,
difficult communication, disorientation, lying on beds of other patients and taking
various objects from them were treated as premises that justified immobilization of
patients. On the basis of records in dossiers, it was difficult to conclude whether these
premises had justified the application of such measures. In addition, according to
obtained information, the medical personnel does not treat isolation and forced
administration of medications as coercive measures and their application is not
adequately recorded. The personnel also fails to notify the administration of the
hospital about this fact (Institute of Psychiatry and Neurology in Warsaw). In reply,
the Deputy Director of the Institute informed that the issue of documenting cases of
applying coercive measures had been discussed with the personnel. He indicated that
laconic justifications were a mistake, however, immobilisation was applied each time
in compliance with legal premises. When it comes to forced administration of
medications, the Deputy Director explained that forced administration of medications
to patients admitted to hospital without their consent cannot be understood as a
coercive measure. Such statement remains contrary to a basic guarantee for a patient
obligatorily placed in an establishment: a free and informed consent for treatment87. In
87
cf. Article 41 of CPT 8th General Report [CPT/Inf (98) 12].
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