CHANCELLOR OF JUSTICE AS NATIONAL PREVENTIVE MECHANISM PART II In one of the inspected institutions57 the seclusion room was used as an ordinary ward and, therefore, sufficient safety of the secluded person was not ensured. For example, there were loose items of furniture in the seclusion room, the window had long curtains and there was a cast iron radiator under the window. The Chancellor is of the opinion that the safety of the patient and the staff must be ensured during restraint. Restraint may only be applied in a designated room where a safe and calming environment for the dangerous person is ensured, so that the person cannot injure themselves. If a room is alternately used either as an ordinary ward or a seclusion room depending on the need, the safety of a secluded person may be endangered as for the time of rearranging the ordinary ward the person in need of seclusion might be temporarily placed in a room not adjusted for seclusion. PART I restraint is carried out within the range of vision of other patients. The Chancellor found that if a person is restrained in view of the other patients this may constitute degrading treatment of the restrained person as it may have a negative impact on self-respect. During the reporting year, there were still problems with maintaining a register providing a quick overview of the means of restraint applied within an institution. In one institution58 the register of the applied means of restraint lacked important information while in another institution59 seclusions were not registered and in the third60 there was no general overview of the cases of restraint because the register was filled in only when a patient’s file was archived. In the opinion of the Chancellor, the register must contain all the cases of application of all kinds of means of restraint because otherwise it does not serve its purpose and fails to provide a quick and general overview of the means of restraint applied by a particular health service provider. Register of the application of means of restraint helps to prevent the risk of ill-treatment first and foremost for those applying the means of restraint and also offers a possibility of retroactive analysis of the cases of restraint based on the information in the register. On the other hand, purposeful maintenance of the register provides a possibility for supervisory authorities to carry out effective review of the lawfulness of the application of means of restraint to protect the rights of patients. To obtain an up-to-date overview, the register must be filled in immediately after the application of means of restraint. PART IV 6.3. Registration of the applied means of restraint PART III On this basis, the Chancellor proposed to ensure that restraint is applied outside the view of the other patients, the seclusion room is sufficiently safe and the seclusion room is used only for the application of restraint. 6.4. Guarantee of privacy As a recurring problem, excessive use of video surveillance infringing the privacy of the patients was identified during the reporting year. In one institution61 extensive video surveillance was used in the premises of the department, including in the wards. In the institution, all the persons, regardless of the need, were subject to video surveillance during their presence in the department, including video surveillance of the patients in all the wards.62 However, in the Chancellor’s opinion, such extensive restriction of human dignity and the right to inviolability of private life without a person’s consent and without consideration of 57 58 59 60 61 62 See the inspection visit to Ahtme Hospital Foundation (case No 7-9/130612). See the inspection visit to Ahtme Hospital Foundation (case No 7-9/130612). See the inspection visit to Narva Hospital Foundation (case No 7-9/130436). See the inspection visit to Kuressaare Hospital Foundation (case No 7-9/130700). See the inspection visit to Pärnu Hospital Foundation (case No 7-9/140146). According to the explanations by the staff, video surveillance was necessary for effective monitoring of the patients and preventing incidents of violence. Video surveillance also helps to ascertain retroactively the circumstances of violent incidents, etc, in the department. 31