Long-term Deprivation of Liberty Doctor’s office in one of the Photograph 53 buildings 197. Notwithstanding the foregoing, a review of the current allocation of physi­ cians to the different buildings is considered necessary, given that said allocation does not always correspond to the characteristics of the people in need of medical attention. For example, there was a general practitioner in the geriatrics building, where the average age is 78, and a geriatrician in the building devoted to mild to moderate mental disabilities, where the average age is 63. The current allocation of 198. Physical and pharmacological restraints are used relatively often in psy­ chiatric hospital and health care residences to prevent falls or injuries to resi­ dents or third parties, to avoid alterations of the therapeutic program (removal of intravenous needles, nasogastric tubes, etc.), or to manage violent or aggres­ sive behavior. Negative effects have been documented in the continued use of both types of restraints (in the case of physical restraints: pressure ulcers, infec­ tions, incontinence or loss of appetite, amongst others, and psychological effects such as shame, aggressiveness, depression, apathy or social isolation; in the case of tranquilizing psychotropic drugs: delirium, impairment of cognitive func­ tions and of communication, depression, dehydration, unstable gait with the risk of falling, etc.). From the foregoing it can be concluded that the unnecessary and/or excessive use of these measures could entail a violation of a person’s right to dignity and free development of his/her personality (Article 10 Spanish Con­ stitution), to liberty (Article 17 Spanish Constitution), to physical and moral integrity and not to be subjected to inhuman or degrading treatment (Article 15 Spanish Constitution). The unnecessary or But despite Constitutional protection, the use of these restraints is not regulated at the national level. Indeed, Basic Law 41/2002, of 14 November, regulating the autonomy of patients and the rights and obligations in respect to clinical infor­ mation and documentation, contains the principle of a patient’s prior consent (the so-called «informed consent»), the right to refuse treatment (except in cases provided by law), and the physician’s right to intervene, even without the patient’s The use of physical and THE OMBUDSMAN OF SPAIN physicians to the buildings must be reviewed excessive use of physical or pharmacological restraints could entail a violation of fundamental rights pharmacological restraints is not regulated at a national level 145