CAT/OP/CHE/ROSP/1 and sufficiently numerous to provide the requisite assistance and care, in an appropriate setting, be that a specialized hospital unit or a specialized prison unit. 173. The Subcommittee noted with satisfaction the work undertaken in specialized units with convicted prisoners subject to therapeutic measures under article 59 of the Criminal Code, in both prisons and hospitals. However, it finds it regrettable that, too often, convicted prisoners under therapeutic measures are held in ordinary detention without access to the treatment facilities and the level of care they would be entitled to expect in order to expedite their recovery, thus affording them the prospect of release. 174. The Subcommittee encourages the State party to increase the number of places in appropriate facilities for persons sentenced to therapeutic measures and wishes to be informed of the decisions taken in this regard. 175. The Subcommittee wishes to draw the attention of the State party to the situation of persons in indefinite detention under article 64 of the Criminal Code. Many of them are suffering from severe psychiatric disorders, and some have been declared not criminally responsible. They are in ordinary detention, sometimes in high-security wings, where they are held in solitary confinement for long periods. They receive no treatment other than that provided by the prison medical unit. That being the case, it is inevitable that their condition will not improve and that their release will remain unattainable. 176. The Subcommittee, bearing in mind rule 109 (1) of the Nelson Mandela Rules, considers that the State party should conduct an in-depth review of the situation of persons in indefinite detention and amend its legislation and institutional responses accordingly. 177. The Subcommittee is particularly concerned about one of the findings of the scientific study ordered by the National Commission for the Prevention of Torture,71 which emphasizes that decisions to extend therapeutic measures are scantly reasoned, often simply summarizing the treatment reports without examining the proportionality of extending the measures while nevertheless approving the request by the enforcement authority to that effect. 178. The Subcommittee recommends that extension of therapeutic measures be based on a detailed examination of the necessity and proportionality of such a step, with due regard for the therapeutic progress made by the person subject to the measures. It further recommends that, for the purposes of the procedure, inmates automatically be heard by the relevant cantonal authorities before the measures are extended and that they have the assistance of counsel. 179. The Subcommittee makes the same recommendation in respect of the review of indefinite detention. 180. Persons sentenced to therapeutic measures could be forced to take medication. 181. The Subcommittee considers, as a matter of principle, that, as provided in the Civil Code, medication should be administered only with explicit free consent, duly documented, other than in the exceptional circumstances envisaged in article 434 of the Code. 182. The Subcommittee is of the view that, in application of the principle of equivalence of care, there is no reason to waive all these conditions in the case of prisoners, including those sentenced to therapeutic measures. 183. Pretrial detainees and convicted prisoners subjected to psychiatric hospitalization were admitted to mental health services not under the mechanism for institutionalization for purposes of care provided for in articles 426 et seq. of the Civil Code, but on the basis of a transfer order issued by the competent authority (the public prosecutor’s office or the cantonal office for the enforcement of sentences) with no consideration of the issue of consent. 71 GE.21-03779 J. Weber et al., « Anordnung und Vollzug stationärer therapeutischer Massnahmen gemäss Art. 59 StGB mit Fokus auf geschlossene Strafanstalten bzw. geschlossene Massnahmeneinrichtungen », étude réalisée pour la CNPT, 2015. 23