injuries due to falls (consequently, even death) by its nature and method of implementation does not fall within special protection measures in the sense of Article 29 of the ZDZdr, since the reason for it and the degree of restriction do not contain the essential elements in Article 29; in particular, one of the most important elements is not given in such cases, which is controlling dangerous behaviour for which an SPM is intended in particular. The management believes that the relevant measure involving a lounger may be defined as a milder preventive measure before the actual implementation of SPM, when the type and level of the actual danger to the elderly person due to their medical condition and the urgent need to implement the measure are so severe that the implementation of SPM is justified professionally. This specific measure, which in accordance with an assessment and risk assessment is implemented by all hospitals, only ensures the basic safety of the patient and also enables the patient to live in a friendly social environment within a therapeutic group or living room. In spite of the severe deterioration of cognitive abilities, and speech and perception disorders, co-habitation with other patients and therapeutic staff is an important condition for attaining suitable communication, emotional response and appropriate supervision. The management also asked how to ensure constant supervision of a person, i.e. of ten persons simultaneously at the same time in ten locations with three nurses covering the ward if the measure with the lounger is considered an SPM as per Article 29 of the ZDZdr, since according to the NPM, persons must be separated in order to respect their privacy when implementing SPM. According to the aforementioned, the management believed that supplementing forms for SPM as was proposed by the NPM did not seem necessary or reasonable. The NPM further explained that the ZDZdr is clear when defining SPM in Article 29. SPM thus includes restriction with safety belts. The NPM is certain that it does not matter to which “surface” the safety belts are tightened to restrict a patient’s movement. If someone is in a lounger and thus equipped with safety belts which prevent them from getting up and leaving at will, then the NPM believes this is a case of SPM. All requirements determined by the ZDZdr must thus be observed regarding the introduction of the measure, time limits, keeping of records and informing. The opinion of the management of Idrija Psychiatric Hospital that the requirements of the Act are different in the case of implementing the measure in social care institutions is incorrect, since it has no basis in the Act. During its visits, the NPM pointed out several times that SPM also refers to the use of safety belts which prevent elderly persons from getting out of wheelchairs, or if a wheelchair is locked and the elderly person is unable to unlock the lock on their own. The NPM’s opinion is similar in the case of restricting (fixing) limbs in order to prevent the removal of a cannula. Regarding the concern expressed by the management of Idrija Psychiatric Hospital on the isolation of a patient and the lack of staff for the constant supervision of restricted patients, let us only highlight that is the NPM’s opinion that isolation is not necessary if a patient agrees to being placed among other patients or does not object to it (explicitly or does not show this with their actions). The NPM also expects that the experts would provide their opinion on the division of so-called protection measures and special protection measures. We have already contacted the Ministry of Health regarding the issue of the division, which explained that the Expanded Professional Board of Psychiatry at the Ministry was preparing recommendations and guidelines for the use of SPM in psychiatry. It was anticipated that the above recommendations or guidelines would be presented to the expert public in 2017. We also submitted the relevant question to the Health Inspectorate of the Republic of Slovenia (ZIRS) and asked for their opinion. The ZIRS explained that its opinion on the nature of the measure of physical restriction with safety belts was not an explanation of the regulation. Regardless of the foregoing, the ZIRS explained that it was understood from the definition in paragraph one of Article 29 of the ZDZdr that SPM was a measure used to enable treatment. Paragraph five of this Article did not determine only the obligation of psychiatric hospitals and social care institutions to enter data on the implementation of SPM in medical records of relevant persons, but also the obligation to establish and keep a special record as per paragraph two of Article 99 of the ZDZdr. The ZIRS is responsible for verifying that psychiatric treatment providers keep such records, that the records include all requested elements and that time limits are observed when ordering SPM. The ZIRS does not verify the justifiability of ordering SPM, since this exceeds its powers. If the justifiability of the order or professional implementation of SPM were doubted during the verification of the aforementioned records of a psychiatric treatment provider, the ZIRS would submit the case to the competent Medical Chamber of Slovenia or another relevant chamber or the Ministry of Health for resolution. When physical restriction with safety belts is not an urgent measure, the ZIRS believes that medical procedures are discussed as per the ZPacP, i.e. the patient’s consent (informed consent) is necessary for the procedure before which the doctor responsible for treatment, the doctor performing the procedure or a qualified doctor must provide suitable clarifications (explanatory duty). Paragraph one of Article 37 of 84 IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2016 NATIONAL PREVENTIVE MECHANISM UNDER THE OPTIONAL PROTOCOL TO THE UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT