JEAN-JACQUES GAUTIER NPM SYMPOSIUM 2016 During the Symposium, the participants highlighted the significant gap between the legal framework for consent and its daily implementation in psychiatric institutions. Indeed, the visiting teams often found that the existence of a (real or perceived) mental impairment justified decisions being taken without even seeking to find out the will of the person involved, who is often ill-informed or not informed of his/her rights. In many cases, there is also a close correlation between deprivation of legal capacity and deprivation of liberty followed by involuntary treatments. Persons who are deprived of their legal capacity (and under full or partial guardianship) are indeed often placed without consent and are wrongly considered to be “voluntary” patients if the institution has obtained the consent of their guardian. The CRPD proposes a paradigm shift that assumes a person has the capacity to make decisions on her/his treatment in every situation. The consent must therefore be sought even if the person does not a priori has the capacity to understand the information provided or to communicate effectively. “We acknowledge that there are situations where people are not able to express their consent or decide on their will and preferences on treatments that would be life-saving. But we must embrace an approach that presumes capacity. We have witnessed over decades that, unless we take that approach, we presume that people are incapable of making decisions and giving consent. This is the paradigm shift we are talking about: we should presume capacity in any situation because every person has moments of clarity.” Dragana Ćirić, Mental Disability Rights Initiative, Serbia 18