Talks between attorneys and patients regarded as being dangerous to others sometimes take place under extremely problematic conditions. One patient reported that he had had to talk with his attorney through the food slit in the door, so that they had both had to kneel down. Since the patient had been kept in a separation room, he had additionally been undressed, apart from his underwear. The attorney involved had described this as an “undignified consultation situation”. The attorney had not considered himself to be endangered by his client and had considered such conditions for the consultation to be unnecessary. These facts are confirmed by the judgment of Bielefeld Regional Court of 9 October 2008, in which the written statement of the attorney is reproduced. In the view of the Commission of the Länder, the conditions for the hearing were undignified for the patient in question. According to the report of the funding institution, the individual case described can only relate to a hearing by a judge. According to the finding of the Commission of the Länder, the discussion took place with an attorney, and not with a judge. This is immaterial for the evaluation of the facts. The facts are said to be as follows: - The patient is said to have been undressed, apart from his underwear, because he was sweating heavily and had rejected a so-called “fixed shirt”. In view of the patient’s acute delusory symptoms, the clinic was said to have endeavoured to not additionally increase the patient’s fear of being given over to alien powers. - The judge had expressed a wish to conduct the hearing in a separate room. The patient had however been exceedingly tense at the time of the hearing, plus judicial officials were said to belong to the special “target group” of possible escalations of violence. Furthermore, the patient was said to be physically far superior to the judge and would not have been easy to secure had he attacked. The judge had not stated that he did not consider himself to be at risk; he had, rather, accepted the situation. As a matter of principle, dealing with patients who pose a risk to third parties is said to always take place in accordance with the individual assessment made of the patient. However, the room was always entered by at least two officers. Therapeutic discussions, visits, doctors’ contacts, etc., also took place The Commission of the Länder also recom- with corresponding security being provided mends that therapeutic discussions should by the officers. not take place under such conditions. There is no decisive distinction by individual Because of the very small number of women diagnosis groups for female patients within being held in detention with a view to reforthe facility, and accordingly there is also no mation, it is said to be fundamentally much specific range of therapies (statement of more difficult than with men to provide custhe Patients’ Council). tomised therapy with sufficiently large groups The Commission would like to point out that of patients. The vast majority of the women therapeutic activities should naturally also be were already being held in two specific locaIt is hard to imagine how a meaningful consultation can take place under the circumstances described. Also, such conditions for the discussion do not do justice to the right to confidentiality. 56