Certain doctors regret the interference of the courts in the medical field.
They dispute the competence of judges to decide the fate of patients and,
for their part, consider themselves in an unsuitable position to note down
patients’ observations with a view to hearings before the JLD.
The recent legal framework leads to new constraints for institutions. Instead of the
hospitalisation by court order (HO) process, which systematically leads to complete
hospitalisation, the Acts of 5th July 2011 and 27th September 2013 prefer a procedure in which
complete hospitalisation is no longer automatic, but constitutes one of the methods of psychiatric
treatment without consent. Persons suffering from psychiatric disorders which render their
consent to treatment difficult, or even impossible, are henceforth committed to complete
hospitalisation, whether by means of committal for psychiatric treatment at the request of a
representative of the State (ASPDRE) or committal for psychiatric treatment at the request of a
third party (ASPDT), or in case of imminent danger, for an observation period of seventy-two
hours. This period is used in order to assess whether the treatment measure is justified. Apart
from this, treatment may be provided on an outpatient basis, using a treatment programme
drawn up by the psychiatrist.
Because complete hospitalisation constitutes a measure involving actual
deprivation of liberty, the Act of 5th July 2011 provides for systematic
control by the judge. The legislature’s intention was not only to control
deprivation of liberty, but also to enable the patient to be treated and
prepare for their rehabilitation within society, while working for the
maintenance or restoration of their autonomy.
As far as medical staff are concerned, the legal framework requires them to provide
responses to the JLD within a limited period of time after committal and, moreover, results in
constraints that are sometimes felt to be unjustified insofar as they are unrelated to their field.
This is the case with regard to the issuing of information of a legal and non-medical nature to
patients, informing them of their rights, drafting successive medical certificates with a view to
hearings, the noting down of observations and obligations concerning the escorting of persons to
hearings.
It is often reported to the CGLPL that all of these necessities are timeconsuming and carry the risk of being carried out to the detriment of the
patient. The CGLPL nonetheless considers that they guarantee patients’
fundamental rights. The right to information, for its part, is a prerequirement for any possibility of autonomy.
Where the layout of premises has maintained an asylum character, it constitutes a
hindrance to the autonomy of the patients as a whole, whether admitted for treatment freely or
without consent. Such buildings were designed in such a way as to close off and isolate
institutions from towns. It is notable that those located in the heart of cities leave more place to
autonomy and raising patients’ awareness of their responsibilities than those established on the
outskirts or in the countryside.
The possibility of movement, connected with the existence of space and the shape of the
latter, is one of the primary factors of autonomy and social rehabilitation of persons. Being able
to go for a walk in the grounds, to choose to be alone or to meet other patients constitutes a
necessary prerequisite of such rehabilitation. In its Annual Report for 2013, the CGLPL has
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