Restrictions of autonomy may also be a result of the team’s difficulty in making patients aware of their responsibilities within the framework of treatment without consent. In general, lack of staff is put forward as an explanation of the difficulty of implementation of projects aimed at promoting the autonomy of persons whose state, moreover, makes close supervision necessary. Indeed, the CGLPL has regularly ascertained that the surveillance of patients constitutes the main priority within departments. Although, in theory, the objective of the treatment framework is the restoration of autonomous self-management by means of treatment, as well as by means of the carer-patient relation, which brings the patient back into life in society, it is frequently used as a justification for this surveillance and, therefore, for measures restricting autonomy. It is claimed that the increased imperative of surveillance and the prohibition of going outside inherent thereto are required to prevent running away and in order to avoid laying the institution open to liability in case of an incident caused by a patient outside. Furthermore, the task of helping patients to readjust is frequently passed on to open institutions within the sector. Although institutions justify the restriction of autonomy by the constraints inherent to the framework of treatment without consent, the layout of premises and limited human resources, the fact remains that the conditions of life imposed upon patients often give cause for concern. The smallest act of daily life subjects patients to the intervention of medical staff. Yet, limitations on the expression of individuality, powerlessness, and self-effacement contribute to patients’ torpor and acceptance of dependence, behaviours that are diametrically opposed to the expected result of psychiatric treatment, whether with or without consent. However, in a system where everything is controlled, a kind of autonomy remains possible within the faults of the institution, by breaking and getting around the rules. Certain patients excel in the art of exploiting the system, accomplishing feats while elaborating stratagems that demonstrate their knowledge of the rules. In the first place, this involves taking advantage of areas where the authority of staff is less apparent, such as the grounds or the time taken for going to the property office, what Goffmann 108 refers to as “the geography of liberty”. The clandestine life of the hospital and, in particular, the use of tobacco (smoking in the toilets or rooms with the window open), the consumption of alcohol (hidden in the grounds, for example) and the bringing of food from the dining room back to rooms etc., sheds light upon patients’ attempts to assert their autonomy. Since certain patients have the right to go out, they may also be used for any sort of trafficking, for the purpose of winning margins of clandestine autonomy and, similarly, those possessing mobile phones may be led to “swap” calls for other services. 3.2 A Personal Requirement: Patients’ Right to Autonomy The CGLPL’s visits to psychiatric institutions have brought to light the variable application of legislative provisions as well as revealing unjustified restrictions of autonomy and, conversely, valuable practices that could be brought into more general use. In this part, the maintenance and restoration of autonomy, from the point of view of fundamental rights, will be compared with the CGLPL’s findings. 108 Goffmann E., Asiles, Paris Minuit, 1968. 125