recommendation is based on the doctor’s examination of a prisoner’s actual health condition. The Special Preventive Group’s impression was that doctors are, in fact, partaking in the enforcement of disciplinary punishment and it is the doctor who determines for how long a prisoner can be held in a solitary confinement cell. It may seem at a glance that a prisoner feels relieved knowing that a doctor endorsed his confinement as safe for his health but, on the other hand, a routine application of such practice may cause resentment in other prisoners who did not receive a positive recommendation from the doctor. We believe such practice may cast doubt on the independence of prison doctors. With a view of raising the independence and competence of the penitentiary healthcare personnel, it is necessary to ensure professional independence of the healthcare staff. The medical ethics principles must fully be incorporated in the legal framework regulating the penitentiary system. Further, the healthcare personnel should be provided with continuous professional training; existing training modules should be enhanced. Finally, an effective mechanism should be created to evaluate and supervise the sustainability of training results. Clear job descriptions should be elaborated for the healthcare personnel. It is an established practice in remand facilities and places for deprivation of liberty that prisoners request an appointment with the doctor through the prison staff who are not healthcare personnel and often times doctors examine prisoners and provide their consultation in the cells. This procedure contravenes the principle of confidentiality of the patient/doctor relations because the patient’s medical complaints become known to non-healthcare staff of the prison and to other inmates.148 Save urgent cases, any medical examination and consultation should be performed in privacy, in observance of the confidentiality principle, in a doctor’s office.149 The principle of confidentiality is breached also by Article 24(2)150 of the Georgian Imprisonment Code, which states that a medical account of a prisoner’s mandatory medical examination carried out on admission must be kept in the prisoner’s personal (non-medical) file. The confidentiality principle is not always respected when prisoners undergo their mandatory medical examination on admission to a penitentiary institution. Thus, the members of the Special Preventive Group who were inspecting a prisoner admission process at the Institution no. 3 witnessed that a woman prisoner’s external inspection was not attended by a doctor-on-duty at all; instead, the doctor was getting the information about prisoner injuries from a controller who was searching the prisoner. Examination of male prisoners’ injuries was limited to very shallow visual observation and asking some general questions of the prisoner; the process was attended by a controller (who does not belong to the healthcare personnel). The described procedure 148 Par. 51, passage from the General Comment of the Committee for the Prevention of Torture (CPT/ Inf(93)12). 149 Ibid., par. 35 150 Ibid. paras. 50-51 NATIONAL PREVENTIVE MECHANISM OF GEORGIA 107