In medical vocabulary, the “framework of treatment” encompasses: - the treatment objectives of each patient taken individually; - collective projects (occupational therapy workshops, support groups, cultural outings etc.); - the therapeutic theories and concepts in reference to which individual care and treatment is considered and elaborated; - the rules of life within hospitalisation units within which patients are accommodated. Attending interviews with psychiatrists, taking the prescribed treatment, complying with the rules of operation of workshops, eating meals, either in common or individual rooms, complying with times for siestas, visits and going to bed: all of these form part of the “framework”. The inspectors were able to ascertain that the framework of treatment is too often stressed in order to justify measures that do not fall within the therapeutic field. Thus, taking a shower every day provides its own justification, since it is a rule of hygiene; on the other hand, it is difficult to justify the impossibility of receiving visits from one’s family on Fridays by simply citing the “framework of treatment” elaborated in the patient’s own interest. The presence of minors in units for adults should also only be justified by therapeutic criteria, to the exclusion of any other consideration. The “framework of treatment” is elaborated and modified in a unilateral manner, by the medical team. Patients have no decision-making power with regard to this “framework” nor any control over its application. For the most part, these major restrictions of fundamental freedoms are not traceable in any way whatsoever. No ad hoc registers have been established. It is sometimes asserted to the inspectors that these prescriptions appear in the medical records, to which the Contrôleur général does not have access. Patients therefore have no remedy against arbitrary decisions that they may legitimately consider to be wrongful, insofar as they are, by definition, unexplained and unwritten. In the first place, this is the case with regard to the denial of patients’ rights to meet family and friends for limited periods, “in their own interests”; in a certain number of hospitals inspected, this denial is even established as a principle at the end of the first week of admission. This is also the case with regard to denial of the right to make or receive telephone calls. Certain institutions have decided to impose the principle that persons committed to hospital cannot have access to the telephone for the first week of their hospitalisation. The length of telephone conversations may also be limited. Patients may also be barred from correspondence with friends and family. In one institution in the North of France, certain letters may be intercepted “in the patient’s own interest and placed in their record”, without the existence of any procedure or traceability in this regard. None of the institutions inspected have put registers in place, in order to ensure the traceability of letters sent by patients to the administrative and judicial authorities. This violation of freedom and confidentiality of correspondence is once again held to be justified by considerations of a therapeutic nature. 102