the relevant Act stipulates that in the case of persons with mental disorders or persons with other reasons affecting their ability to decide, the legal representative of the person provides consent if the person is unable to give consent on their own. The ZIRS believes that without a comprehensive and suitably implemented explanatory duty, neither a patient who is capable of making decisions nor a legal representative of a patient incapable of making their own decision can provide legally valid consent to any medical procedure, i.e. also to the introduction of SPM. The explanatory duty is thus of key importance also when a patient cannot decide for themselves, in which case suitable clarifications are given to the legal representative or persons mentioned in paragraph four of Article 37 of the ZPacP. According to the ZIRS, this also arises from the commentary on Article 37 of the ZPacP, which states, inter alia, that in all cases when a legal representative has not been appointed (yet), the persons close to the patient make decisions on medical procedures and care (according to item two of Article 2 of the ZPacP, these are persons other than close family members, but who are in a close relationship with the patient or are at least likely to display this characteristic). Regarding the conduct of an inspection as per the ZDZdr and minor offence procedures relating to the ZPacP, the ZIRS does not determine such forms of physical restriction; as a result, no measures against individual providers were adopted in this regard. In the response to the NPM’s final report, the Ministry of Health stated that it must be reconsidered if SPM were actually involved in both cases in connection with the comments referring to the implementation of SPM as per Article 29 of the ZDZdr and when restricting dementia patients in loungers in living rooms. The dilemma about the definition of SPM as per the ZDZdr and when these are only protection measures for patients was highlighted several times. To harmonise the practice and observe the protection of human rights in all cases of restriction, the Ministry of Health would strive to include the proposal among the amendments to the ZDZdr to also determine protection measures in addition to SPM which are not the result of dangerous behaviour, but which include special medical requirements (keeping still during intravenous infusion etc.), somatic medical conditions (spinal cord injuries) or risk of falling (from bed, chair, wheelchair etc.). In addition to the aforementioned, the Ministry agrees with the comments/recommendations of the NPM regarding the implementation of SPM and hopes that the Expanded Professional Board of Psychiatry would adopt new expert guidelines, whose preparation was announced in the reply to the latest inquiry of the Ministry of Health. The Ministry also added that it was expected that the new expert guidelines for the application of SPM would be harmonised with the comments/recommendations of the NPM. We believe that special attention must be paid to ensure suitable privacy of male and female patients, particularly during personal care. We thus proposed that Ljubljana University Psychiatric Hospital further emphasise this issue also by informing staff thereof and perhaps special education of the staff on this topic. In their response to the preliminary report, the management of Ljubljana University Psychiatric Hospital stated that they would make more efforts to ensure patients’ privacy. They particularly stressed that they would examine all possibilities of ensuring privacy in rooms where SPM were being implemented. We recommended that Ljubljana University Psychiatric Hospital separate cases of discreet supervision, which is implemented in a way least visible and disturbing for the patient, from cases of constant supervision. In their response to the preliminary report, the management of Ljubljana University Psychiatric Hospital claimed that every case of discreet supervision is recorded in medical documentation, and a form on the application of special protection measures is completed, although the ZDZdr does not require this for cases of discreet supervision. The management believed that discreet supervision was not very burdening for a patient, and was also sufficiently reliable to serve its purpose and not burden the patient. In its 2012 report, the NPM proposed that Ljubljana University Psychiatric Hospital implement SPM only in rooms intended for the application of these measures in order to prevent other patients from seeing restricted patients, unless the patient subject to restriction explicitly wanted to be accommodated in IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2016 NATIONAL PREVENTIVE MECHANISM UNDER THE OPTIONAL PROTOCOL TO THE UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT 85