CYIL vol. 8 (2017)

PETR ŠUSTEK CYIL 8 ȍ2017Ȏ statutory regulation of the use of means of restraint. The new legislation, as a part of a broader health law reform, reflects a continually increasing emphasis on both the general autonomy of will and dignity of patients and the protection of specific vulnerable groups of patients, including those who suffer from mental illness. 57 According to Section 39 (2) of the Act on health services, means of restraint can be used only for the purpose of averting imminent danger to the life, health, or safety of the patient or third persons, and only for the period during which the legitimate reasons for their use persist. Section 40 (2) of the Act on health services provides that the provider of health services has to notify the court of the use of any means of restraint (with the exception of the grip of the patient by authorized person) within 24 hours, unless the patient approves the restraint. Section 39 (3) of the Act on health services sets out further criteria for the use of means of restraint. It must be ordered by a physician or, in exceptional cases of urgency, by another member of the health care staff and immediately brought to the physician’s attention. The use of a means of restraint must also be recorded in the patient’s personal medical file. The patient must be informed about the reasons behind the use of a means of restraint and his or her representative or guardian must be informed of the use of a means of restraint. The patient whose movement is restrained must be under appropriate supervision of the health care staff. The provision of Section 39 (1) of the Act on health services contains an exhaustive list of permitted means of restraint: – the grip of the patient by medical personnel or other persons designated by the provider of health services, – protective strips, – placement in net-beds, – isolation of the patient in a special room designed for safe movement (a seclusion room), – straightjackets restraining the movement of upper limbs, – psychotropic medication, – or other parenterally administered drugs suitable for restraining the patient’s movement. Each of these means of restriction can be used alone or in combination with other means. Even though the use of means of restraint is a controversial area itself, most of the contemporary controversies are connected with the use of net-beds. About ten years ago, the use of cage-beds in the context of child psychiatric care in the Czech Republic was subjected to heavy international criticism. The wide medialization of the matter was inspired by the famous Harry Potter novels author J. K. Rowling. After reading a newspaper article about children placed in cage-beds in the Czech Republic in 2004, which she describes as a shocking experience and “the most disturbing thing” 58 she has 57 See ŠUSTEK, Petr, The Provision of Health Services in the Czech Republic from the Perspective of the UN Convention against Torture. In ŠTURMA, Pavel, LIPOVSKÝ, Milan et al., Preventivní mechanismy dle opčního protokolu k Úmluvě proti mučení. (Univerzita Karlova, Právnická fakulta v nakladatelství Eva Rozkotová, Praha 2016), p. 71. 58 CALLAGHAN, Louise, Czech hospital patients in cage beds. (29 June 2014.) accessed 28 April 2017.

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