CYIL vol. 8 (2017)

PETR ŠUSTEK CYIL 8 ȍ2017Ȏ Regular inspections by staff of patients placed in net-beds carried out every two hours cannot substitute for this measure.“ 76 At this point, the CPT mentions the case of the tragic death of a 51-year old patient placed in a net-bed, mentioned also in the CAT Report. The CPT recommends that net-beds be withdrawn from service, while, in case of necessity, staffing levels in facilities providing psychiatric care should be reviewed in this context. If necessary, „more suitable protective means“ should be found to ensure patients‘ safety (for example „hospital beds which can be lowered and/or which are boarded along the sides and enable the staff to assist the patient from both sides“). 77 The lack of adequate supervision is, however, a broader problem affecting the use of all means of restraint. The CPT criticised the fact that the Act on health services does not require continuous, direct and personal supervision by staff and the placement of a restrained patient away from direct contact with other patients. The CPT, on the other hand, requires a continuous presence of a member of the health care staff. 78 In its official Response to the CPT Report , the Government stated that it does not find the setting of a maximum duration of the application of mechanical restraint feasible, since its disconnection when the patient is not yet ready would in certain cases lead to the necessity of radical pharmacotherapy. 79 The Government highlighted the explicit establishment of the principle of subsidiarity of restraint use and the principle of applying the least restricting means corresponding the intended use, which should have been enacted by the draft amendment to the Act on health services. This amendment should have also obliged the providers of health services to keep a central register of means of restraint. The amendment was later enacted and entered into force on 31 May 2017. The Government also promised that the Ministry of Health “will continue to work methodically in psychiatric hospitals by providing a training programme for the staff of psychiatric hospitals on the use of restraints, and by publishing a model of internal regulation for the use of restraints (including chemical restraint) in psychiatric hospitals“. 80 According to the Government, “[i]n general, net-beds are withdrawn from service“, but their use is in certain cases „considered necessary“. However, the Government promised future efforts „to find other protective means to replace net-beds“. 81 As to the CPT standards of supervision over restrained patients, the Government considers them “currently hard to achieve in all psychiatric hospitals”. A “long term approach” will be taken by the Government in order to meet the CPT requirements. 82 76 Council of Europe. Report to the Czech Government on the visit to the Czech Republic carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) from 1 to 10 April 2014, p. 70. accessed 29 April 2017. 79 Response of the Czech Government to the report of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) on its visit to the Czech Republic from 1 to 10 April 2014, p. 25-26. accessed 29 April 2017. 80 Ibid ., p. 26. 81 Ibid ., p. 26-27. 82 Ibid ., p. 26. 77 Ibid ., p. 71. 78 Ibid ., p. 69.

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