5(E). Developments internationally since 2003

English

In August 2003 the UN Human Rights Committee (the monitoring body of the International Covenant on Civil and Political Rights) reviewed Slovakia, which had very similar cage bed prevalence and laws as the Czech Republic. In its concluding observations, the Committee said that it was “concerned at the continuing use of cage-beds as a measure of restraint in social care homes or psychiatric institutions” and recommended that “[c]age-beds should cease to be used”.34

In its report to the Czech government in 2004, the European Committee for the Prevention of Torture (CPT) noted that both netted and metal cage beds were frequently used in two psychiatric hospitals it visited,35 finding that they, “are not an appropriate means of dealing with patients/residents in a state of agitation”. The CPT’s inspection standards clarify that restraints including handcuffs and cage beds are “totally unsuitable” for dealing with agitated people, and “could well be considered as degrading”, breaching Article 3 of the European Convention on Human Rights (the right to freedom from torture and inhuman or degrading treatment or punishment). The CPT has unequivocally called for all such forms of restraint to be immediately withdrawn.36

In its response to the CPT’s 2004 report the Czech Government stated that all directors of health care facilitates had been told withdraw the use of metal cage beds.37 The subsequent Medical Services Act (No. 372/2011) did not ban, but actually legalised the use of restraints, including netted cage beds. It was silent on the topic of metal cage beds. In 2012, the UN Committee against Torture recommended that the Czech government prohibit the use of cage beds (whether metal or netted, noting that netted cage beds have “effects [that] are similar to those of [metal] cage-beds”).38

In 2012, the UN Committee against Torture noted that the high level of psychiatric coercion reflected a failure by the Czech government to adopt mental health reforms, expressing concern at “reports of frequent placement of persons with intellectual or psychosocial disabilities in social, medical and psychiatric institutions without their informed and free consent”. Reforms had been slow and piecemeal, the Committee found, causing concern to be raised about “the continued use of cage-beds, despite the prohibition in law, and of net-beds as well as the use of other restraint measures such as bed strapping, manacles, and solitary confinement, often in unhygienic conditions and with physical neglect”. “In addition, the “absence of investigations into the ill-treatment and deaths of institutionalized persons confined to cage and net-beds, including suicides” was a matter of particular concern highlighted by the Committee.39


34 UN Human Rights Committee, Concluding Observations with regard to Slovakia (CCPR/CO/78/SVK), 22 August 2003, para. 13.

35 European Committee for the Prevention of Torture, 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 21 to 30 April 2002, (Strasbourg: Council of Europe, CPT/Inf (2004) 4, 12 March 2004), at p. 51.

36 European Committee for the Prevention of Torture, Committee for the Prevention of Torture Standards (Strasbourg: Council of Europe, CPT/Inf/E (2002), Rev. 2013), at p. 59.

37 Government of the Czech Republic, Follow-up response of the Government
of the Czech Republic
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 21 to 30 April 2002, (Strasbourg: Council of Europe, CPT/Inf (2005) 5, 14 April 2005), at p. 27.

38 Committee against Torture, Concluding observations of the Committee against Torture: Czech Republic, (CAT/C/CZE/CO/4-5, 7 May–1 June 2012), p. 7.

39 Ibid.

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